GTZ-SPAA Private Sector Involvement in National TB Control Examples in Namibia, Malawi and Ghana

1. GTZ-SPAA • Private Sector Involvement in • National TB Control • Examples in Namibia, Malawi and Ghana • By • Dr Valentine Douala- Mouteng • Chief Executive Officer, PABC 11th October 2010, GBC TB Conference

2. INTRODUCTION • There is an average of 600 000 new cases of active TB in Africa every year . • The situation worsened due to the dual infection with HIV and TB and of multi and extremely drug-resistant tuberculosis (MDR-TB) and (XDR-TB). • The direct and indirect costs of tuberculosis and the social consequences are often catastrophic for the individual, the family and the wider community. • Tuberculosis affects the business of companies. • Private sector and companies have introduced TB workplace programmes . But are they geared to contribute towards eradication of the disease? 11th October 2010, GBC TB Conference

3. THE STUDY • Study performed by SPAA project and the PABC, to provide information about: • The transmissibility of TB and the implication for the workplace • Existing TB control activities at the workplace • The existence of legislation for infection control relevant for workplaces • METHODOLOGY • A review of literature and publications (not complete) • Interview with key informants: National Business Coalitions (NBCs) , National TB program, companies, ILO, GTZ representatives. • LIMITATIONS: only 3 countries; few informants, 11th October 2010, GBC TB Conference

4. Workplaces: environment with high level of disease transmission • Infectiousness starts before onset of symptoms (up to 3 months) • Treatment delay increases transmission to close contact in households and workplaces. • A long delay is common in African countries • Studies report high numbers of transmission in workplace settings (34% – 39% infection rates of contacts) • Poorly ventilated areas, share car rides to and from work and joint lunches are identified as factors contributing to transmission . • PLWHA are very vulnerable to TB transmission 11th October 2010, GBC TB Conference

5. The economic impact of TB is huge • 75% of people infected are between 15 and 54 years of age. • Estimation: TB reduces workers’ productivity by as much as US$ 13 billion annually. • A large gold mining company in S. A. estimated that each case of TB among its unskilled employees cost US$ 410 in lost shift. • The disease causes severe losses through, absenteeism, reduced productivity, need for replacement of lost workers. • On average, an employee with active TB will lose up to nine months of work. • With treatment, infected employees take up work again after two to four weeks. 11th October 2010, GBC TB Conference

6. TB legislation have the effect to In the workplace • Education programme • Screening, for TB and referral for diagnosis and treatment • Prevention of discrimination and stigmatization • measures such as improving the ventilation 11th October 2010, GBC TB Conference

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8. National Business Coalitions involvement 11th October 2010, GBC TB Conference

9. National Business Coalitions involvement 11th October 2010, GBC TB Conference

10. EXAMPLES OF GOOD PRACTICES 11th October 2010, GBC TB Conference

11. CONCLUSION/RECOMMANDATIONS • Increase awareness on the importance of combined TB and HIV control among National Business Coalitions, the Private Sector and Public partners; • Increase the support for NBCs to respond to the demand of the companies and the need to mobilize more companies to implement TB programmes as NBCs play a critical role. • Perform contact tracing systematically at company level • Expand collaboration between NBCs and the NTBP (including re- assessment of the policy) • Realise research on the financial impact of TB on companies in different economic sectors. 11th October 2010, GBC TB Conference

12. THANK YOU FOR YOUR ATTENTION MERCI 11th October 2010, GBC TB Conference