The Show Must Go On: Our TB Activities during COVID-19 Pandemic 17.06.2020

UNOPS as a Principal Recipient of the Global Fund is continuing to deliver impact against HIV, tuberculosis and malaria while responding to the COVID-19 pandemic.

Since in the wake of COVID-19 pandemic, the Global Fund through its Principal Recipient Programme of the Asia Regional Health Cluster (ARHC), UNOPS is working closely with the Ministry of Health and Sports and its Sub-Recipients (SRs) to support the mitigation and response efforts. As of today, Myanmar confirmed 262 positive cases with more than 5,486 suspected cases.

While tackling the COVID-19 pandemic, it is important to ensure that essential services and operations for dealing with other killer diseases, such as HIV, TB and malaria, are not neglected and to continue the provision of life-saving services for these diseases. In the case of TB, PR-UNOPS remains committed to maintain continuity of essential services for people affected with TB during the COVID-19 pandemic, to make sure that the progress made in TB prevention and care is not reversed by the pandemic.

Continuity of essential TB services

PR-UNOPS has been working together with the Ministry of Health and Sports and implementing partners to implement both Community-based TB Care services and Multi-Drug Resistant TB Care Services. In the context of COVID-19 pandemic, PR-UNOPS is taking the effort to continue the essential TB services while taking preventive measures for both healthcare providers and patients.

For Community-based TB care services, although large sessions such as community awareness sessions, mobile team activities are stopped due to the pandemic, one-to-one Health Education session and patient counselling are ongoing.

In the case of Multi-Drug Resistant TB Care services, PR-UNOPS continue to provide transportation allowance and nutrition support to MDR-TB patients via ATM transfer or direct cash payment. TB volunteers are providing Directly Observed Therapy (DOT) supervision either in one-to-one or via tele-communications.

Strengthening Fever Clinics for TB Screening

In order to screen patients for symptoms of COVID-19 and refer them if necessary to the nearest public hospital, fever clinics are set up in most of the townships across the country. In the case of TB, the private general practitioner clinics are the first point of contact for the majority of presumptive TB patients in urban and peri-urban areas. In the wake of COVID-19, where there are travel restrictions, semi-lockdown and temporary closure of clinics due to the fear of infection.

Therefore, MOHS and National TB Program (NTP) discussed strengthening fever clinics as a frontline role for TB screening. Through the Global Fund’s support, NTP is planning to conduct TB active case finding activities with portable digital X-rays at Fever Clinics. The linkage with fever clinic and TB screening is an innovative approach which will help people in need during this difficult situation as well as the country's TB control activities. 

Activities of Our Sub-Recipients

Myanmar Medical Association (MMA)

Under the Global Fund’s grant, MMA is implementing Public-Private Mix Tuberculosis Project (PPM) and MDR-TB activities.

  • Tele-consultation is conducted in PPM Project to follow up on patients
  • Under PPM project, activities in private hospital are limited due to the pandemic
  • Scheme I (TB Referral) and Scheme III (comprehensive case holding) are reduced as many General Practitioners closed their clinics due to the pandemic
  • MDR-TB activities are continuing but training, meeting, and awareness-raising session are withholding

Myanmar Health Assistant Association (MHAA)

Under the Global Fund’s grant, MHAA is providing Community-based TB Care services and Multi-Drug Resistant TB Care Services.

  • Monthly meetings with volunteers and staff are held online
  • Mass HE sessions are halted and new case finding activities temporarily stopped but case holding function is continuing
  • DR-TB contact screening activity has stopped but other diagnoses and patient care activities are ongoing

Pyi Gyi Khin (PGK)

Under the Global Fund’s grant, PGK is providing Community-based TB Care services and Multi-Drug Resistant TB Care Services.

  • TB case finding activities temporarily stopped due to pandemic but case holding activities are continuing
  • DR TB contact screening activity has stopped but other diagnoses and patient care activities are ongoing

Medical Action Myanmar (MAM)

MAM has integrated Tuberculosis Active Case Finding (TB-ACF) into the current malaria activities in 2014. The services are provided through trained volunteers.

  • Individual health education sessions provided by Integrated Community Malaria Volunteers (ICMVs) are ongoing
  • Conflict areas and hard to reach ethnic areas have limited access to TB diagnosis services
  • Supervision visits to ICMVs are ongoing

International Union Against Tuberculosis and Lung Disease

Under the Global Fund’s grant, the UNION is providing Community-based TB Care services and Multi-Drug Resistant TB Care Services.

  • Sputum Collection Centers are in operation
  • Health Education session (Special Outreach Programme) activity are ceased due to pandemic
  • Volunteers conduct patient adherence home visit on a daily basis or three times per week (with tele-DOT on other days)
  • Where there is limited public transportation, follow up sputum transportation cannot be sent to the referral lab

Clinton Health Access Initiatives (CHAI)

Under the Global Fund’s grant, CHAI is providing technical support in developing the tools to better track and treat MDR-TB to reduce the number of cases of MDR-TB.

  • Technical Assistance on the OpenMRS system is continuing