Unique Employer Led Model (ELM) for TB care and prevention launched in Dibrugarh

Dibrugarh, November 8, 2017: The inaugural meeting for the pilot phase of the
Employer Led Model for Tuberculosis (TB) Prevention and Care in the tea
gardens of Dibrugarh was held earlier today. This was organized by REACH, a
non-profit organization currently implementing the TB Call to Action Project in
Assam, in partnership with the State TB Cell.
Speaking on the occasion, Smt. Laya Madduri, Deputy Commissioner, Dibrugarh,
said, “I am glad to see that the idea of ELM is well received by the tea gardens in
Dibrugarh. The implementation of ELM is very important because TB can affect
anybody… I urge all the tea garden members to consider providing full TBrelated
support to their employees”.
Through the ELM strategy, REACH aims to reach out to all formal, informal and
migrant workforce for improved awareness about TB and link anyone with
symptoms of TB to the public health system for diagnosis and treatment.
Shri Jadav Saikia, District Development Commissioner, Dibrugarh, who was also
present, urged participants to join hands to eliminate TB. “TB is a potential
threat to everyone. It is our social responsibility to eradicate TB. We extend full
support of the district administration and expect the managers of all the tea
gardens to come forward and participate in the implementation of ELM,” he said.
Dr. Udayan Barua, Joint Director Health Services of Dibrugarh, noted, “The tea
communities are more vulnerable to TB because of poor nutrition and bad living
conditions.” He appealed to the tea garden managers to spread awareness about
TB and its treatment to their workers.
Dr S N Misra, Consultant, REACH explained the ELM process, saying, “ELM is
globally accepted as a best practice because employers have the power to reach
those that even governments cannot sometimes reach.”
“By piloting the ELM programme in the tea estates of Assam, we hope to
demonstrate that employers can put in place a sustainable system to help reduce
the burden of TB and provide their employees with access to free TB services
within RNTCP”, said Ms Smrity Kumar, Project Director, TB Call to Action,
REACH, speaking from New Delhi.
A total of 37 tea garden stakeholders from Assam Branch of Indian Tea
Association and Bharatiya Cha Parishad, Assam participated in the event. The
two associations gave their commitment for the implementation of the Employer
Led Model.
Shri Mrigendra Jalan, President, Bharatiya Cha Parishad, Assam, said, “We are
ready to support the initiative as this will go a long way to help the community”.
“The Assam Branch of Indian Tea Association extends its full support to REACH
for the implementation of ELM”, said Shri Rana Dey, Deputy Secretary, Zone – 1,
Assam Branch of Indian Tea Association.
Dr. Hiten Sonowal, District TB Officer, Dibrugarh; Dr. Basant Laskar, Head of
Department for Pulmonary Medicine, Assam Medical College; Dr P. Bordoloi, IEC
Officer, RNTCP Assam and Dr Purnananda Khaund, CMO, APPL & Senior
Administrator RHRC, Amalgamated Plantations Pvt. Ltd, Assam also took part in
the programme.
“The main reasons for TB in our tea gardens are over-crowding and inadequate
direct involvement of state TB initiatives. In all the 1100 tea gardens of Assam,
both organized and unorganized establishments exist. We need to put our best
foot forward and adopt ELM for all employees“, said Dr Khaund.
In the post-inaugural sessions, representatives from tea garden companies
participated in technical sessions on TB-related issues, the TB context in Assam,
the ELM process and the framework for action. A group discussion was
conducted with the tea garden stakeholders to chart-out the implementation
plan for ELM of TB care and prevention in tea gardens.

Daily Regimen for TB launched in Jharkhand

Ranchi, October 17, 2017: “We are all gathered here today as the state of Jharkhand takes one big step towards our common goal of eliminating TB by 2025. Now, TB drugs will be given daily as against the earlier alternate day regimen. This is a great initiative by the Revised National Tuberculosis Control Programme and the Jharkhand state government, to make this treatment easier for all patients. The treatment is now simplified and we hope that this will be very successful,” said Shri Ramchandra Chandravanshi, Hon’ble Minister of Health and Family Welfare, Government of Jharkhand, at the launch of Daily Regimen for TB in Ranchi, Jharkhand on Tuesday, October 17.

