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1 The Lancet Respiratory Medicine. The End TB strategy: a global rally. Lancet Respir Med 2014; 2: 943. 2 WHO. The End TB Strategy. Geneva: World Health Organization, 2014. http://www.who. int/tb/post2015_TBstrategy.pdf (accessed Dec 2, 2014). 3 Boulanger RF, Seidel S, Lessem E, for the Critical Path to TB Drug Regimens’ Stakeholder and Community Engagement Workgroup. Engaging communities in tuberculosis research. Lancet Infect Dis 2013; 13: 540–45. are rarely, if ever, included in decisionmaking processes, and are treated as passive individuals. Also of concern is the fact that the editorial mentions the need to make resources reach the poorest communities and most marginalised members, and yet does not mention the need to empower and work with them, or to fight the social inequities that put these communities in situations of poverty and marginalisation, of which tuberculosis is a visible consequence. Isolated examples of engagement with communities exist. The Community Research Advisors Group of the Tuberculosis Trials Consortium and the Global TB Community Advisory Board are examples of successfully integrating communities into the research process from protocol conception to results dissemination. Within the International Union Against TB and Lung Disease, eff orts exist to improve communication with and engagement and inclusion of aff ected communities for all activities of the organisation, especially the planning of and participation in their annual Union World Conference on Lung Health. The TB Alliance, a product development partnership, has an integrated community engagement programme that helps give the community perspective on the research that the Alliance implements. However, to really eliminate tuberculosis, patients, survivors, and affected communities have to be included from the beginning and throughout the whole process, from research design through to programmatic implementation on a regular basis in all activities to address tuberculosis. The affected communities should no longer be passive recipients of care but valuable partners with decision-making power in choices and policies that affect them. The examples should no longer be the exception. We must address the underlying issue driving the tuberculosis epidemic—inequity. Douala, Cameroon (MMN); National Institute for Medical Research, Dar es salaam, Tanzania (EN); University of Calabar Teaching Hospital, Calabar, Nigeria (ONN); and College of Medicine of the University of Lagos, Lagos, Nigeria (OO) |
