Tuberculosis (TB) is the ninth leading cause of death worldwide, ranking above HIV/AIDS. Globally, 10.6 million people developed TB while an estimated 1.6 million people died of TB in 2021 alone. Despite progress made in the last two decades, the incidence of TB is not declining fast enough to end the disease. In Zimbabwe an estimated 29,945 people developed active TB in 2021 and only 16,541 were diagnosed and put on treatment. A significant number of people are still being missed and not getting the treatment they need and deserve. In addition, the proportion of children who were diagnosed with TB has been consistently low, and has been 6% for the past 4 years. Stigma and discrimination, limited resources, limited capacity to diagnose TB in children and catastrophic costs suffered by TB patients as they seek services remain a challenge.
To address some of the challenges and increase efforts to end TB by 2030, Zimbabwe launched the process of the development of the Multi-Sectoral Accountability Framework for TB (MAF-TB) on 17 January 2023. The MAF-TB aims to support effective accountability within government and all stakeholders from various sectors in order to accelerate progress to end the tuberculosis epidemic. The MAF-TB development process is being led by the Ministry of Health and Child Care (MoHCC) with support from Jointed Hands Welfare Organization (JHWO), Clinton Health Access Initiative (CHAI), Stop TB Partnership Zimbabwe and the World Health Organization (WHO). Financial support for the development process is coming from USAID.
"Active participation and involvement of all sectors that contribute to health is highly needed to address the above TB gaps and challenges effectively and efficiently. Finding the missing undiagnosed people with TB and linking them to quality care remains a priority for us," said MoHCC Public Health Chief Director Dr Munyaradzi Dhobbie during the launch.
The MAF-TB was developed following the United Nations High level meeting on TB that brought together world leaders who committed to accelerating efforts in ending TB and reaching all affected people with prevention, care and support. It addresses accountability at national, local, regional and global levels, under four components which include commitments, actions, monitoring and reporting, and review. The framework recognizes the role of civil society and affected communities, parliamentarians, private sector and academia, involved in diverse sectors including health and social protection, justice, labour, working effectively with governments.
"The MAF-TB will open doors in areas of research, advocacy, infection control, and most importantly in the fight against stigma," noted Stop TB Partnership Zimbabwe Chairperson Ronnald Rungoyi. "Involvement of traditional leaders helps our communities with correct information on TB subsequently helping them make better decisions about their health," added Chief Murambwa, a Traditional Leader from Mhondoro-Ngezi, Mashonaland West Province after the launch.
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WHO is working with MoHCC to establish clear policies and strategies based on the latest guidelines and evidence, to enable access to people-centred services for all people with TB. WHO is also working closely with a range of stakeholders, civil society, and national TB programmes to strengthen the multisectoral response to TB.
"To help drive the TB response to save lives and reach the global TB targets, WHO is calling for an increase in domestic and international investments to close funding gaps for TB implementation and research. There is also need for a doubling of financing for TB research to drive discovery of new tools, including vaccines, and to scale up lifesaving innovations, among other critical areas," said WHO Zimbabwe Technical Officer for HIV and TB Dr Mkhokheli Ngwenya.
