OUR APPROACH-heading

Under the Sustainable Development Goals (SDGs), the United Nations and its member states have committed to ending the global TB epidemic by 2035. This means that the global TB burden needs to decline by 90% in 20 years.

Despite significant progress, the current rate of decline in TB incidence means that it will take until the year 2130 (95 years longer than planned) to reach the target.

A multifaceted strategy to eliminate TB is urgently needed.

FIT and our partners are working to pilot, evaluate and scale comprehensive, patient-centered TB prevention and care programs aimed at stopping TB transmission, saving lives and reducing suffering.

Our comprehensive approach involves four main areas of focus:

Search

Treat

Prevent

Integration & Sustainability

Under the Sustainable Development Goals (SDGs), the United Nations and its member states have committed to ending the global TB epidemic by 2035. This means that the global TB burden needs to decline by 90% in 20 years.

Despite significant progress, the current rate of decline in TB incidence means that it will take until the year 2130 (95 years longer than planned) to reach the target.

A multifaceted strategy to eliminate TB is urgently needed.

FIT and our partners are working to pilot, evaluate and scale comprehensive, patient-centered TB prevention and care programs aimed at stopping TB transmission, saving lives and reducing suffering.

Our comprehensive approach involves four main areas of focus:

Search

Treat

Prevent

Integration & Sustainability

Search

We follow two key approaches when implementing active case finding:

  1. Actively search for people with TB and those exposed to TB outside of health facilities
  2. Use fast and accurate diagnostic tests

Most people who have TB do not get screened until they begin to show serious symptoms. By the time they visit a health facility, the infection has rapidly progressed, decreasing the likelihood of recovery, and increasing the chances of transmission among family and friends.

If TB patients can be identified sooner, they can be cured faster and transmission can be prevented.

FIT goes into communities to conduct TB screening and testing, in the places where it is convenient. If an individual is suspected of having TB, they undergo sputum testing to confirm a diagnosis.

In many low- and middle-income settings, the most common test for TB is called sputum microscopy. This laboratory test is over 100 years old, its quality is reliant on the skills of the individual technician and ultimately it misses about half of all people sick with TB. We work with partners in Viet Nam to reduce diagnostic delays and to introduce and scale-up new screening and diagnostic technologies, so that we are able to find as many people with TB as possible.

Search

We follow two key approaches when implementing active case finding:

  1. Actively search for people with TB and those exposed to TB outside of health facilities
  2. Use fast and accurate diagnostic tests

Most people who have TB do not get screened until they begin to show serious symptoms. By the time they visit a health facility, the infection has rapidly progressed, decreasing the likelihood of recovery, and increasing the chances of transmission among family and friends.

If TB patients can be identified sooner, they can be cured faster and transmission can be prevented.

FIT conducts community TB screening and testing activities in places that are easy to reach for individuals living in those communities. If an individual is suspected of having TB, they undergo sputum testing to confirm a diagnosis.

In many low- and middle-income settings, the most common test for TB is called sputum microscopy. This laboratory test is over 100 years old, its quality is reliant on the skills of the individual technician and ultimately it misses about half of all people sick with TB. To address this issue, we work with partners in Viet Nam to reduce diagnostic delays and to introduce and scale-up new screening and diagnostic technologies, so that we are able to find as many people with TB as possible.

Treat

We follow three key approaches when supporting people during their TB treatment:

  1. Start treatment as soon as possible with the correct medicines
  2. Use shorter and less toxic medicines which are easier for patients to ingest
  3. Support patients throughout their TB treatment to manage their side-effects, mitigate loss of income and reduce out-of-pocket costs

As soon as an individual is diagnosed with TB, they need to be put on treatment immediately. We work with the National TB Control Programme (NTP) in Viet Nam to reduce treatment initiation delays and to provide access to newer drug regimens with shorter duration, lower toxicity and friendlier delivery methods (e.g. pills vs injections).

It is critical that people with TB receive the correct medications for their type of TB, for the entire duration of treatment. Drug-resistant TB is a major challenge and about 5% of TB patients in Viet Nam require more toxic medications over a longer treatment period. We know that soon after a person with TB starts taking the correct medications, they will no longer be contagious.

Treat

We follow three key approaches when supporting people during their TB treatment:

  1. Start treatment as soon as possible with the correct medicines
  2. Use shorter-duration and less toxic medicines which are easier for patients to ingest
  3. Support patients throughout their TB treatment to manage their side-effects, mitigate loss of income, reduce out-of-pocket costs, and ensure treatment completion

As soon as an individual is diagnosed with TB, they need to be put on treatment immediately. We work with the National TB Control Programme (NTP) in Viet Nam to reduce treatment initiation delays and to provide access to newer drug regimens with shorter duration, lower toxicity and friendlier delivery methods (e.g. pills vs injections).

It is critical that people with TB receive the correct medications for their type of TB, for the entire duration of treatment. Drug-resistant TB is a major challenge and about 5% of TB patients in Viet Nam require more toxic medications over a longer treatment period. We know that soon after a person with TB starts taking the correct medications, they will no longer be contagious.

Prevent

We follow two key approaches when conducting TB prevention activities:

  1. Prevent people from being exposed to TB
  2. Treat people who have been exposed to TB so they do not become sick

If we can prevent people from being exposed to TB bacteria, we can prevent them from getting infected and becoming sick. Our programs implement airborne infection control measures to prevent healthy people from being exposed to TB bacteria.

People infected by TB bacteria can live for many years without developing the disease. However, latent TB infection can become active at any time. When this happens the person will become sick with TB and will be able to spread the TB bacteria to others. At FIT, we are increasing access to TB infection testing and introducing new prophylactic treatment regimens to prevent children and adults from becoming sick with TB.

Prevent

We follow two key approaches when conducting TB prevention activities:

  1. Prevent people from being exposed to TB
  2. Treat people who have been exposed to TB so they do not become sick

If we can prevent people from being exposed to TB bacteria, we can prevent them from getting infected and becoming sick. Our programs implement airborne infection control measures to prevent healthy people from being exposed to TB bacteria.

People infected by TB bacteria can live for many years without developing the disease. However, latent TB infection can become active at any time. When this happens the person will become sick with TB and will be able to spread the TB bacteria to others. At FIT, we are increasing access to TB infection testing and introducing new prophylactic treatment regimens to prevent children and adults from becoming sick with TB.

INTEGRATION & SUSTAINABILITY

Our comprehensive approach will never work if FIT works in isolation and with a short-term, project-based mindset.

Our projects are fully integrated into the existing NTP services and are developed in consultation with, and have received approval from the provincial TB programme, the provincial Department of Health, the City People’s Committee, as well as local political and health officials in the districts. Along with other research activities led by the NTP, the programs that we are implementing in Viet Nam and their rigorous evaluation are contributing to the evidence base that informs national policy and investment plans on TB prevention and care service delivery in Viet Nam.

INTEGRATION & SUSTAINABILITY

Our comprehensive approach will never work if FIT works in isolation and with a short-term, project-based mindset.

Our projects are fully integrated into the existing National TB Programme services and are developed in consultation with, and have received approval from the provincial TB programme, the provincial Department of Health, the City People’s Committee, as well as local political and health officials in the districts. Along with other research activities led by the National TB Programme, the programs that we are implementing in Viet Nam and their rigorous evaluation are contributing to the evidence base that informs national policy and investment plans on TB prevention and care service delivery in Viet Nam.

To learn more about the principles of our SEARCH-TREAT-PREVENT approach, you can read the Activists Guide to Fighting Tuberculosis or special series on TB elimination published in the Lancet.
To learn more about TB,