Our areas of action
The fact that tuberculosis persists today is a cruel paradox. Effective treatments for the disease exist, and yet over 1.6 million people die of tuberculosis every year through lack of equitable access to diagnosis and care.
The World Health Organization estimates that 10.6 million people contract tuberculosis (TB) every year, 4.3 million of whom remain undiagnosed. This high level of non-detection is compounded by a new challenge: Mycobacterium tuberculosis, the bacteria responsible for the disease, is becoming increasingly drug-resistant.
Over the last few years, the COVID-19 pandemic has substantially slowed progress in fighting tuberculosis. In 2020, the number of deaths from the disease rose for the first time in 10 years, reaching 1.5 million. This situation was exacerbated by the increasing burden of drug-resistant tuberculosis, which rose by 3% between 2020 and 2021. More than ever, therefore, it is time to take action to reverse this trend and strive to reach the initial target of reducing deaths from tuberculosis by 90% by 2035.
Supporting our partners in all aspects of the response to TB
L’Initiative invested over €1.7 million to combat tuberculosis in 2022, which included mobilizing expertise (38%) and supporting catalytic projects (62%). We are involved in all essential aspects of fighting TB, from scientific research and therapeutic innovation to diagnosis and treatment of pediatric tuberculosis, improving care for marginalized populations and capacity building within communities.
We support operational research
Since 2018, L’Initiative has published two calls for projects specifically targeting operational research to fight tuberculosis, in addition to the projects already funded via other calls for proposals. These efforts include prevention, screening, and treatments, as well as projects that address the needs of vulnerable populations by making them the focus of activities to combat TB. Two examples of the initiatives we support are the Drive-TB project, which aims to reduce tuberculosis among intravenous drug users in the city of Haiphong (Vietnam), and the Armauer Hansen Research Institute’s project, which seeks to design, implement, and evaluate a series of community interventions against tuberculosis, with the aim of detecting and treating more cases in poor urban communities in Addis Ababa (Ethiopia).
Meeting the challenge of latent tuberculosis infections
Tuberculosis is described as “latent” when a person infected with Mycobacterium tuberculosis has no active symptoms of the disease. Around 1.7 billion people worldwide are affected by this “dormant” form of the disease. Since these people form a major reservoir for TB, it is essential to invest in targeted strategies to detect the disease early and provide treatment. L’Initiative, therefore, supports several research projects in this field, including “Improving the screening and overall management of latent tuberculosis infection in Cameroon and Madagascar (APRECIT),” and “Optimizing latent tuberculosis treatment initiation in Cambodia among people living with HIV (OPTICAM),” led by the Institut Pasteur du Cambodge.
We are investing in childhood tuberculosis
Every year, over one million people under the age of 15 contract tuberculosis around the world. Children are, therefore, a major focus of our activities, as they are among the most vulnerable to the disease. First, as tuberculosis is more difficult to diagnose in children due to the lack of appropriate tools, and second, as young patients with a latent tuberculosis infection are at greater risk of developing a severe form of the disease and passing it on to those around them. Consequently, we support solutions that promote better access to diagnosis and treatment for children.
Improving diagnostic approaches for pediatric TB
The TB-Speed project, which includes the “TB-Speed Pneumonia” research component funded by L’Initiative, has been deployed over four years in seven African and Southeast Asian countries. This project has enabled the implementation of new molecular testing equipment and new child-friendly sample collection methods in many hospitals and health centers. The results of this project have also allowed amendments to be made to the WHO guidelines and operational handbook on tuberculosis, published in March 2022.
We place communities at the center of our actions
We support projects that are designed for and with people that are most exposed to tuberculosis due to social or economic marginalization: young women, prison inmates, drug users, migrants, etc. By placing these communities at the heart of our activities, they actively contribute to designing, managing, and evaluating the health services that directly affect them. In this way, we are working to significantly improve their health and well-being.
Improving treatment in Madagascan prisons
Prison inmates suffer from inadequate access to healthcare, in Madagascar and elsewhere. L’Initiative supports the MIARINA project, backed by the Institut Pasteur de Madagascar, which aims to improve the comprehensive treatment of tuberculosis and HIV in prisons on the island. The project has been operating in four prisons since 2019, where it conducts research programs (study of health strategies in prisons) and develops appropriate medical care, psychosocial support, and rehabilitation schemes.
Improving active case finding in Burundi
The recent COVID-19 pandemic led to a reduction in the number of tuberculosis cases reported to health authorities around the world. In Burundi, this widened the already significant gap between the number of people screened and the number of cases reported to the WHO. To address this situation, L’Initiative supports the country’s National Integrated Programme against Leprosy and Tuberculosis in its new strategy to improve the provision of TB treatment and screening for high-risk populations (miners, fishers, refugees, prison inmates, etc.). The authorities have made the involvement of these communities a central focus of their approach.
Raising awareness and involving communities in Laos
Southeast Asia accounts for 46% of new tuberculosis cases worldwide and has the highest TB-related mortality rate. Within the region, the situation in Laos is alarming, with a tuberculosis mortality rate of 27 deaths per 100,000 people, much higher than neighboring Cambodia, Vietnam, and Thailand. These figures mainly stem from the population’s lack of knowledge about the disease and its symptoms, especially in isolated rural communities. In response, L’Initiative has been funding an active case-finding project in two Laotian provinces since July 2020. The project is run by an NGO, the Community Health and Inclusion Association (CHIAs). The objective is to act through community health workers to improve awareness, detect suspected cases, and facilitate access to screening and treatment for tuberculosis.