Isifo sephepha siselelinye lamazwe akwizifo ezibulalayo ezibulalayo kwimbali yoluntu, ezisoloko zikwindawo ephambili ebangela ukufa ehlabathini lonke. Ngokutsho kweWorld Health Organization (WHO, izigidi zabantu zigula ngesifo sephepha unyaka ngamnye, nobunzima obukhulu obuxhonywe kumhlaba ophantsi nophakathi. Kula mazwe, ingakumbi lawo agqalwa njengemiqobo ephezulu yeWHO, imiqobo yezemali ekhoyo yokunyamekela ininzi. Iinkqubo zezempilo zisoloko ziphathwa phantsi kwesifo, izixhobo zokuxilonga, kwaye ukufikelela konyango olusebenzayo kuxhomekeke kwimiba okanye kwingeniso. Kulo mongo ukuba uncedo lwamanye amazwe luba ngumqobo obalulekileyo wempilo yehlabathi lonke. Imiqobo yemali kunye noncedo lwezobugcisa, zibangela ukuba amazwe afikelele kwimiqobo ephumelelayo ekungenelweni kwezifo ezinokulinganayo.

Ukulwa neTB asilulo nje ucelomngeni lwezonyango; luvavanyo lomanyano lwehlabathi lonke. Amazwe aphezulu asoloko elawula umthwalo ombini wesifo, ukulwa neTB kunye nezinye izisongelo zempilo ezicinezelayo njengeHIV/AIDS nemalariya. Uqingqo-mali lwempilo lwasekhaya, olusele lunciphile, lusoloko lungonele ukuhlangabezana neendleko zodweliso lwesizwe lweTB. Oku kulapho umanyano lwezizwe ngezizwe lungenayo, lunika izihluzo zemali kunye nobuchule bobugcisa bokwakha impendulo esebenzayo. Ngaphandle kokuxhaswa oku, usukelo lokuphelisa umqeda-TB ngo-2030, isisulu esimiselwe yiZizwe Ezizimeleyo iDevelopmentalmentation Development, siya kuhlala singekho.

Indima Ebalulekileyo Yoncedo Lwamanye Amazwe Ekulawuleni Isifo Sephepha Emhlabeni Wonke

Iinyaniso zezoqoqosho zamazwe anomthwalo ophezulu zidala umahluko omkhulu phakathi koovimba abafunekayo ekulawuleni iTB noko kukhoyo emakhayeni. Isifo sephepha sisifo sobuhlwempu, kwaye amazwe athwala umthwalo wawo omkhulu ngokufuthi awanawo amandla okuxhasa ukulawulwa kwayo. Uncedo lwamazwe angaphandle lunento yokwenza nalo msantsa wemali, olusebenza njengenjini yobuchule bobuchule boluntu lonke lweTB. Le nkxaso ayiyosongezo nje; isoloko iyiyo engumthombo oyintloko wemali yokufumana unyango, amayeza, kunye nobuncwane obukhethekileyo babantu.

Ukwakhiwa Kwemali Ehlabathini Lonke

Uncedo lweTB lwamanye amazwe luthunyelwa ngomjelo oluntsonkothileyo weentlangano ezininzi, abanikeli bezibonelelo, neziseko ezizimeleyo. Owona mthombo mkhulu wemali yehlabathi lonke yeTB yiNgxowa-mali yehlabathi Lonke yokulwa noGawulayo, iTB kunye neMalaria. Olu manyano lwahlukeneyo luzilungiselela ukuqokelela nokuzinikezela ngezigidi zeeramawaka zeerandi ukuxhasa iinkqubo kumazwe angaphezu kwekhulu. Kumazwe amaninzi aphezulu anezibonelelo, iNgxowa-mali yemali yehlabathi lonke exhasa uninzi lwendlela ye-TB, igqubugq, igquma yonke into isuka ekufumaneni kwemiqatha ye-layini yokuqala kunye neyesibini yeziyobisi ukuze kuhlawule abasebenzi bempilo.

