Boundless
Ending Tuberculosis Through a Comprehensive Health and Social Solution

Although medications to treat tuberculosis (TB) exist, it continues to be one of the world’s top 10 causes of death because it is inextricably linked to poverty.

Poorly ventilated and overcrowded quarters facilitate its transmission, and those living in poverty have limited access to healthcare and suffer higher rates of malnutrition and disease. People with TB also experience stigma and discrimination, which increases their vulnerability to TB.

The Visayas islands in the Philippines are some of the poorest regions in the country, with the highest rates of TB. We plan to end TB in the Visayas regions by providing the medical knowledge to diagnose and treat it and the economic tools to elevate 2 million over the national poverty line. Outside of our model site, findings will be adapted for other regions in the Philippines and beyond. Our multi-pronged approach will uniquely empower communities to combat TB and change lives.

PROOF OF CONCEPT

Our partnership has successfully reduced TB rates for over 10 years in the Philippines, Pakistan, China, Nepal, Bangladesh, Uganda and Swaziland. Our COMDIS work witnessed an 80% reduction in TB prevalence in Shandong in 10 years. This success has persisted because of the Chinese government’s simultaneous commitment to poverty reduction via economic development in the region. Our approach of patient support, active TB screening and timely treatment has proven effective in reducing TB transmission; the WHO has adopted it as a global policy to scale-up to LMICs.

Recent studies in Vietnam demonstrated that our approach is successful, and explains the 50% reduction in TB prevalence that we were able to achieve within three years. In addition, the methods we are proposing in our mobile health clinics, equipping them with computer-aided x-ray machines, demonstrated an improved ability to find TB cases, while electronic monitoring boxes reduced treatment failures.

Now in its 25th year, ICM’s four-month TRANSFORM program has successfully graduated its millionth person. Data shows that households experience an increase in: income (20~40%), food security and savings (143% increase in savers, 30% increase in savings). Income of the poorest increased proportionately more, reducing inequalities. Family satisfaction and trust in neighbours was significantly correlated to a willingness for TB testing. Social networks measurably increased in communities after TRANSFORM.

External evaluations showed shifts to non-agricultural self-employment, livestock-tending, fishing and other informal employment and an increase in household income associated with the values-oriented training.

GOVERNANCE STRUCTURE

A consortium of leading experts will provide guidance and advice for our project, following the model shown here.

OUR PARTNERS

  • University of Toronto

    The partnership is led by Dr. Xiaolin Wei, Dalla Lana Chair in Global Health Policy at the University of Toronto. The University of Toronto consistently ranks among the world’s top 10 public universities and among the world’s top five for research output. With its thousands of collaborations around the globe and history with complex multidisciplinary initiatives, it is uniquely equipped to manage a project of this scale. Its public health school holds an exceptional reputation for global health and development.
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  • ICM

    ICM’s four-month TRANSFORM program has successfully graduated its millionth person. Designed to reduce poverty and improve health outcomes in the Philippines, TRANSFORM has reduced malnutrition, increased detection and treatment rates of tuberculosis, and delivered other benefits which improved the lives of the Philippines’ poorest populations.
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  • University of Leeds

    The University of Leeds is a leading UK public research university. Its Nuffield Centre for International Health and Development provides the technical expertise to create tested, practical, scalable healthcare solutions in lower and middle income countries.
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