Jharkhand will now begin providing daily treatment to those affected by TB, and the Health Minister administered drugs to three patients to kick off this new, improved regimen. The launch event was organised by the State TB Cell, Jharkhand, in partnership with REACH and with support from United States Agency for International Development (USAID).

Speaking at the launch, Shri Sudhir Tripathy, Additional Chief Secretary, Health, Government of Jharkhand, said, “This is an important day for us because we are transitioning from one regimen to a better, more efficient one. TB is the biggest public health crisis that affects people in their most productive years. It would have been easier to digest the deaths caused due to TB if there was no treatment available, but it is curable and treatment is free. Even then, to see these numbers, shows our weakness. That is why this is a good opportunity, to launch such innovative ways to address this problem.”

The event also saw the official release of communications materials featuring Arjuna awardee Olympic archer Deepika Kumari. TB Ambassador Deepika Kumari lent her voice to the TB campaign through a series of video and audio messages as well as posters developed by REACH’s TB Call to Action project, with support from USAID. “Deepika Kumari’s message will now be showcased in every home and every village. I congratulate REACH for this very special work,” said Shri Chandravanshi while launching the campaign. “We are grateful to Deepika for her support and commitment as a TB Ambassador, and we are confident that through these messages, we can help improve awareness about TB, reduce stigma and connect people to TB services”, said Smrity Kumar, Project Director, REACH.

Jharkhand is the first state in the country to have a State Task Force on TB, which was set up earlier this year under the chairmanship of the Additional Chief Secretary. Congratulating Shri Tripathy and REACH for this unique achievement, the Hon’ble Health Minister said, “This is an unique initiative that brings together various departments to integrate TB into the mainstream. I request all of you present here to join hands for a TB-free Jharkhand.”

The event also saw representatives from the Jharkhand TB Cell as well as REACH and other development partners. Dr Rajkumar Beck, State TB Officer, addressed the gathering by sharing the state TB scenario while Dr Anindya Mitra, Training Officer, STDC, shared details about the new regimen.


Chennai, Tamil Nadu: REACH held its 18th Annual General Body Meeting on September 21 at the M.S. Swaminathan Research Foundation.

The AGM began with a welcome address by Ms. Sheela Augustine, Deputy Program Director, REACH.

Speaking on the occasion, Dr. M.S. Swaminathan, former Rajya Sabha Member, renowned Agricultural Scientist and Chairman, REACH said, “REACH has come a long way from that first meeting I remember almost 20 years ago. There is still a lot of work to be done and involving the community is a priority to achieve TB control”.

Dr.P.R. Narayanan, Former Director, National Institute for Research in Tuberculosis, presided over the meeting as the special guest and acknowledged the achievements of REACH, particularly in demonstrating a model of private sector engagement.

Dr. Nalini Krishnan, Director, REACH thanked Dr M.S. Swaminathan and Dr. Narayanan for their guidance and support over the years.

Dr. Ramya Ananthakrishnan, Executive Director, REACH, presented an overview of the organization’s activities and key achievements in 2016-17. Following her presentation, members of the REACH team shared their experiences of working on various initiatives.

“It was a rich experience for me and my team to support patients and their families to go through the process of contact screening. We were able to counsel patients, educate them about TB, and provide them with symptom screening, X-Ray support and GeneXpert testing, if required. If TB was detected, we were able to guide them to start treatment at the TB unit,” said Ms. Juliet of the IMPACT initiative.

Mr. Joseph of EQUIP initiative is grateful to the private practitioners who are supporting the initiative, “we have so many memories of meeting new private practitioners for the EQUIP initiative, whose support has been vital in using the newer diagnosis, GeneXpert, thereby providing quality diagnosis and treatment to TB patients.”

“To think that REACH is now working in five states of India, in addition to Tamil Nadu, for TB care and prevention is a source of pride. We started in Chennai, moved out into the districts of Tamil Nadu through Axshya, and now have broadened our work to include other states as well. It’s been wonderful to see the welcome that REACH has received in other states through the Call to Action project,” said Ms. Anupama Srinivasan.

