PCI TB MexicoYesterday was World Tuberculosis Day. If you missed it, you are not alone. Nearly one person in three is estimated to have latent TB infection. About 3 million people each year are not reached with TB services, and over half those not reached die. TB is second only to HIV/AIDS as the most lethal infectious disease worldwide. This is not meant to cause a panic, just to illustrate that TB is still an issue, despite years of fighting the curable disease.

PCI has seen this issue first had, through our Mexico TB prevention and control project in 2004-2012, which stands as our most successful TB project to date. Partnering with the National TB Program in Mexico, we began the project in 2004, in two municipalities, eventually expanding to 35 municipalities across thirteen different states. The project concluded in five municipalities: Guadalupe, Nuevo León; Tijuana, Baja California; Reynosa, Tamaulipas; Guadalajara, Jalisco; and Ciudad Juárez, Chihuahua.

We engaged directly with those affected, to determine their needs down at the individual level and sought to strengthen health systems at the regional level through improved collaboration and strengthening the capacity of county level health systems. National agreements were established between national programs, and local ownership was improved at the national and district levels through better information sharing and joint decision-making.

These early successes allowed us to pay increasing attention to the 20% of the close to 18,000 individuals with TB in México that also had Diabetes, and the fact that close to 40% of individuals with TB who died in 2010 also tested positive for HIV/AIDS. Multiple-disease infections complicate treatment considerably.

We had to intensify our work, building in additional measures for people with TB also suffering from Diabetes or HIV/AIDS. We forged new partnerships with other organizations and the government, improved health care training methods, and increased awareness about the challenges and opportunities of providing care to people with multiple diseases. One major breakthrough was the introduction of a person-centered approach to testing, diagnosis, and referral for individuals with TB and HIV/AIDS or Diabetes.

Being able to test and treat these multiple-disease infections facilitates early access to care, preventing complications and possible death. Ultimately, PCI contributed to strengthening the Tuberculosis prevention and control program in Mexico in a way that provided lasting change.

At the beginning of the program, only 20% of TB clients were tested for HIV. By the time the program ended in December 2012, over 80% of TB clients were tested at clinics. As of last year, two years after the project ended, the percentage of TB clients tested for HIV has remained high – over 75%. Similarly, Diabetes testing of TB clients was improved to 53% by the end of the project in 2012, and is now reported to be 83% nationally. We hope that the legacy of this program continues, and that we can all work to reach, treat, and cure everyone with TB around the world.