Uncedo olusuka kumazwe anjenge-United States, ngokuyintloko nge-Arhente yoPhuhliso lwezizwe ngezizwe (USAID), lukwadlala indima enkulu. Inkqubo yenqanawa ye-USAID ehamba nomphathi weTB ixhasa ungenelelo olujoliswe kuyo kumazwe anomthwalo omkhulu, ibhekisa kwizixhobo zonyango, ukuphucula iziphumo zonyango, kunye nokulwa neziyobisi ze-apply TB. Ezinye iziphumo ezibalulekileyo ziquka i-UNITAID, ezithi zifake iprojekthi zokuphucula ixabiso le TB kunye namayeza, kunye ne-Stom shabic shartrial shartrip, ezidibanisa ihlabathi lonke, i-advokiecevs kwaye zinika uncedo lobugcisa. Le nkxaso yemali yemali yenza umnathathi okhusela imali evumela amazwe aphezulu anezixasombululo ukuba asebenze kwaye asebenze ukuphucula ulawulo lwesifo.

Imimandla Engundoqo Apho Uncedo Lwamanye Amazwe Lunempembelelo Engqalileyo

Uncedo lwangaphandle asilotshengo olungenanto; lujoliswe kwimimandla ethile ebangela ukubuyiselwa kobomi obugciniweyo nokudluliselwa okungenangozi kuphazamisekile. Ukuqonda ezi ndawo zingundoqo kunika ingqiqo ngendlela inkxaso-mali yezizwe ngezizwe eguqulela kwiziphumo zempilo yoluntu.

Ukomeleza Unyango Lonyango

Ngokwembali, ukuxilongwa kweTB kuxhomekeke kwimicroscopy encinane, inkqubo ephantsi kodwa engekho mthethweni kakhulu, ingakumbi kubantu abahlala neHIV kunye nabantwana. Uncedo lwamanye amazwe luye lwaqhuba utshintsho lokuhlola kumazwe omthwalo ophezulu ngokuxhasa ukusetyenziswa kwee-molekyuli ezikhawulezayo, njengenkqubo ye-GeneXperst. Le matshini iyakwazi ukufumanisa ngokuchanekileyo isifo seTB nokufumanisa ukuxhathisa kweziyobisi ngaphantsi kweeyure ezimbini, ivumela ukunyuswa ngokukhawuleza kwendlela yonyango olufanelekileyo. Imali yezizwe ngezizwe igqubuthelela iindleko zezixhobo, iinqwelo-mafutha, kunye nezivumelwano zokuzigcina ziqhubeka zihamba kwiikliniki ezikude. Uncedo lukwaxhasa ukumiswa kwemichiza ekhoyo kunye nenkqubo yokuthuthwa kwemichiza efunekayo ukushukuma koo kwasemaphandleni ukuya kwii-cental ephakathi.

Ukukhusela Amaqolo Okunikwa Kweziyobisi Angenangxaki

Unyango oluthe ngqo lweTB lufuna unyango lwezibulali-ntsholongwane ezine ukuya kwezintsethu zeenyanga. Unyango lwe-DR-TB olunika amayeza amaninzi alwanya i-DR lungaphezulu, lunetyhefu eninzi, kwaye lubiza kakhulu. Ukuphazamiseka kokunikezelwa kwala mayeza kuyintlekele, nto leyo ekhokelela ekungaphumeleli konyango, ukuhambela phambili kokuxhathisa kweziyobisi, kwaye kwandisa ukufa. Unyango lwamazwe angaphandle luzinzisa unikezelo lweziyobisi lweziyobisi emhlabeni wonke. I-Drubian Facity (DF), exhaswe yi-Stop TB , ixhaswa yi-Stop, ixhaswa ngabantu bezizwe ngezizwe zonke kwaye inika ukulingana okuphezulu, ukunyuka kwemichiza yesifo se-TB kumazwe ngamazwe ngamazwe, ukusetyenziswa kwemali ephantsi kwe-100. Ukusetyenziswa kwe-atrobithiweyo, i-GDF ihlisa ixabiso lobomi beziyobisi olufana ne-accuriesss.