Mr. Anbarasan of the Pharmacy Initiative said, “Pharmacists are a difficult group to work with, as they have their business to manage, but once they are convinced and trained on their role, they start contributing to TB control.”

Some of the TB patients associated with REACH were also a part of the event. They shared their experiences of fighting TB with REACH’s support.

“I feel healthy now and am thankful to the team at Rotary Nanganallur Centre that has helped me overcome my fears and defeat TB,” said Mr. Kuppuswamy, a TB Survivor. Another TB Survivor, Mr. Venkatakrishnan, said, “I would like to acknowledge the support of my wife, who helped me in my battle against TB. I also remember the care provided by the REACH team that always made sure that I was taking my TB tablets and would visit me so many times when I was not well. A person’s life has meaning only when they help others, and I congratulate REACH for their work in TB care.”

Ms. Amrita Limbu, an MDR-TB survivor and now an activist, talked about her journey. “I am an MDR-TB survivor. TB made me strong and I wanted to support others in the society. Therefore, I am happy to help other patients,” she said.

The meeting was followed by the launch of the REACH Annual Report 2016-17 by Dr. M.S. Swaminathan. A special memento was presented to Dr. M.S. Swaminathan for his guidance and support to REACH over the years.

Dr. Sivamurugan, President, Ms. Suraksha Giri, Secretary, Mr. K Ravi and other committee members took part in the meeting.

“The journey has been wonderful and we have been able to show good work. With the dedication and hard work of the REACH team, we can move towards our vision of a TB-free society,” said Dr. Sivamurugan, President, REACH.

Members of the REACH staff were also awarded and honoured for their dedication and service through the years. Ms.  Nalini. K, Ms. Deenathayabari, Ms. Mangaiyarkarasi, Mr. Joseph, Ms. Shanthi, Mr.Ganesh. M, Ms. Kalpana and Ms. Rajalakshmi were given recognition for their work.

Hon’ble Governor Launches TB Call to Action project in Assam

Guwahati, August 24, 2017: “TB requires urgent attention and it is necessary to involve local governments, corporates and those personally affected by TB, for a meaningful contribution to this national cause,” said Hon’ble Governor of Assam Shri Banwarilal Purohit, while speaking at the launch of the TB Call to Action (TBC2A) Project in Assam.

Shri Purohit was the Chief Guest at the launch event of the TBC2A project, implemented by the Resource Group for Education and Advocacy for Community Health (REACH) with support from the United States Agency for International Development (USAID). The project seeks to amplify and support India’s response to TB by involving previously unengaged stakeholders and broadening the conversation around the disease.

Narrating a personal experience, the Hon’ble Governor said, “Back in the 1950s, when I was 10, my uncle was diagnosed with TB and the environment in the house was morose, as if there was no hope. Jewellery was pawned, we saved money and he was sent off to a sanatorium for six months. More than 30 people from our village went to see him off at the border because most believed he wouldn’t ever come back. That was the scenario back then. But today, it is different. TB is entirely curable, early identification is all it takes. Since the commitment of the Government of India is now on record, it should become that much easier for us to realize the dream of a TB-free Assam by 2025.”

Through the TBC2A project, REACH will prioritize two interconnected aspects of India’s response – strengthening and supporting the community response to TB and advocating for increased financial, intellectual and other resources for TB. “If we don’t unite now, the TB scenario will become worse than it is. With initiatives like ELM in tea gardens, we will get an opportunity to reach the unreached,” said Dr Achyut Baishya, Executive Director, National Health Mission, Assam.

The launch event was preceded by a consultative meeting on Employer Led Model (ELM) for TB Care and Prevention, which brought together senior representatives from tea garden associations to discuss the need for industries and corporates to work towards the welfare of their employees. Explaining the proposed ELM initiative, Dr SN Misra, Consultant, REACH, said, “ELM is globally accepted as a best practice because employers have the power to reach those that even governments cannot sometimes reach.”

Participating in the launch, Dr Amar Shah, Project Management Specialist, Health Office, USAID/India, said, “We must all work together to successfully turn the tide on TB. USAID is working hand-in-hand with the Assam government, healthcare professionals, corporate organizations, patients and survivors, to foster an environment that supports TB patients and moves us toward a TB-free India.”

