FBOs: Serving Peoples Health Where People Live

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FBOs Serving Peoples Health Where People Live

• Presentation by Rev. Msgr. Robert J. Vitillo
• Head of Geneva Delegation, Caritas
  Internationalis
• Chairperson, Catholic HIV and AIDS Network
• 25 March 2009

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WHO CONSULTATION TOWARDS PRIMARY HEALTH CARE
RENEWING PARTNERSHIPS WITH THE FAITH-BASED
COMMUNITIES AND SERVICES, GENEVA DECEMBER 2007
- MAJOR FINDINGS

• FBOs cover approximately 40 of healthcare and
  services in Africa alone.
• They often operate outside governmental planning
  exercises and are, therefore, generally
  unrecognized.
• New global initiatives and funding mechanisms
  (GAVI, GFATM) advocate their engagement in the
  design, planning and implementation of national
  health programmes (e.g. GFATM Round Eight).
• Engaging FBOs will bring challenges, but all
  parties stand to gain by this new approach.
• Ultimately, the communities that WHO, the public
  health sector, FBOs (and NGOs, CBOs) seek to
  serve will be better cared for, and there will be
  a greater possibility to achieve the MDGs.

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ADDITIONAL FINDINGS OF WHO REVIEW OF FBO
ENGAGEMENT

• FBOs could become significant partners in the new
  primary healthcare approach to strengthening
  health systems, especially in contributing to
  attain the goal of universal access.
• However, FBOs do not receive an adequate
  proportion of governmental and multi-lateral
  funding.
• National health plans should consider the full
  potential of all health service providers.
  Partnerships with FBOs could increase the
  effectiveness of governments in mobilizing all
  available resources and facilitate government
  support for FBO initiatives.
• Effective partnerships are already in place, at
  local or at national level, in Ethiopia, Rwanda,
  Uganda, Zambia, and other countries.

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SOME ADVANTAGES OF PUBLIC SECTOR COLLABORATION
WITH FAITH-BASED ORGANIZATIONS

• FBO facilities have offered long-term support to
  the inclusion of TB control in primary health
  care services.
• FBOs are present in the most disadvantaged areas
  and often operate within complex humanitarian
  emergencies.
• FBOs are strong partners because they are
  strongly motivated by lasting values (dignity of
  the human person, solidarity, the common good,
  subsidiarity).

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SOME EXAMPLES OF FBO COLLABORATION WITH
GOVERNMENT, MULTI-LATERAL ORGANIZATIONS, AND
CIVIL SOCIETY

• Catholic AIDS Action in Namibia collaborates with
  the Ministry of Health and Social Services to
  implement comprehensive screening for TB through
  the use of staff and community-based volunteers.
• In the early 1990s, the Catholic Diocese of Ndola
  introduced a comprehensive approach to primary
  health care, AIDS care, and TB care, utilizing a
  home-based care approach with referrals to
  hospital when necessary. In 1998, a study by WHO
  demonstrated 84-85 cure and completion rates for
  the diocesan DOTS programme vs. 24 results for
  the government programme. In 1999, the government
  officially recognized the diocesan programme as a
  TB treatment programme and the diocese agreed to
  communicate TB case statistics to the government.

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ADDITIONAL EXAMPLES OF FBO COLLABORATION

• For more than 10 years, Caritas Luxembourg has
  collaborated with the governments of Moldova and
  of Tajikistan to implement a STOP TB Programme,
  including a DOTS approach in the prisons of these
  two countries additional support for this
  programme comes from Caritas Switzerland, UNICEF,
  KNCV Tuberculosis Foundation, and the Soros
  Foundation.
• According to a 2007 Health and Demography Study
  in the Democratic Republic of Congo,
  approximately 60 of all TB treatment in that
  country is offered through Caritas Congo and
  other Catholic Church-related structures.
• Catholic Relief Services, one of the Caritas
  member organizations in USA has
• Utilized private funds and collaborated with the
  Vatican and the Catholic Church in North Korea to
  provide treatment for more than 205,000 people in
  that country
• Partnered with key stakeholders in the Autonomous
  Region of Muslim Mindanao to enhance the quality
  of TB microscopy, improve access to effective TB
  services, and strengthen community mobilization
  and local participation in TB Control within this
  regions of the Philippines
• Integrated TB case-finding and treatment into its
  PEPFAR-funded AIDS Relief Programme in nine
  countries (Guyana, Haiti, Kenya, Nigeria, Rwanda,
  South Africa, Tanzania, Uganda, and Zambia)

