A report released online earlier this week states that effective partnerships can improve tuberculosis responses globally. The summary report, titled, "Whole Is Greater Than The Sum Of Its Parts", was also distributed at the 42nd Union World Conference on Lung Health in Lille, France (online at: http://www.citizen-news.org/2011/ 10/tb-partnerships-whole-is-greater-than.html). This report is the summary of the online consultation that was facilitated by CNS: www.citizen-news.org - a partner of the Stop TB Partnership - using social media platforms and also the Stop-TB eForum that was established by the Health and Development Networks (HDN) in early 2001, and currently is supported by the Stop TB Partnership, the International Union Against Tuberculosis and Lung Disease (The Union) and the International HIV/AIDS Alliance, and managed by CNS. The online consultation was held during October 2011.
The guiding question was: What are the different types of groups, people, organizations or entities you have partnered with to fill a gap in TB prevention, care and/or control?
Over hundred commentaries from 24 countries came in through a diverse range of channels including the global Stop-TB eForum, blog, twitter, Facebook, and comments sent by email.
The participants of the online consultation came from the following countries: Afghanistan, Bangladesh, Brunei Darussalam, Cambodia, Ghana, India, Indonesia, Kenya, Mexico, Myanmar, Nepal, Nigeria, Pakistan, Saudi Arabia, Sri Lanka, Switzerland, Tanzania, Thailand, Uganda, United Arab Emirates, United States of America, Viet Nam, Zambia, and Zimbabwe.
A strong element of some partnerships has been the advocacy, communication and social mobilization (ACSM) strategies. For example in Mexico, the national TB programme (NTP) provided its technical expertise and infrastructure and PCI through its Solucion TB Programme provided the knowhow of working with affected and vulnerable communities.
An important innovation of a partnership consisted of the appropriation of a person-centered model of service delivery and mechanisms that foster community empowerment and work to reduce stigma and discrimination. The partnership addressed healthcare needs for TB, HIV/AIDS and diabetes.
Engaging most-at-risk-populations (MARP) as equal partners with dignity is crucial to make programmes work optimally. These MARPs include: Injecting drug users (IDU), poor people, people living with HIV (PLHIV) among others.
A participant from Nigeria said: "The structured partnership mechanism set up by Stop TB Partnership (Nigeria Stop TB Partnership has not worked due to so many reasons including interim National Committee's inability to function. However, at informal level partnership for TB control and care has worked and is an effective tool for TB control and care. Through our organisation advocacy efforts, we have been able to form informal partnership with community leaders and community members, thus involving and selecting community volunteers for TB case finding.
Also informal partnership with primary health centres in the community has helped to educate TB patients on drug adherence and other issues."
Open, simple and practical communication solutions are also a key in making partnerships work at all levels.
Partnerships require real collaboration and coordination, not just meetings. Many participants described weaknesses not so much in the model itself, but in how it is being implemented. The issue of community voices being present in various partnerships - but not necessarily heard - was raised repeatedly. They need to be involved at all levels - planning, budgeting, implementation, and monitoring and evaluation phases.
Country-level partnerships should make sure that louder voices don't dominate- and - they are truly driven by the communities even if governments, big NGOs and donors are a part of it.
Partnerships work only when members agree on a common agenda rising above and beyond their organisational agendas at times. If we limit ourselves to our organisational mandates only, then partnerships are likely to suffer.
Participants also highlighted the need to engage non-traditional stakeholders such as other Ministries in addition to Ministries of Health and other non-governmental organisations other than those working on TB directly (for example those working on diabetes, HIV, poverty, nutrition among other issues).
A participant said: "We also have to stop thinking that civil society cannot do the work properly." People who are dealing with TB are also equal partners in finding solutions that work. In order to optimise the reach and impact of TB programmes, affected communities need to be involved meaningfully at all levels. Their expertise in 'reaching the unreached' among others must be recognized and duly respected. Another participant said: "Real action if any has, and will, come at local level. That is where a partnership can make a real difference." Another participant said: "One way to m