Thailand - Stop TB Partnership

In Tanzania, where over 50 percent of people living with HIV/AIDS are coinfected with TB,
many politicians and local government leaders believe that TB is a “disease of the past” that
affects relatively few people and therefore do not consider TB a priority.
The scarcity of information and educational resources adapted for use at the community
level is an obstacle to the initiation of awareness-raising efforts. And patients who do
not understand the requirements of treatment are more likely to default, raising the risk of
multidrug-resistant TB (MDR-TB), which few high-burden countries, including Bangladesh,
Nigeria, Tanzania, and Thailand, have the capacity to detect and treat. Brazil has a strong
system in place for treating its relatively few cases of MDR-TB but has undertaken a national
investigation to determine whether high treatment default rates could be affecting national
rates of drug resistance. A prominent TB doctor in Bangladesh expressed frustration that
so little effort has been made to produce and disseminate culturally sensitive materials in
the local language: “We are producing documents in English—for whom? For the donors!
[We need TB materials] in Bangla, Bangla and more Bangla. And we have to remember that
only one in three people can even read Bangla.” 20 Researcher Jamillah Mwanjisi reported
that available information on TB in Tanzania is overly technical and jargonistic, especially
in comparison to resources on HIV/AIDS, and that TB officials make little attempt to communicate
the basic, essential information that people need in language they can understand.
“There is quite a lot of room for social mobilization around TB—for activists to get involved,”
she said. “The problem is that TB is so closed to [everyone except] the experts.” 21
People from the communities most affected by TB and TB/HIV must be involved
in the creation of materials about TB that are accurate and sensitive to local social and cultural
contexts. Direct support to community activists and leaders would help them develop
and use such materials to promote TB awareness in their communities.
Media involvement
[World TB Day is like] a flash of the camera, and then it’s gone.
—Somsak Akksilp, director, Office of Disease Prevention and Control, Thailand 22
Except for official statements on World TB Day, the NTPs in all five countries have made
little attempt to communicate important information about TB through newspapers, television
or radio outlets on a systematic and continuous basis. NTPs generally lack strong communication
strategies and staff has little experience working with the media.
Mirroring the situation within the general population, most journalists know little
about TB. Nigerian researcher Olayide Akanni—a journalist herself—found that journalists
are reluctant to report on TB because they are not sufficiently aware of the issues. “The
majority of journalists,” she said, “do not even know that TB is an issue.” 23 At one recent
PUBLIC HEALTH WATCH MONITORING REPORTS 17