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ADDITIONAL EXAMPLES OF FBO COLLABORATION

• The Health Commission of the Catholic Bishops
  Conference of India has signed an MoU with the
  Government of India to involve its wide range of
  health facilities (gt5000) in the Revised National
  TB Control Programme (RNTCP) through two of its
  implementing partners - Catholic Health
  Association of India (CHAI) in 7 States (having
  more than 3266 member institutions in India) and
  Catholic Relief Services (CRS) in 4 States.
•  
• The Objective of the Project is
• To improve access to the diagnostic and
  treatment services provided by the RNTCP within
  the Catholic Church healthcare facilities and
  thereby improve the quality of care for patients
  suffering from Tuberculosis in India.
• The Catholic health network will be linked with
  the RNTCP at national, state, and district levels
  and will be provided with opportunities to
  effectively train their health care providers
  using facilitators, modules and training material
  provided by RNTCP.
•  
• Funding for this collaboration has been obtained
  through the Global Fund Round 4.

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A UNIQUE COLLABORATIONJOINT MISSION TO
SWAZILAND WHO STOP TB DEPARTMENT WITH CARITAS
INTERNATIONALIS

• TB Burden in Swaziland - Tuberculosis is the
  leading cause of morbidity and mortality among
  adults in Swaziland. It is estimated that TB is
  the cause of death among 50 of HIV infected
  patients.
• Broad Objectives of the Mission - To identify
  issues, challenges and opportunities for
  partnership between CBOs, NGOs, FBOs and the
  National TB Programme in the context of the
  national priorities and strategic direction for
  TB prevention and control.
• Main Activities of the Mission
• Joint Planning and contact with respective
  in-country and regional contacts
• On-site visits to FBO and Red Cross Health
  Clinics St. Philips Mission, Good Shepherd
  Hospital, Red Cross Clinic
• Overview of the epidemics (TB/HIV) in Swaziland
  briefing by MOH, WHO, and UNAIDS officials
• Listening sessions
• international and local FBO and CBO experiences
  including reports from sites visited as well as
  Anglican and Adventist projects and those
  organized by Persons living with HIV/TB
• perspectives of multi-/bi-lateral donors active
  in Swaziland
• Strategic Planning steps toward partnership
• Formation of Joint Working Group

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POSITIVE RESULTS OF THE WHO/CARITAS JOINT MISSION
TO SWAZILAND

• WHO provided funding for technical assistance to
  Swaziland for preparation of Tuberculosis-focused
  Application in Round 8 of the Global Fund. The
  sum of US 10 million over a five-year period was
  awarded.
• Permanent dialogue has been established among the
  government of Swaziland and FBOs and CBOs
  responding to the tuberculosis pandemic in that
  country.
• Agreement has been reached with the Swazi
  government on areas of both HIV and TB control
  that will be covered by FBOs the Global Fund
  project will allocate funds on the basis of this
  plan.
• WHO has assigned an expert in TB to assist with
  implementation of this programme.
• The Joint Mission and collaborative planning
  could serve as a model in other countries that
  are heavily affected by TB and by HIV/TB
  co-infection.

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A SPECIAL ADVOCACY INITIATIVE BY CARITAS
INTERNATIONALISCAMPAIGN TO INCREASE ACCESS TO
PAEDIATRIC HIV AND TB TESTING AND TREATMENT
HAART FOR CHILDREN

• The deadly duo In Africa, a person co-infected
  with HIV and TB dies every three minutes.
  Children with TB and HIV, and without access to
  early diagnosis and treatment, rarely survive
  beyond their second birthday .
• The medications required to treat both of these
  diseases are not available in child-friendly
  liquid or tablet forms. There are particular
  challenges with diagnosis in co-infected children
• This Campaign is designed to promote greater
  access to Paediatric HIV/TB Testing and
  Treatment through actions taken by Faith- and
  Community-Based Organizations, including by
  children themselves, to insist that governments,
  private industry (especially pharmaceutical and
  medical technology companies), universities, and
  research institutes allocate the funds and
  expertise to develop HIV and TB testing and
  treatment that is adapted for use with children
  and in low-income and rural settings.
• The Campaign is being conducted in collaboration
  with WHOs own Make Medicines Child Size
  Campaign visit www.caritas.org for more
  information.