Presenting an overview of the TB Call to Action project, Ms Smrity Kumar, Project Director, outlined priorities for Assam, including engaging elected representatives, involving private pharmacies, strengthening the community response and inter-sectoral coordination for a comprehensive response to TB.

‘Touched by TB’ – the coalition of TB people in India formed

New Delhi, 2017: During the Regional Capacity-Building Workshop for TB Survivors, participants from India held several discussions on the urgent need for a network or coalition of those affected by TB. This has since resulted in the formation of Touched by TB-The Coalition of TB People in India.

At the first ‘official’ meeting held on the last day of the workshop, the group identified national coordinators as well as regional focal points. In keeping with their self-identified mandate to support the TB programme in India, they agreed on several key objectives including creating and sustaining a coordinated and capacitated national coalition; ensuring treatment literacy and awareness for people living with TB; advocating for acceptable, accessible, compassionate, comprehensive, rights-based services; and networking with and support the Ministry of Health and the RNTCP and its partners to achieve the goal of ending TB in India by 2025.


REACH focuses on Paediatric TB

Chennai, 2017: REACH broadened its vision to tackle the issue of Paediatric TB. The EQUIP Initiative collaborated with Kanchi Kamakoti Child Trust Hospital – a leading multi-specialty children’s hospital – with the aim to facilitate early diagnosis and treatment of TB in Children. REACH officials conducted a sensitization event for doctors at the hospital.

Around 50 doctors attended the meeting and were updated on the recent developments in paediatric TB management, standards of TB care in India, and about the services provided by REACH. The Child Trust Hospital will function as a nodal centre and referral hub for paediatricians practicing in Chennai.

According to WHO estimates, 210,000 children died of TB in 2015 across the globe, including 40,000 deaths among children who were HIV-positive. As many as one million children became ill with TB.


National Consultation on Role of Nurses in response to TB held

July 6, 2017, New Delhi: “TB is not just a biomedical problem, and we must develop the capacity of nurses across socio-economic and socio-medical factors for effective tuberculosis control,” said Dr Khaparde, Deputy Director General, TB, Central TB Division, Ministry of Health and Family Welfare, Government of India. He was speaking at a national consultation on the involvement of nurses in India’s response to TB, organized by REACH in New Delhi, in keeping with its mandate to involve previously unengaged stakeholders under the Tuberculosis Call to Action (TBC2A) project. The consultative meeting brought together experts from the nursing and medical professions along with development partners, to come up with a sustainable way to incorporate TB into the current nursing curriculum and training modules.

Nurses have the unique advantage of having earned the trust and respect of the public, having access to all levels of the population, working with patients over the course of their lifespan, utilizing a horizontal approach to healthcare, providing a range of services – from immunization to palliative care and everything in between – and finally providing individual and community-level interventions. In addition, nurses provide services at all levels of the service delivery system, from the PHC level to tertiary care hospitals.

“The National TB Programme has for long been working with medical colleges and NGOs, but not so much with nurses. A nurse is with the patient from womb to tomb – the first and often also the last point of contact for the patient as well as the patient’s family. We need to tap into this vast workforce, across stages of detection, diagnosis, treatment and adherence. Nurses, with their medical and paramedical background, can understand the complex TB treatment, that involves four, sometimes six types of drugs, including injectables. Nurses can also play the role of counsellor, for better treatment adherence and management of adverse drug reactions,” Dr Khaparde added.

Also speaking at the consultation, Mr T Dilip Kumar, President, Indian Nursing Council, said, “We need to keep nurses engaged all the way through, and here, periodic updation of their syllabus, curriculum and manuals goes a long way. Nurses, in addition to working for efficient treatment and adherence, also play a crucial role in early detection, if they are familiar with symptoms. In addition, they also come in contact with the close relatives or contacts of the patient, and can hence contribute significantly towards early detection of the TB disease.”

Participants discussed the many ways in which nurses could be involved in responding to TB, including a curative role in disease prevention and health promotion; providing health education at an individual and community level, and interdisciplinary work with other healthcare and public health professionals in order to provide the most comprehensive care possible. Nurses can contribute significantly by ensuring priority screening & diagnosis of presumptive TB cases, providing cross referrals of People living with HIV and patients seeking TB services to rule out HIV Infection, providing education regarding cough hygiene and adherence counseling, among other areas.

