Le projet Axshya est en cours, et il est prévu que le projet sur cinq ans pour le contrôle de la tuberculose et l’organisation des soins parmi la société civile atteigne 744 millions de personnes dans 374 districts et 23 états indiens d’ici 2015. Le Gouvernement indien, World Vision India (WVI) et L’Union constituent les principaux partenaires.
With a population of nearly 1.2 billion to serve, public health experts in India are used to thinking in big numbers, and the planners of the massive new tuberculosis control project, Project Axshya, are no exception. Funded by the largest tuberculosis grant ever given by the Global Fund, the US$199.54 million project is getting underway this year and expects to reach 744 million people in 374 districts and 23 Indian states by 2015.
Three organisations are leading the five-year civil society TB care and control project: the Government of India, World Vision India (WVI), and the International Union Against Tuberculosis and Lung Disease (The Union).
“The logistics of Project Axshya sound daunting, but the concept is to extend the impact of our efforts by building new stronger networks for TB control”, says Dr Nevin Wilson, director of The Union South-East Asia Office in New Delhi. “For The Union’s activities, we have put in place a good project team, and we are partnering with nine organisations, each of whom has an excellent track record of working with different segments of the population. These people are the core group, but many more will be involved”.
“Our Revised National Tuberculosis Control Programme has done an outstanding job, but we have now recognised that TB in India cannot be successfully addressed by the government alone”, says Dr Wilson. “Multiple stakeholders need to become involved to expand the reach of information and resources, increase accountability and empower communities. This is what Project Axshya will do”.
Project Axshya’s expected outcomes by the end of year 1 are:
- Increase the number of districts with a new smear-positive case detection rate of 70% from 109 to 113 of the 300 target districts
- Increase the percentage and number of target districts where at least 90% of all smear-positive TB patients are started on treatment within 7 days of TB diagnosis from 48% (145 districts) to 53% (159 districts)
- Increase the percentage and number of target districts where at least 40% of registered TB patients (all forms) are supervised through a community volunteer from 44% (132 districts) to 48% (144 districts)
A special focus of Project Axshya will be those who have had the greatest difficulty accessing information and treatment for TB under the existing system – that is women, children and marginalised groups, such as tribal people, as well as other vulnerable groups, such as people co-infected with TB and HIV.
The Union will manage the Civil Society Initiative in 16 states; two others will be managed by WVI, and five by both. The 21 states in which The Union will be working have a population of 577 million people.
To orient its nine partner organisations, The Union recently held a five-day training for the 73 programme managers, assistant programme managers, district coordinators and finance managers who will be implementing the activities in the field. The training covered basic knowledge of tuberculosis and the tuberculosis control systems in place, the activities of Project Axshya and organisational details, such as recording and reporting requirements.
District TB Officers from the 90 of total 300 districts involved joined the group for the last day to hold planning sessions with the project staff. At the end of the training, each district had developed a plan for their project activities.
Working with its partner organisations, local governments and other groups, The Union has helped organise colourful and well-publicised launch events in 13 out of total 21 states to build awareness of the project and its goals.
“Infectious diseases like TB spread from person to person”, says Dr Wilson, “and eventually you have millions of people who are sick. With Project Axshya we are reversing the process — spreading information about the symptoms of TB, that it is curable and where to go for treatment. In this way, we will also reach millions.”
The Union’s partners in Project Axshya
The following organisations are sub-recipients of the Global Fund grant working with The Union to implement Project Axshya:
Catholic Health Association of India (CHAI)
Catholic Relief Services (CRS)
Christian Medical Association of India (CMAI)
Emmanuel Hospital Association (EHA)
MAMTA Health Institute for Mother and Child (MAMTA)
Mamta Samajik Sanstha (MSS)
Population Services International (PSI)
Resource Group for Education and Advocacy for Community Health (REACH)
Voluntary Health Association of India (VHAI).