Ukunikezelwa kwenkxaso-mali

Amaphulo ezempilo kawonke-wonke aqhutywa ngoncedo lwamanye amazwe abalulekile ekunciphiseni ihlazo elinxulumene nesifo sephepha nokukhuthaza abantu abaneempawu zokufuna unyango. Kubantu abaninzi abakwimeko ephezulu, isifo sephepha siyaqondwa kwaye soyikwa, nto leyo enokulibazisela ukuxilongwa nokunyangwa. Amanyathelo okukhuthaza uluntu aqhutywa ngoncedo asebenzisa amajelo oluntu, iinkokeli zoluntu, kunye noontanga bokufundisa ukusasaza ulwazi oluchanileyo ngokusasaza isifo se-TB, ukuthintela, nokufumana unyango lwamadlamdla. Ngaphezu koko, uncedo lwamanye amazwe luxhasa unyango olusekelwe ngqo kwibutho labantu (DOT), apho abasebenzi bezonyango abaqeqeqeshiweyo besebenzisa amayeza abo. Le mizekelo iphucula i-mediote, inciphisa uxanduvano kumthwalo wezibhedlele, kwaye ixhasa izigulana ezibhedlele ezinokulandela iimpulu.

Ukwakha Umsebenzi Wezempilo Oyingcaphephe

Impumelelo yayo nayiphi na inkqubo yeTB ixhomekeke kubantu abadlulisela inkathalo. Amazwe anomthwalo ophezulu asoloko ethwaliswa kukunqongophala okunzima kwabasebenzi bonyango abaqeqeshiweyo, abasebenza ngoonomathotholo kunye namagcisa oonolwazi ukuya kubongikazi nakubenzi bezempilo boluntu. Uncedo lwamazwe angaphandle luzinikela kakhulu ekuphuhliseni inkxaso-mali yemiba yoluntu ngokuxhasa inkqubela yangaphambili kunye nokuxhasa iinkqubo zoqeqesho lwezempilo. Oku kuquka ukuqeqesha abasebenzi abasebenza kwimigaqo yonyango elungeleleneyo, ulawulo losuleleko, kunye nolawulo lweziphumo ezisecaleni zeziyobisi ze-DR-TB. Uncedo lukwaxhasa ukuditya nokuzinza kooomantralathi benkqubo abakhethekileyo, njengabaphathi besifo seTB kunye ne-MEE (monito kunye novavanyo), ababalulekileyo ekuqinisekiseni ukuba iinkqubo kunye noovimba abasebenza kakuhle.

Ukunyuka kwezifo kunye neenkqubo zogcino-lwazi

Awukwazi ukulwa noko ungakwaziyo ukukubona. Iinkqubo zokujonga iziphumo zesifo sephepha ziyafuneka ukuze zibone ukuba sisiphi na isenzeko seTB, zijonge ukuvela kokuchana kwamayeza, zilinganise impembelelo yokungenelela. Kumazwe amaninzi anobunzima obuphezulu, ezi nkqubo azinamandla okanye ziyaqhekeka. Olu ncedo lunceda ukwakha ubugcisa bolwazi obufunekayo kwizixhobo zolwazi ze-elektroniki kunye nokuhlola okusekelwe kulwazi. Oku kuquka ukunikezela nge-software, i-hardware, kunye nokuqeqeshwa kokungena kogcino-lwazi kunye nohlalutyo. Uphando oluphuculiweyo luvumela abaphathi bempilo ukuba baqonde iindawo ezishushu, oovimba abazixhobayo, kwaye bafumane ukuqhama ngexesha lokwenene. Utyalo lwenkqubo yogcino-data luyilungu lolwazi olusisiseko lolawulo, luqinisekisa oko kubungqina, hayi ukusetyenziswa kwe-groodry, i-dry-dry-ory.

Uphando lwetyala: Impumelelo elinganiswayo kwiintlanga ezidume kakhulu

Impembelelo yoncedo lwamanye amazwe ayithethwa. Kulo lonke ihlabathi, amazwe axhaswa kakhulu ngamazwe abonise inkqubela ebalulekileyo ekunciphiseni umthwalo weTB. Olu hlolisiso lubonisa oko kunokwenzeka xa kuxhaswa ngemali nokuzibophelela kwezobupolitika.

