Challenge TB is the U.S. Agency for International Development (USAID) flagship global mechanism for implementing its tuberculosis (TB) strategy and contributes to the TB/HIV activities under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). A five-year project, Challenge TB is a coalition of nine international TB control organizations, each with offices in USAID’s TB-priority countries.
Challenge TB has these main objectives:
- Improved access to quality patient-centered care
- Prevention of transmission and progression of the disease
- Sustained and enhanced systems for prevention and treatment
The project achieves these objectives by working in partnership with other national and international initiatives to provide global leadership and support for TB control efforts.
As an implementing partner for Challenge TB, FHI 360 is working in Cambodia, Indonesia, Mozambique, Myanmar (Burma) and Zambia in the international coalition led by the KNCV Tuberculosis Foundation. The project vision aligns with the global End TB Strategy, the U.S. government’s TB strategy and National Action Plan for Combating Multidrug-Resistant Tuberculosis, and USAID’s Global Health Initiative and overall vision for a world free of TB.
Our country-level activities include:
In Cambodia, our emphasis is on finding undiagnosed TB cases, especially among the elderly. The project aims to improve everyone’s access to quality, patient-centered care for TB and multidrug-resistant (MDR) TB services. This includes reaching the most rural, impoverished and at-risk populations, while improving case detection and closing the diagnosis gap for specific risk groups. Other priorities are introducing new drugs and regimens for treating MDR-TB and strengthening laboratory capacity for infection control and targeted screening.
The main focus of our work in Indonesia is improving TB/HIV collaborative activities, in coordination with our Linkages across the Continuum of HIV Services for Key Populations Affected by HIV (LINKAGES) project. We also work to ensure that prisoners and detainees are reached by TB and HIV services. In the province of Papua, we cover the full spectrum of TB strengthening activities, including the expansion of Gene Xpert testing, MDR-TB care decentralization, childhood TB identification and treatment, improvement of monitoring and evaluation and laboratory systems, and TB/HIV service integration.
Community-based directly‐observed treatment, short course (CB-DOTS) is the pillar of our activities in Mozambique. We provide technical assistance to improve laboratory diagnosis and the quality of care for TB patients, intensify case finding, strengthen the TB surveillance system and improve pediatric TB diagnosis. We also support the National Tuberculosis Program to introduce new drugs and regimens, conduct the first national TB Drug Resistance Survey and implement the current national TB prevalence survey.
In Myanmar, we focus on expanding access to quality TB diagnostic and treatment services in hard-to-reach as well as fragile and conflict areas, improving the referral system between public hospitals and the private sector, increasing TB diagnosis and case notification by the private sector and building laboratory capacity. As we do in other Challenge TB countries, we are working to introduce new TB drugs and regimens along with active drug-safety monitoring and management.
The project’s work in Zambia started in 2017. It focuses on rapid scale-up of time-bound, highly impactful, focused interventions. We are strengthening the laboratory network to provide rapid, quality diagnostics; improving infrastructure in clinics and laboratories to support infection control and quality services; building health care staff capacity to implement new TB drugs and regimens; and introducing an electronic recording and reporting system.