The meeting was organized by REACH in association with the Central TB Division, MoHFW and the United States Agency for International Development. Speaking at the meeting, Ms Smrity Kumar, Project Director, TB Call to Action, said, “Nurses are an important part of the health system, and all such stakeholders must come together to achieve the country’s target of eliminating TB by 2025. The objectives of this meeting were to assess the existing role of nurses and the way forward. Nurses need to be engaged in the implementation of the national TB programme from the highest to the lowest levels”.

Dr S N Misra, Consultant, REACH, who has vast experience in training of nurses in HIV, TB and ANM care, spoke about the impact of investing in such training. “India was the first-ever country selected by Global Fund for an exclusive training programme for nurses. While it started out for training on HIV, it was expanded to include TB and ANM training, thanks to the success seen in the HIV component. These trainings cover patient etiquette, bedside etiquette, infection control, communicating with family, confidentiality and other soft skills. Nurses felt empowered by these trainings and this ensured continuous engagement over their professional career,” he said.

The group discussed issues regarding sustainability of a training programme for nurses, as well as the engagement of nurses in private sector hospitals and the need for infection control mechanisms to protect the workforce. The meeting was also attended by representatives from the NITRD (expand), World Health Organization, JHPIEGO, Fortis Hospital, REACH and other key partners in India’s response to TB.

REACH is a non-profit organization dedicated to the fight against TB since 1999. The TB Call to Action project, supported by USAID and implemented by REACH in six states, seeks to amplify and support India’s response to TB by broadening the conversation around the disease and involving previously unengaged stakeholders.

REACH, USAID and Stop TB Partnership Train Survivors in TB Advocacy

New Delhi, April 12, 2017: Tuberculosis (TB) survivors and advocates from India, Indonesia, Vietnam, Cambodia, Bangladesh and the Philippines met in New Delhi from April 10-13 to take part in a first-of-its-kind capacity building workshop.

Organized by REACH, in partnership with the U.S. Agency for International Development (USAID) and the Geneva-based Stop TB Partnership, the four-day workshop brought together 32 people from six countries who shared personal experiences on TB, documented the societal and systemic barriers they faced, transformed the barriers they faced into concrete advocacy goals and strategies and discussed the power of collective community-driven advocacy to change the status quo in TB.

Participants at the TB Champions Workshop

“The voice of the survivor becomes the voice of India. In TB, there is a dual stigma – one is the disease itself but the other is poverty. This dual stigma can be explained best by the TB survivors. The TB fight is not finished – but survivors will help us get there. TB survivors at different levels can be great ambassadors and pass the message very efficiently so that TB loses, and we all win,” said Dr Sunil D Khaparde, Deputy Director General, TB, Central TB Division, Ministry of Health and Family Welfare, Government of India, who was the chief guest at the valedictory session.

Speaking at the valedictory session, Xerses Sidhwa, Director of Health at USAID/India, said: “USAID is proud to support this workshop, which helps TB survivors to become powerful agents of change in India and other regional countries. It is critical that we actively engage TB champions in designing and implementing programs and advocating for policy change. Their experiences can guide the way forward as we move toward a TB-free India and world.”

Dr. Nalini Krishnan, Director, REACH, added: “At the core of our work is ensuring that those affected by TB are an integral part of all efforts, extending beyond tokenism. This capacity-building workshop is an important step to achieving a long-term role for trained, committed advocates in policy advocacy, overseeing program and program implementation.”

The workshop addressed issues such as the science and burden of TB, and focused on the need for powerful and effective storytelling. “I lost my father to TB. And a few years ago, I was diagnosed with TB as well and I could never speak about it. It’s a huge burden to suffer alone. That is why this workshop just clicked for me. People wanted to listen to our stories, and I have learnt how to tell my story even better,” said Arun Singh Rana, a TB survivor from India, at the closing ceremony. Another TB Champion,Cherry Florida from the Philippines, said, “I would like to honour REACH for bringing us all together to hear everyone’s stories, it’s really encouraging to come together like this on an international level. This workshop really changed my perspective and helped me look at the broader picture.”