EIndiya: Ukucutha Izinto Ezixilongwa Yimolekyuli

I-Indiya ithwala owona mthwalo mkhulu weTB ehlabathini, ityala elimalunga nekota yamatyala omhlaba wonke. Ngokuxhaswa ngamandla yiNkxawa yehlabathi, iUSAID, kunye namanye amaqabane, iNational TB I-Endromediation Program (NTEP) iguqulelwe kakhulu. Olu ncedo lwangaphandle luye lwasetyenziswa ekulinganiseleni umatshini we-GeneXpert kunye nowe-Truth we-Modeltary ohlola ii-molecule ukusuka kumakhulu ambalwa ukuya kumawaka ali-300, okuzisa ngokukhawuleza umlinganiselo omlinganiselo ongaphantsi kweqondo lephepha le-TB. Oku kuye kwalinciphisa kakhulu ixesha lokuxilongwa nokuphuculwa kwemiqatha yemeko. Uncedo lukwaxhasa ukukhuthulwa kwe-Niksha iqonga lombane, inkqubo ebanzi yokuhlola ii-molecurediota ezihambayo ezidlulayo, ukuxhasa iziyo ezinkozo ezifumaneka nge-mali, kunye nokuncedisa ekuncediseni kwe-TB.

UMzantsi Afrika: Isalathisi/Imodeli yoHlahlo lweTB

UMzantsi Afrika unesinye sezona mali ziphezulu zokudibana neTB neHIV, okwenza ukudityaniswa kwezi nkqubo zonyango lwezifo zimbini kube yinto yokuqala kuluntu. Uncedo lwamazwe angaphandle, ingakumbi ukusuka kwiSicwangciso se-Emergency se-AIDS (PEFAR) kunye ne-Global Fund, ibe sesona sisembindini wokudityaniswa kwesi sifo. Imali yehlabathi jikelele yenza ukuba kubekho uthungelwano oluninzi lwekliniki-kliniki olunika unyango lwe-RGPS (ARTB) kunye nonyango lweTB phantsi kophahla olunye. Uncedo lwaxhasa uqeqesho lwabongikazi lokubonisa bonke abaguli abanezikhuseli abaphezulu ze-RGB (PT) kunye nokuqalisa unyango lweTB (T). Iziphumo zokudibana nokungena kwe-transfer, i-South Africa ibone ukuncipha okuninzi kokufa kweTB, ukubonakalisa ukusetyenziswa kwasotywa kwemodensile-se.

IBangladesh: Ukunyangwa kweTB okuxhaswe ngabemi

IBangladesh iye yajamelana nobhubhani onzima we-milligin-druid TB ye-Bangladesh, uhlobo lwesifo esinzima kakhulu nesibiza imali eninzi ukunyanga. Ngoncedo lwamaqabane amazwe ngamazwe afana ne-Stop TB internant kunye ne-Médecins Sans Frontières (MSF), iBangladesh yaphuhlisa imodeli esekelwe kwimodeli esisiseko yoluntu yonyango lwe-MDR-TB. Endaweni yokufuna izigula ezihlala ezibhedlele ukwenzela ukuhlala ezibhedlele ixesha elide (oko kwakungumthetho oqhelekileyo), ibonelela inkqubo apho abaguli abanokunyangwa kuyo ngokwabo ngokwabo ngezakhono abaqeqeshiweyo. Le yindlela yonyango ephuculwe ngoku ilungeleyo nokuzinzisa izibonelelo zoncedo loncedo lobomi nokuzigcina phantsi komthwalo wempilo kwinkqubo yempilo. I-Bangladeldal inika impumelelo yendlela elungele ukusetyenziswa ngoku, ngoku i-TRCM.

Ukuzingisa Nokujamelana Nocelomngeni Olungakumbi

Phezu kwazo nje izinto eziphawulekayo eziphunyezweyo eziye zancedwa ngoncedo lwamanye amazwe, ukulwa neTB akukapheli. Indlela yokusiphelisa ithintelwa lucelomngeni oluzingisileyo olufuna ukuhlala luphaphile yaye luxhathiswe ngabantu bamazwe ngamazwe.

Isisongelo Sesifo Sephepha Esinemichiza Eninzi

Ukwanda kwemichiza elwayo neTB kumela esinye sezisongelo ezinzulu kukhuseleko lwempilo yehlabathi lonke. Ukunyanga iMDR-TB kunye ne-amayeza alwayo eTB kuntsonkothile, kubiza, kwaye ixesha elininzi kubandakanya amayeza amaninzi, amaninzi aneziphumo eziyingozi, kwaye unyango lusezantsi kakhulu kuneziyobisi ezinokusetyenziswa yiTB. Indleko yonyango lwe-MDR-TB. Ixabiso lokunyanga ityala elinye le-MDR-TB linokuba likhulu kakhulu kunexesha lokunyanga iziyobisi-isifo se-TB, liquka ukuxhonywa kwemali eninzi kakhulu kwemali kwimiqatha yemali efunekayo kuzo zombini iindleko zoqingqo mali kunye nezixhobo zangaphandle. Ngoxa iziphumo zokusetyenziswa kweziyobisi zincinane, kunye nezobuncinci, zifumaneka ngaphandle koqoqoliso lwamazwe angaphandle.

