Tokyo Statement on Community Engagement in End TB Strategy
Asian National Stop TB Partnership Forum 2016

The Asian National Stop TB Partnership Forum 2016 was held on March 14-15, inTokyo, Japan, with the participation of a total of 18 delegates from 8 Asian countries /territories (Cambodia, Indonesia, Korea, Myanmar, Nepal, Philippines, Taiwan, andThailand). These participants represented the non-governmental organizations (NGO)and other civil society organizations (CSO) engaged in tuberculosis control.
The missions of the Forum were;-To enhance people’s awareness of the importance of their ownership for andcommitment to tuberculosis control activities,-

To

promotetheeffective

collaboration

betweengovernmental

andnon-governmental sectors in the fight against tuberculosis, with special reference tothe potentiality of women’s roles,-

To clarify the problems and challenges of tuberculosis control of each target area orcommunity to be addressed in their action plans, and-To advance cooperation between partners of different groups beyond country
borders.

During the two-day meeting the participants shared their experiences and views of theirgroups, as well as those of the Women’s anti-TB Association and Western PacificRegion of WHO, and had discussions over the ways to enhance respective group’activities in the perspective of End TB Strategy. Following are the summary findings ofpresentations, discussions, and proposals from the forum, as agreed upon by all theparticipants.
Background: Paradigm shift in the fight against tuberculosis
Along with the paradigm shift from the Millennium Development Goals toSustainable Development Goals, the global TB program has turned to End TB Strategy
as endorsed in 2014. In this strategy, tuberculosis is recognized more clearly than everas a socio-economic challenge, not merely as a medical issue, to which moreengagement of communities, or non-governmental organizations, is badly needed, as1

claimed throughout the pillars of the strategy. Specifically, integrated, patient-centered
TB care and prevention is claimed as the fundamental element in Pillar 1. This is alsostressed in the Regional Framework developed by WPRO, adapting the End TB
Strategy to its regions.
Roles of NGOs in End TB Strategies: Missions, Opportunities, andChallenges
In country presentations and group discussions, the following four points werehighlighted as important roles of NGOs / CSOs, each with special emphasis as
supplemented in numbers 1, 2, …. . Although the roles and challenges of NGOs/CSOs
are diverse and variable according to the countries and organizations, the key issues
such as community and patient-oriented approach were common, and this sharing wasfelt as most critical in promoting the spirit of the stop TB partnership.
1) Cooperation with the government in implementing NTP
1. Supporting TB case detection through urging symptomatic subjects, or TB suspects,to visit health facilities.
2. Encouraging patients to take medications regularly.
3. Increasing the awareness and knowledge of TB among community people on
various occasions to reduce the stigma, discrimination and superstition, and to takeproper action against illnesses.
2) Social support of patients and families
1. Supporting, educating, and empowering patients and their family facing financial
barriers through forging UHC.
2. Providing patients with food, transport, housing, etc., as important areas of patient
support.
3) Advocacy
1. Advocating voices of patients and vulnerable people.
2. Increasing awareness of TB among the community.
3. Creating patients’ groups, so that they have a stronger voice for claiming better
service and protection, and also enhancing community awareness of TB.
4. Creating peer support groups with high capacity to support vulnerable groups (e.g.,2the very poor, women, children, HIV-infected or elderly persons, etc.).
5. Advocating research for TB control, especially operational researches andresearches involving community activities.
6. Engage other areas of the society/community with TB, such as education,agriculture and MCH, etc..
7. Empower health activists and volunteers to set up networks at grass-root level
involving other community members
4) Women’s roles and potentials
1. Gender equity should be addressed in TB care, including access to health services
and knowledge of TB.
2. Women’s potential in community activities should be fully recognized.
Fund raising issues
Many groups suffer from inadequate budgets, but few of them use specificschemes of their own for fund raising, e.g., Christmas-seal campaign, Calendar sales,
donation box (in shops, etc.), and charity events, in addition to donations fromindividuals (group members and others) and companies.
Other funding sources include government programs, the Global Fund, WHO,Union, Stop TB Partnership, UNICEF, other bilateral plans (e.g., JATA, USAID,TBREACH), and charitable foundations.
Apart from the inadequacy of funds, possible concern may exist for receiving
donations from pharmaceutical industries (in some countries, also other health-relatedbusinesses), to say nothing of donations from tobacco and alcohol industries.
Challenges
1. The high turn-over rate of volunteers is common, possibly due to inadequate
incentives and lack of community recognition, or volunteers’ dignity.
2. Incentives for volunteers may include privileged free access to health services,periodic meetings for reporting volunteers’ activities, opportunities of training andexchange with other groups, awarding for outstanding performance, and provisionof travel allowances.
3. Addressing patient’s confidentiality or privacy.
4. In some cases, consensus between government and NGOs is not enough, and some3

care providers have difficulty in implementing International Standards of TB Care.
5. Low capacity of research activities, when NGO’s operational research is expected asvery significant, especially in UHC and social protection schemes.
6. Documentation of success stories of community activities may be important insharing recognition of bases of TB control such as UHC and patient-centered care.
Forum slogan
The forum decided to adopt a following slogan to be shared by member organizations asa priority message of activities.
- Women are creators of community health through family health.

Acknowledgement
The Forum acknowledges the contribution and efforts of the following individuals andorganizations that made the meeting possible and successful. The Forum also expresses
deep thanks to the observers for their kind interest in the meeting.

Participants[Organization] Cambodia: National Center for TB and Leprosy control (CENAT),
Cambodia Anti-Tuberculosis Association (CATA). Indonesia: Headquarthers of Forum
Stop TB Partnership Indonesia and Stop TB Partnership Cimahi City, Korea: Korean
National Tuberculosis Association (KNTA), Stop TB Partnership Korea, Myanmar:
Myanmar Maternal Welfare Association (MMWA), National Tuberculosis Program,Kachin State, Nepal: Japan-Nepal Health & TB Research Association (JANTRA),
Philippines: RIT/JATA, Philippines Inc. (RJPI), Taiwan: Taiwan Anti-TB Association(TATA), National Chang-Hua Hospital MDR TB Department, Thailand: TB/HIV
Research Foundation (THRF), Chiang Rai Volunteer Ladies against TB[Member] Cambodia: Khloeung Phally, Monyrath Chry, Chharvy Ringsey Keo,Indonesia: Mariani Reksoprodjo, Fitriani Manan, Korea: Seungjoon Chang, KangheeKim, Hong Jo Choi, Myanmar: Tha Zin Nw‚…, Ei Ei Chaw, Nepal: Ram Sharan Gopali,Jamuna Panthi, Philippines: Aurora G Querri, Leonardo G. Parungo Jr, Taiwan:Chih-YunLin,

Wei-WenChen,

Thailand:Ngamvitayapong-Yanai
4SarmwaiLuangjina,

JintanaStaff[Organization] Stop TB Partnership Japan, Japan Anti-Tuberculosis Association (JATA),
Research Institute of Tuberculosis, JATA, Council of Japanese Women•fs
Anti-Tuberculosis Associations, Western Pacific Regional Office of World HealthOrganization[Member] Ram Sharan Gopali, Makiko Goto, Yumi Ishikane, Nobukatsu Ishikawa,
Shoji

Kudo,

Ayako

Miyamoto,

Toru

Mori,

Nobuyuki

Nishikiori,

JintanaNgamvitayapong-Yanai Kosuke Okada, Kintaro Shibuya, Noriko Shirasu, Noriyo
Shimoya, Keiji Tanaka, Tomoko Tsuji, Takeko Yamashita

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