The International Union Against

Tuberculosis and Lung Disease

(The Union)

Promoting Lung Health Since 1920

I.D. Rusen MD, MSc

Director, Department of Tuberculosis, The Union
December 4, 2009, Cancun
 Outline
• Union mission

• Pillars of work

• Tuberculosis burden

• FIDELIS

• Questions and answers

 Union Background
• World’s oldest humanitarian organization dealing with
health founded in Paris in 1920

• Mission: to bring innovation, expertise, solutions and

support to address health challenges in low- and middle-
income populations

• Headquarters in Paris with several regional and

country offices including Mexico, New York, Delhi,
Kinshasa and Kampala
 Union Pillars
• Technical Assistance

• Research

• Training
 Union Technical Departments
• Tuberculosis

• Lung Health

• HIV

• Tobacco Control
 Tuberculosis
• 9.27 million cases globally in 2007

• 1.77 million deaths due to TB

• 511,000 cases MDR-TB

• 1.4 million HIV co-infected cases

• Poverty spiral – economically productive most affected

 Special Tuberculosis Initiatives
• FIDELIS

• TREAT TB
 FIDELIS
• Fund for innovative DOTS expansion through local
initiatives to Stop TB

• CIDA multi-lateral grant managed by The Union

• Launched in April, 2003

• Aim to increase global case detection of new smear

positive tuberculosis while maintaining high cure rates
 FIDELIS (main principles)
• Small projects of one-year duration (USD 150K-250K)

• Local solutions to local problems

• Encourage innovative ideas within existing programs

• Focus on populations with limited access

• Systematic monitoring and evaluation

 FIDELIS (activities)
• 6 application rounds completed

• 53 phase I projects implemented/approved in 18

countries (166 proposals)

• 13 projects approved for phase II activities

• Final ‘best practice’ project completing activities

 FIDELIS (phase I countries)
• China (15)
• Pakistan (9)
• Kenya (5)
• Indonesia (4)
• Tanzania (4)
• Bangladesh, Nigeria, Uganda (2 each)
• Afghanistan, Ethiopia, Eritrea, Madagascar, Myanmar, Sierra
Leone, Somalia, Sri Lanka, Sudan, Tajikistan (1 each)
 FIDELIS (results)
• 51 phase I projects completed one year of activities

• A total of 273,239 new smear positive cases were

detected in these 51 projects

• Represented an additional 85,267 NSP cases over

the previous year in project sites
 FIDELIS (project highlights)

• In rural Bangladesh, project utilized community

leaders to mobilize the community to seek care for
symptoms
 FIDELIS (project highlights)

• In Indonesia, project to engage private practitioners

to strengthen tuberculosis control services
 FIDELIS (project highlights)

• In Anhui, China, project mobilized primary

school students to identify tuberculosis
suspects in their families with follow up
assured by village doctors
 Future Directions
• Need to address (emphasize again) basic approaches
to tuberculosis control

• Need to support research into new tools and

approaches to diagnosis and care (TREAT TB)

• Need to strengthen systems – health systems,

laboratory systems – that serve beyond tuberculosis
International Union Against Tuberculosis
and Lung Disease (The Union)
68 boulevard Saint-Michel
Paris 75006
France
Tel (+33) 1 44 32 03 60
Fax : (+33) 1 43 29 90 87
e-mail: IRusen@theunion.org www.theunion.org