Bangladesh asked to reduce donor dependency in controlling TB

International reviewers on Thursday suggested Bangladesh government to reduce its donor dependency gradually in the “successful, but challenging” tuberculosis control programme as global funds would shrink “progressively”.

Bangladesh has achieved the Millennium Development Goal (MDG) target of 70 percent case detection and 85 percent cure rate in tuberculosis well before the 2015 time frame.

But government spends 15 percent of its total TB budget while rest comes from the Global Fund that had pledged more than $90 million for 2014—2016.

Team Leader of the independent reviewers Leopold Blanc after his assessment in a primary briefing on Thursday said external funds would decrease gradually.

“It’s (reducing external funds) nothing unusual,” he said.

Photo: Reuters

The TB programme is being assessed once in three years by independent global experts. Blanc was a former WHO expert on TB.

He said he did not find any lack of political commitment from the Bangladesh government in fighting tuberculosis.

“….but it is no reflected in the budget allocation at central and local level,” he said.

“But it is very crucial to increase domestic funding progressively and optimal use of donor funding to ensure ‘sustainability’ as we all know external funding will progressively decrease,” he said.

Government officials who joined the briefing at a Dhaka hotel blamed overall budget constraints of the health sector that on average gets around 5 percent of the national budget.

The independent reviewers who will give their final report later also highlighted few challenges of the TB programme.

“Human resource is not sufficient for introduction and expansion of new TB programmes,” team leader Blanc said and that skilled manpower would be needed to launch sophisticated equipment “so that they can use the tool efficiently”.

He said identifying childhood TB and tackling multi-drug resistant TB were also challenges that the government earlier acknowledged.

Only recently after a spell of training, child TB detection rate has rose to around 5 percent of the total TB cases, though according to the reviewer it should be 10 percent of the total TB cases in the country.

TB prevalence rate is 434 per 100,000 people in Bangladesh, according to the government statistics.

The reviewers also stressed on decentralisation of the managerial responsibilities including involvement of the local level staff in budgeting.

Officials say the review is crucial as it directs future TB programme and funding.