Ukulondolozwa Ngaphezu Kwemali Yamazwe Asemzini

Amazwe amaninzi athe axhatshazwa kakhulu luncedo lwamanye amazwe ukuze aqhube iinkqubo zeTB. Oku kubangela ukuba kubekho ubungozi obucacileyo. Ukuba ukutshintsha kwezinto eziphambili zomnikeli okanye uqoqosho lwehlabathi lonke lungena kuhlengahlengiso, ukuncitshiswa kwemali okubangelwa yintlawulo kungakhawuleza kutyhile iminyaka yenkqubela. Ukukhuthaza ukugcinwa kwemigudu yokulawula iTB kungumngeni omkhulu. Usukelo lwamazwe ngamazwe lugxininisa ngakumbi ekujongeni "kuceba ukulwa" ukunceda amazwe athathe inkxaso kwiinkqubo zawo zempilo. Oku kubandakanya ukukhuthaza ukuqokelelwa kwemali emakhaya ukuze afumane inkxaso yempilo, uqinisa ubuchule bokwakha imveliso yeziyobisi nokufumana ingeniso. Injongo yoluntu lulwa nenkqubo yempilo ekwazi ukuxhasa ukulwa ne-TB xa kuthe kwamazwe angaphandle.

Ukuthetha nabachaphazelekayo

Isifo sephepha sisifo sobuhlwempu, kwaye ukuqhubekeka kwaso kusekelwe ekungalungelelanini kwentlalo nezoqoqosho. Ukungondleki kakuhle, ukugxabhagxabhaza kwezindlu, ukungena komoya obandayo, kunye nomoya opholileyo ngaphakathi, bonke abaqhubi abanamandla bobhubhani besifo seTB. Uncedo lwamazwe angaphandle olujoliswe kuphela ekungeneleni kwezamayeza alunakwanelisa isifo sokungalawuleki kwale ngxaki ukuba ezi zipheli zizinto zokuthintela intlalo-ntle yabantu zingekabhekisiselwa. Iinkqubo zamazwe ngamazwe ngamazwe ziqalisa ukudibanisa ukulawulwa kweTB nobuhlwempuzeko obugqithisileyo. Oku kuquka ukuxhasa izigulo ezintshunxileyo kunye neentsapho zabo, ukudibanisa ukusetyenziswa kwentlalo entlalo-ntle, nokuxhasa intlalo-ntle ekhoyo. Ukusetyenziswa kweziko zasekuhlaleni kubandakanya kakhulu kuthenwa koluntu.

Izinto Eziza Kuqala Ezifanelekileyo Kwihlabathi Elingenayo Isifo Sephepha

Ukujonga phambili, uluntu lwehlabathi kufuneka lwakhe kwisiseko esinikwe luncedo lwamanye amazwe ukuphuhlisa nokusebenzisa iindlela ezisebenzayo. Uqwalaselo lusuka kulawulo ukuya kukhupha, nto leyo eza kufuna zombini ukunyuka kwezixhobo ezikhoyo nokuzidibanisela ekuhlaziyeni.

Ukugutyungelwa Kwempilo Yendalo Yonke

Eyona ndlela ihlala iqinileyo yokulwa neTB kukwakha iinkqubo zempilo ezingenakulinganiswa ezinokunceda wonke umntu. Ukutyhalela uwonke wonke Wezempilo inxulumene kakhulu nolawulo lweTB. Xa abantu benolwazi oluphambili, basenokufunyaniswa beselula kwaye bagqibelele unyango lwabo. Uncedo lwamazwe angaphandle lusetyenziswa ngokuqhubekayo ukuxhasa inkqubo yezempilo yokomeleza (HSS), nto leyo equka ukwakha iitsheyina ezingcono zokunikezela, ukuphucula imithambo yegumbi lerekhonta, kunye nokuxhasa iinkqubo ze-inshorensi yempilo kawonke. Ngokuxhasa ukufuduka ukusuka kwindawo ethe nkqo, ukuxhasa ukudibana kwezifo, inkqubo yokuxhasa, inkqubo yokuxhasa, abanikeli banceda amazwe afanele afumane inkxaso kwi-TB kunye nezinye iingxaki zempilo. Oku kuluncedo ngakumbi, nokunye ukukhuthaza iziphumo, nokuxhasa iinshobondlo-mali kawonke.

