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Good practices in strengthening health

systems for the prevention and care of
tuberculosis and drug-resistant tuberculosis

Consolidated Action Plan, area of intervention 6
M. Elchin,1 E. Pashayev, 2 A. Irada,3 A. Gulmira,4 G. Zabit,4 K. Bunyad4
Saglamliga Khidmat Public Union; 2 Against AIDS; 3 Scientific Research Institute for Lung Diseases; 4 World Free of TB


Strengthening the voices of people with tuberculosis

Azerbaijan is one of the 18 countries of the WHO European
Region that is a high priority for tuberculosis (TB) and one of
the world’s 27 countries with a high burden of multidrug-resistant TB (MDR-TB). In a national survey of resistance to
TB drugs in 2013, 72 (13%) new and 66 (28%) previously
treated patients had MDR-TB; of these, 38% of new and 46%
of previously treated cases had extensively drug-resistant
TB (XDR-TB) or signs of XDR-TB.1
A Country Coordination Mechanism for TB has been in place
in Azerbaijan since September 2008. In addition to Government and private constituencies, nongovernmental organizations (NGOs) and civil society organizations active in TB
control also have a voice in this mechanism. In 2014, six civil
society organizations were working on TB in Azerbaijan.
These organizations can play an important role in preparing
strategic plans that in turn inform policies for TB prevention and management. Until 2014, however, there was was
no organization or group of former TB patients that directly
represented the interests of TB patients and TB-affected
communities in the country.

In June 2014, the patient organization Veremsiz Dunya
(World Free of TB) was established. It comprised former TB
patients and focused on developing skills and knowledge
with regard to the TB situation in the country and globally,
prevention strategies, advocacy, the Global Fund and preparation of a national strategic plan for TB to comply with the
new funding mechanism of the Global Fund. Meetings were
held with the national TB programme (NTP) and the ViceChair of the Country Coordination Mechanism to promote
the newly formed organization.
A member of Veremsiz Dunya was elected as a member of
the Country Coordination Mechanism in August 2014 as
the representative of TB affected-communities, giving TB
patients and communities a voice in the Mechanism, so that
they could provide input and feedback to the national strategic plan and Global Fund concept note. The members of the
organization often meet with TB patients and visit TB-affected communities throughout Azerbaijan.

Health system challenge


As a national strategic plan on TB for 2016–2018 was
required for a concept note for funding from the Global Fund
to Fight AIDS, Tuberculosis and Malaria (Global Fund) and
in view of the vital role that patients play in preparing such
plans, an organization was needed that could represent the
interests of patients with TB and TB-affected communities.

The Saglamliga Khidmat Public Union thus helped to establish the first TB patient organization in Azerbaijan. Members

Good practice in health system strengthening to
improve prevention and care of M/XDR-TB
The Saglamliga Khidmat Public Union, a national NGO,
undertook establishment of a patient organization. The
aim was to empower a TB patient organization to participate actively in TB advocacy and in Global Fund-related pro1 Alikhanova N, Akhundova I, Seyfadinova M, Mammadbayov E,
Mirtskulava V, Rüsch-Gerdes S, First national survey of antituberculosis drug resistance in Azerbaijan and risk factors analysis.
Public Health Action 2014;4(Suppl 2):S17–23.


cesses. The project was supported financially by technical
assistance from the Stop TB Partnership.

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of the organization participated in preparing the national
strategic plan and the concept note for the new Global Fund
funding mechanism. The Union also helped the group to be
represented in the Country Coordination Mechanism so that
they could play an active, meaningful role in discussions and
decisions on TB care and control. This also contributed to a
dialogue between national and international technical partners, civil society groups, affected populations and populations at greatest risk, the NTP, the Country Coordination
Mechanism and the TB working group in Azerbaijan.

Potential for scaling up and future areas of
This experience will be shared with other TB NGOs working
in the country.

Good practices in strengthening health systems for the prevention and care of tuberculosis and drug-resistant tuberculosis