World Health Organization (WHO) Global TB Program
The World Health Organization (WHO) will receive a $817,788 grant over 3 years to leverage the ENGAGE-TB Approach as a platform to improve information, awareness and detection of lung cancer and chronic lung conditions.
Cancer is a leading cause of death, globally. In 2012, there were an estimated 14 million new cases and more than 8 million deaths (WHO, 2014). Approximately 13% of all cancer-related diagnoses were lung cancer, resulting in nearly 2 million new cases (Torre, 2012).
Global Cancer Observatory (GCO) of the International Agency for Research on Cancer provides estimates by cancer site using the best available data for each country. In Africa, they estimate a rate of 79 per 100,000 population (GCO, 2012), recognizing that the low rate is fuelled by the poor availability of high quality data. The incident number of lung cancer cases was estimated at 30,314, of which 72% were among males (N=21,756) and 28% (N=8,558) among females.
Lung cancer and tuberculosis (TB) are intricately linked and too often TB masks the diagnosis of lung cancer resulting in late presentation. Tobacco use, which is the most important risk factor for cancer, causing about 70% of global lung cancer deaths (WHO, 2015) has also been linked to more than 20% of TB cases worldwide (Sitas, 2004). A number of retrospective cohort studies also report that previous TB increases risk of lung cancer (Liang, 2009). Feedback from oncologists and pulmonologists in consultative meetings indicate that many lung cancer patients are referred to them late after spending four to six months being managed in the TB programmes.
WHO’s ENGAGE-TB Approach, supported by the Bristol Myers Squibb Foundation's SECURE THE FUTURE since 2010, has been instrumental in guiding and scaling up integrated community-based TB activities through engagement of nongovernmental organizations (NGOs). The experience and achievements of ENGAGE-TB to date can easily be tailored to manage community-based TB activities with other chronic lung conditions including lung cancer. ENGAGE-TB has also mobilised US $31.5 million through The Global Fund, and in 2016, 49 countries reported on ENGAGE-TB indicators in their Global TB reports compared to 13 in 2013.
Therefore, it will be useful to address the knowledge gap that exists and help the scale-up of integrated community based TB activities with other chronic lung conditions particularly lung cancer. Furthermore, such efforts are aligned with the Sustainable Development Goals, which has ambitious targets of ending TB and the non-communicable diseases as public health concerns. Building on the success of the ENGAGE-TB Approach and the innovative models, the proposed continued partnership will uniquely address the implementation of integrated community-based TB activities with lung cancer and chronic lung conditions.
The aim of this grant is to leverage the ENGAGE-TB Approach as a platform to improve information, awareness and detection of lung cancer and chronic lung conditions by:
- Educating TB programs about similarities between TB and lung cancer symptoms
- Developing demonstration projects in four TB high burden countries for them to differentiate diagnosis
- Identifying global research needs and gaps to further improve the delivery of integrated community-based comprehensive lung care
Activities in each of the focus countries will be monitored by WHO Global TB through financial and technical progress reports every three months. Each WHO Country Office will be responsible for sharing such reports in a timely manner. As per the agreement during phase I and II of the Bristol Myers-Squibb Foundation/STF & WHO partnership, WHO will prepare and deliver financial and technical progress reports of the activities every six months.
- Ministries of Health and National TB Programmes and Non-communicable diseases in Tanzania, South Africa, Lesotho and Swaziland.
- WHO NCD office in Geneva
- Hospitals supported by the Bristol Myers Squibb Foundation