Ukubuyiselwa konyango kunye nokuxilongwa

Unyango lwangoku oluqhelekileyo lweTB olusetyenziswayo ngokubhekiselele kwimichiza ye-TB luyinto ekudala ikho. Uphando kunye nophuhliso, oluxhaswa kakhulu ngabantu bezizwe ngezizwe kunye nemibutho yoncedo, lujoliswe ekufumaneni unyango olufutshane, olukhuselekileyo nolulula. Ukuqalisa konyango lwe-odolo-odar-TB olusekelwe kwi-bedaquiline kunye ne-delawad kumela impumelelo enkulu. Uphando lwexesha elizayo lufuna ukunciphisa unyango lwe-TB olunokubonwa njengeenyanga ezimbini okanye ezingaphantsi, eziya kutshintsha ukubambelela nokuncitshiswa komthwalo kwizigula kunye neendlela zezempilo. Ngokufanayo, ukwenziwa kovavanyo lokuhlola kubhekiso-del'umva kumele ukuba kwenziwe kwipopu ye-post ngaphandle kwezixhobo zombane. I-Pijective yezobugcisa kwiziphumo zexesha elizayo ezilwanolwazi lwe-TBCB ifuna uncedo lwangaphandle kolwazi olufuna ukuphumelela kwizixhobo ezikhoyo emhlabeni wonke.

Ukufuna Umchiza Omtsha

Kuphela komjovo weTB ogunyazisiweyo, iBCG (iBacillus Calmette-Guérin), inikela ukhuseleko oluthile kwiintlobo ezimandundu zeTB kwiimveku kunye nabantwana abancinane kodwa ithe yasilela ukuphumelela kakhulu ekuchaphazeleni iTB yemiphunga kwabakwishumi elivisayo nabadala. Ukuvelisa isitofu esitsha nesinempumelelo kakhulu sijongwe njengesixhobo esinamandla esifunekayo sokuphelisa esibulala isifo. Isitofu esinokuthintela ukusulelwa kwesifo, okanye ukuthintela ukuqhubekeka kwaso kusuleleko olusebenzayo kwizifo ezisebenzayo, siya kuba nefunxele kakhulu ekudlulisweni kwemichiza. Abaninzi abazamkela isitofu bemi bafumana iimvavanyo eziphambili zonyango. Ukuphuhliswa kwesi sisixhobo sokugomathiso esibiza imali eninzi kakhulu nesiphezulu esixhomekeke kakhulu ekuvelisweni kwemali kawonke wonke kwimibutho elifana ne-ephalthrop kwimishoni ye-Foundation. Imali ephumelelayo kwi-Foctivection ephumelelayo kwi-eactive kusetyenziswa kwi-octivel, uphandol

Umlo wokulwa nesifo sephepha ngumgama omde owenziweyo, hayi owenziweyo. Inkqubela eyenziwayo ekunciphiseni isenzeko seTB nokufa kwabantu kwiminyaka engamashumi amabini edluleyo ingqinelana namandla okusebenza ngokumanyeneyo. Uncedo lwamazwe asemzini luye lwanika isiseko esibalulekileyo socwangciso lwesizwe ukuba lwakheke. Ngokuqhubeka nokuveliswa kwemiqathango eqinileyo yempilo, uphando olutshayelelweyo, kunye nenkathalo ephakathi komonde, uluntu lwehlabathi lonke lungaluxabisa ukuzimisela kwalo ukuphelisa i-TB. Izenzo ezixhathayo nentsebenziswano zemali azizizinto nje eziluncedo; zilulo lwezorhwebo kwizinto ezikhuselekileyo, ezisempilweni, ezilungele ukulinganayo, nezinokuthe kratya kwihlabathi kumntu wonke.