Blessina Kumar interacts with TB Champions

Speaking during the workshop, Blessina Kumar, CEO (I), Global Coalition of TB Activists, one of the lead facilitators for the workshop, said, “The energy brought in by the TB Champions who won the fight against MDR, XDR TB and just TB was palpable. The TB response across the world is missing passion and if we want to End TB in our lifetime, we need their lived experiences, their passion and their energy to bend the curve and win the battle.”

Globally and in South-East Asia, the TB crisis demands a comprehensive response from both government and non-government actors, including the private healthcare sector, business leaders, civil society and most of all, those directly affected by TB—patients, survivors and their families. However, responses to TB have remained top-down and TB survivors, patients and their families have had little or no role to play in the fight against the disease.

“If we are serious about ending TB, engaging those who have experienced TB first hand in a meaningful way is critical,” said Dr Lucica Ditiu, Executive Director, Stop TB Partnership. “The Stop TB Partnership is therefore delighted to partner with REACH to support the desire of TB Survivors from the South East Asia region to further build their skills to become even more powerful TB advocates and we look forward to continuing our collaborations with other community and civil society partners in the region such as the newly established Asia-Pacific Activists’ Coalition on TB (ACT Asia Pacific) and the regional arm of the Global Coalition of TB Activists (GCTA),” she added.  

The workshop was organized by REACH in partnership with USAID and the Stop TB Partnership. With support from USAID, REACH is implementing the TB Call to Action project in India, which seeks to strengthen USAID’s efforts to end TB in India by advocating for policies and programs that empower patients, caregivers and communities.

Elected representatives pledge commitment to fight against TB in Bihar

Patna, March 24, 2017: A high-profile gathering of elected representatives, public health officials, TB and HIV affected communities and representatives of civil society organizations pledged their commitment to the fight against TB in Bihar at a World TB Day programme held in Patna. This was organized by the State TB Cell, Government of Bihar, in partnership with REACH and the National Coalition of People living with HIV (NCPI+).

The oath-taking was led by Shri Krishna Nandan Prasad Verma, Honourable Minister, Public Health Engineering and Law, Govt. of Bihar. Shri Shyam Rajak, MLA Phullwarisharrif, Shri Neeraj Kumar, MLA Graduate Constituency, Dr Ravindra Yadav, MLA Jhajha Jamui; Shri Nitin Naveen, MLA Bankipur, Patna; and Shri Vinod Narayan Jha, Member Legislative Council also participated.

Speaking on the occasion, Shri Verma extended his support in the fight against TB, saying, “Earlier TB was considered a deadly disease and we thought no one would survive. Now we know there is treatment available. We need to work more especially in the rural areas of the state. Let us try to reach the unreached population, the homeless and the poor”.

Shri Neeraj Kumar, MLA, called on all departments to work together, noting the need for nutritional and social support for those affected by TB. “We need to link social welfare schemes to the TB programme”, he said. Shri Shyam Rajak MLA Phullwarisharrif, declared his commitment to work towards a TB-free Bihar. “Just as we eliminated small pox and other deadly diseases, we can defeat TB as well if all of us work together”. Shri Vinod Narayan Jha MLA spoke of the stigma associated with the disease.

State TB Dr (Maj) KN Sahai briefly described the TB programme in Bihar.  Shri UN Vidyarthi, Chairman – Bihar TB Association; Dr SK Akela, Addl. Project Director-BSACS; Dr VK Singh, Director TBDC; and Dr Kailash, Regional Director RHO also participated.

With over 1,300 deaths per day, TB continues to be a grave public health crisis in India. The New National Health Policy re-emphasizes India’s commitment to eliminating TB by 2025, reducing deaths, suffering and catastrophic costs related to the disease. “Through the Call to Action project we are implementing in Bihar, REACH will amplify and support India’s response to TB by involving previously unengaged stakeholders and broadening the conversation around the disease,” said Ms Smrity Kumar, Project Director, TB Call to Action.

REACH and NCPI+ partnered to observe the World TB week, with events held from 20-24 March including a rally, street plays, drawing and quiz competitions and a poster exhibition.