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The Union:

Paula I Fujiwara, MD, MPH

Scientific Director, The Union

Citizen News Service

September 19, 2017
TB, HIV, Lung Health, NCDs, Tobacco Control and Policy
Union/MSF OR Model

MDRTB Short-course
Treatment Trials
S RT IT Course
(Structured Operational Research and Training IniTiative)
Union and MSF Model
Purpose: To teach practical skills for
conducting and publishing operational research

Approach: combines training with implementation

Product oriented [a submitted research paper]
Modular approach
Milestones must be achieved to stay in course
Targets must be achieved to keep the brand
Research Projects undertaken in 39 courses
Research Project Subject Number
Tuberculosis / HIV-TB / Diabetes-TB 226
Maternal and Child Health 18
Malaria, NTDs and Ebola 71
Malnutrition 5
Other [smoking, NCD, Cancer] 87
Outputs from 26 completed
OR courses: by 30 June, 2016

Participants starting the course 314

Participants finishing the course with all 288 (92%)

milestones completed
Scientific papers submitted to peer- 329
reviewed journals
Papers published or in press 279 (85%)
Union MDRTB Short-Course Tx Studies
STREAM Observational Cohort
Standardised Treatment Regimen of (9 West African countries)
Anti-Tuberculosis Drugs for Patients
with MDR-TB Performed w/in framework
Randomized control trial, of NTP PMDT approach
non-inferiority design No comparison regimen
Control regimen: WHO
recommended regimen Study regimen
Study regimen Same as STREAM,
9 mo Clofazamine, except lower moxifloxicin
Moxifloxacin, Ethambutol, dose
Pyrazinamide 83% tx success; adopted by
In addition to initial phase WHO
w/ 4 mo Kanamycin, INH,
International Management Development Programme
International Management and Development Programme
Goal: Management training for health professionals Strengthened
health systems and quality patient care
Specific courses addressing:
Developing budgets that meet governmental and/or donor
Organising and training healthcare staff at different levels
Coordinating procurement and management of medicines and
Handling human resources issues, such as motivating overworked
Creating communications plans to disseminate important health
Adhering to practices needed to monitor and evaluate programme
Active Case Finding

Decreasing Tobacco
Active TB-Case Finding in Uganda:
Slum Partnerships to Actively Respond to TB in
Kampala (SPARK-TB) (12/11-6/14)
SPARK-TBplus expanded to 4 districts w/ 1.7M
population (7/14-current)
Active case finding increased access to
quality TB diagnosis and treatment
Targets private health facilities for urban poor
traditionally outside of NTLP purview
SPARK-TB Results
Partnership with Ministry of Health, Kampala
City government, 70 private health facilities to
identify people with TB symptoms, diagnose
and treat
20,423 identified with TB symptoms
1725 TB cases diagnosed and treated
80% success rate
Expansion planned through new Global Fund
Union Role in Global Initiative to
Reduce Tobacco Use 2007-2016
Support to governments and civil society
low- and middle-income countries
highest1 prevalence
of tobacco use
introduction and enforcement of policies proven to
Subtitle in lowercase
reduce tobacco and thin font
Technical Advice to >130 government departments and
Civil Society organisations
Over 300 grants across 43 countries
100 Technical Capacity Building courses in 21 countries
for 3150 participants
Union Impact in Global Initiative
to Reduce Tobacco use
Introduced national smoke-free laws in 28 countries
Protected 2.85 billion people from harms of second-
hand smoke
Graphic health warnings on tobacco packaging have
helped smokers quit and discouraged others from
starting in 18 countries (2.59 billion people)
10 countries have established sustainable tobacco
control funding (2.05 billion people)
World Conf on Lung Health
Guadalajara, Oct 2017
Media Field visit on ZTB: cheese factory,
Press conferences
ZTB press conference to launch ZTB Roadmap
New TB science and technologies (vaccines,
molecular tools, serologic tests
Late breakers sessions
Students work featured