The what, why and how of health and development

Closing the gap: locally based TB charities and national policies

One of the biggest obstacles facing local community organisations working to control TB in their area is that they are not represented at national and international levels.

When global or national organisations meet to develop health strategies without the input of these local organisations, community health groups can often be left working either with policies that do not fit their cultural environment or that do not respond to the real needs of the people they are trying to help.

When Target TB work with grassroots organisations the problem they face is one of closing the gap between these community organisations and the bigger national and international global health organisations.

“The World Health Organisation sits at national levels but they don’t see what the grassroots programmes are doing,” explains Nikki Jeffrey, director of Target TB.

“The problem is that people on the ground don’t often have national representation. There should be input from grassroots organisations who are working with people but they aren’t getting scope to do that.”

Once thought of as a disease of the past, TB actually causes the highest number of deaths from a single infection, taking nearly 3 million lives a year according to the National Foundation for Infectious Diseases (NFID). Although it was declared a world emergency by the World Health Organisation nearly two decades ago, in November last year the organisation was still calling for governments to start taking TB seriously as a global threat.

Jeffrey’s says it never fails to amaze her that TB isn’t recognised as an international emergency and has even seen the Global Fund to fight AIDS, TB and malaria referred to without TB included in the title.

Even when structured national systems are put in place to tackle TB, they are sometimes ineffective or inefficient because they do not engage with issues important in local communities and cultures. India has national policies on TB control that apply to the whole of the country. But, as Jeffrey explains, the policies don’t work well with the range of cultures in India.

“Because there are so many cultures in India, this one framework isn’t always applicable,” says Jeffrey.

“It can be complicated for people and people don’t always understand their rights. You can’t have a rigid policy to fit all.”

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