The Bangkok TB Community-led Monitoring Statement
"Transforming the TB Response Collaboratively to Reach Every Person Affected by TB OneImpact – Community-led Monitoring for TB"
Joint Position Statement and Global Solidarity Appeal from TB Communities to all TB Stakeholders
Bangkok, Thailand, 1 November 2022
Stop TB Partnership Community Summit
Today at the Stop TB Partnership Communtiy Summit in Bangkok Thailand, we as a collective of community organizations from high burden TB settings agree that to find the missing people with TB, we need to systemically identify and respond to the challenges they face at local and program levels. Community-led monitoring (CLM) is key to achieving this collective responsibility.
As such we ask for solidarity and call on all community partners, national TB programmes, technical partners, technical assistance providers and donors to help build a common understanding of CLM for TB and to champion, integrate, scale up and mainstream CLM, as part of our collective commitment and response to calls from the Global Plan 2023-230, WHO End TB Strategy, and the UN Political Declaration, for an equitable, rights-based response to end TB.
Through community-led monitoring, informed and empowered people affected by TB can highlight the challenges preventing vulnerable and marginalized populations from accessing TB care and support services, for rapid and sustained health and community system responses, to reach the missing people with TB. In so doing CLM ensures that quality TB care and support services are available, accessible, acceptable for all – the last mile in the TB response.
Designed by and for people affected by TB, OneImpact CLM is an approach to community empowerment, participation, and accountability in TB. Through community participation and local health and community system responsiveness the OneImpact CLM approach enables rapid action to ensure that quality TB care and support services are available, accessible, acceptable for all, and the generation of new information to support evidence-based decision making for sustained and tailored programmatic responses to find the missing people with TB. In so doing the OneImpact CLM approach establishes a common accountability platform for systematic information exchange and collaboration which puts people affected by TB at the heart of the response.
Built on the principles of community leadership, country ownership, people centeredness, institutionalization, and evolution, the OneImpact CLM approach has been designed, led and implemented by affected TB communities, with strategic guidance, support, and continuous engagement from national TB programmes for accountability . It draws on 6 years of implementation experience across 23 countries.
OneImpact CLM for TB is distinct and has resulted in and contributed to the following:
Community Empowerment and system strengthening
- It empowers, mobilizes, and increases affected community-engagement in the TB response, thus advancing community led and driven responses in TB.
- It leverages existing community and health responses, thus strengthening community responses to TB.
Finding the missing people with TB for an equitable rights-based TB response
- It focuses on reaching, engaging, and supporting TB key and vulnerable populations (missing people with TB), and linking them to screening, testing. treatment, and support services, thus transforming the TB response to be equitable, rights-based and people centred.
Health System Strengthening
- It generates new and complementary information, from people affected by TB to foster community and health system capacities and to support the screening, testing and treatment targets of National TB Programmes, thus improving the overall performance of health services and strengthening one of the main health system functions – responsiveness to people’s needs and expectations.
- While TB can be the entry point OneImpact CLM is adaptable can integrate challenges facing other key and vulnerable populations, such as people living with HIV, people at risk for COVID-19 etc. Therefore, CLM contributes to building capacity and resilience of the health systems for effective disease control including preparedness and response to future pandemics.
Heightened Partner Engagement, Information Exchange, and Accountability
- It provides a platform for systematic information exchange and collaboration between affected TB communities, national TB programmes and other key decisions makers, thus enhancing accountability in TB.
Advanced innovations for efficiencies, reach and impact in TB
- It facilitates real time data collection, thus propelling rapid reactions and responses to overcome TB challenges in a timely manner.
- It generates new and complementary information to systematically reach the missing people with TB, with tailored responses.
- It can leverage technology, thus facilitating timely and efficient data collection, analysis, and reporting.
- With the OneImpact approach all CLM tools (social audits, budget monitoring, scorecards, surveys) and data collection methods (paper, APPS, excel, call centers) can be used and unified under one common warehouse for CLM, thus creating opportunity for CLM mainstreaming and scale-up.
Fully understood, aligned, collaborative, integrated, mainstreamed, and resourced OneImpact CLM approaches are critical to ensuring equitable, evidence-based TB responses to find the missing people with TB.
We therefore call on national TB programmes, technical partners, technical assistance providers and donors to address the below common CLM challenges:
- CLM is often misunderstood by the broader TB community, whereas the OneImpact CLM approach articulates the aim, objectives and required steps required for effective CLM.
- CLM can be seen as adversary to national disease programme goals, whereas the OneImpact CLM approach is designed to foster collaboration across sectors to meet the common goals and objectives of national programmes and affected communities.
- CLM initiatives can be ad hoc, unintegrated, and poorly funded, whereas the OneImpact CLM approach and platform provides a pathway for integration, scale-up and mainstreaming.
- CLM data is not well understood and as such is underutilized and is not mainstreamed, whereas the OneImpact CLM approach includes data analytics, specific and actionable indicators and M&E tools for programmatic alignment, mainstreaming, reach and impact.
- CLM is underfunded and as such does not reach its potential impact.
To address these challenges, all co-signatories, appeal to national TB programmes, technical partners, technical assistance providers and donors to champion the calls of the Global Plan 2023-230, WHO End TB Strategy, and to advance progress UN Political Declaration, through the following ways:
- To reinforce and contribute to building a common understanding of CLM for TB, drawing from the OneImpact CLM approach and country experiences.
- To systematically collaborate with affected TB communities to design, adapt, roll out, institutionalize, mainstream, evolve and scale-up the OneImpact CLM approach for equitable TB responses that find the missing people with TB.
- To institutionalize and mainstream the OneImpact CLM approach so that affected communities are at the heart of the TB response and so that CLM data is systematically used for rapid responses and enhanced evidence-based decision making for impact.
- To link / integrate OneImpact CLM with the National DHIS2 or other National MIS systems.
- To include information on the OneImpact CLM approach and tools in national communication and dissemination strategies.
- To include and prioritize OneImpact CLM in National Strategic Plans.
- To prioritize OneImpact CLM in funding proposals for TB e.g. NFM 4 .
- To reinforce and contribute to building a common understanding of CLM for TB, drawing from the OneImpact CLM approach and country experiences and to reflect this approach in all technical and normative guidance.
- To commit to championing the OneImpact CLM approach in engagements with National TB Programs, implementers, and other partners.
- To expand upon the available technical assistance to support the adaptation and scale up of the OneImpact approach for all countries and communities.
- To continue to explore and evolve the OneImpact CLM approach drawing from country experiences and feedback.
- To create spaces for continuous sharing and cross learning across implementers and countries.
- To leverage or build on the existing OneImpact CLM efforts and to understand the nuances, distinctions, and differences in CLM for TB.
- To raise awareness, build capacity and overcome misconceptions regarding the OneImpact CLM approach.
- To use and draw from the STP guidance and resources on how to operationalize the OneImpact CLM approach.
- To recognize, leverage, and build on existing OneImpact CLM approaches and to fully fund country OneImpact CLM interventions.
- To ensure all TB, MDR TB and TB/HIV countries are financially and technically supported to adapt, implement, and scale up the Oneimpact CLM approach as a priority.
- To ensure the Global Plan to end TB 2023-2030 target to conduct TB CRG Assessments, and to develop and implement costed TB CRG Action Plans is met as a means to inform OneImpact CLM approaches.
- To mandate an appropriate percentage of all funding for CLM for equitable, rights-based TB responses.
Joint Statement Signatories