The Union:

Paula I Fujiwara, MD, MPH

Scientific Director, The Union

Citizen News Service

September 19, 2017
TB, HIV, Lung Health, NCDs, Tobacco Control and Policy
Union/MSF OR Model

MDRTB Short-course
Treatment Trials
 S RT IT Course
(Structured Operational Research and Training IniTiative)
Union and MSF Model

Purpose: To teach practical skills for

conducting and publishing operational research

Approach: combines training with implementation

Product oriented [a submitted research paper]
Modular approach
Milestones must be achieved to stay in course
Targets must be achieved to keep the brand
 Research Projects undertaken in 39 courses
Research Project Subject Number
Tuberculosis / HIV-TB / Diabetes-TB 226
HIV/AIDS 46
Maternal and Child Health 18
Malaria, NTDs and Ebola 71
Malnutrition 5
Other [smoking, NCD, Cancer] 87
TOTAL 453
 Outputs from 26 completed OR
courses: by 30 June, 2016

Participants starting the course 314

Participants finishing the course with all 288 (92%)

milestones completed
Scientific papers submitted to peer- 329
reviewed journals
Papers published or in press 279 (85%)
 Union MDRTB Short-Course Tx Studies
Observational Cohort
(9 West African countries)
STREAM
Standardised Treatment Regimen of Anti-Tuberculosis Drugs for
Patients with MDR-TB
Performed w/in framework
Randomized control trial, non- of NTP PMDT approach
inferiority design No comparison regimen
Control regimen: WHO
recommended regimen Study regimen
Study regimen Same as STREAM,
9 mo Clofazamine, except lower moxifloxicin
Moxifloxacin, Ethambutol, dose
Pyrazinamide 83% tx success; adopted by
In addition to initial phase WHO
w/ 4 mo Kanamycin, INH,
Prothionamide
International Management Development Programme
 International Management and Development Programme
(IMDP)
Goal: Management training for health professionals Strengthened health
systems and quality patient care
Specific courses addressing:
Developing budgets that meet governmental and/or donor requirements
Organising and training healthcare staff at different levels
Coordinating procurement and management of medicines and
supplies
Handling human resources issues, such as motivating overworked staff
Creating communications plans to disseminate important health
messages
Adhering to practices needed to monitor and evaluate programme
performance
 Uganda
Active Case Finding

Decreasing Tobacco
Use
Active TB-Case Finding in Uganda:
SPARK-TB and SPARK-TBplus
Slum Partnerships to Actively Respond to TB in
Kampala (SPARK-TB) (12/11-6/14)
SPARK-TBplus expanded to 4 districts w/ 1.7M
population (7/14-current)
Active case finding increased access to
quality TB diagnosis and treatment
Targets private health facilities for urban poor
traditionally outside of NTLP purview
 SPARK-TB Results
Partnership with Ministry of Health, Kampala City
government, 70 private health facilities to identify
people with TB symptoms, diagnose and treat
20,423 identified with TB symptoms
1725 TB cases diagnosed and treated
80% success rate
Expansion planned through new Global Fund
proposal
Union Role in Global Initiative to
Reduce Tobacco Use 2007-2016
Support to governments and civil society
low- and middle-income countries
PART
highest1 prevalence
LITA KASD GUBERGREN
of tobacco use
introduction and enforcement of policies proven to
Subtitle
reduce in lowercase
tobacco consumptionand thin font
Technical Advice to >130 government departments and
Civil Society organisations
Over 300 grants across 43 countries
100 Technical Capacity Building courses in 21 countries
for 3150 participants
Union Impact in Global Initiative
to Reduce Tobacco use
Introduced national smoke-free laws in 28 countries
Protected 2.85 billion people from harms of second-
hand smoke
Graphic health warnings on tobacco packaging have
helped smokers quit and discouraged others from
starting in 18 countries (2.59 billion people)
10 countries have established sustainable tobacco
control funding (2.05 billion people)
 World Conf on Lung Health
Guadalajara, Oct 2017
Media Field visit on ZTB: cheese factory, abattoir
Press conferences
ZTB press conference to launch ZTB Roadmap
New TB science and technologies (vaccines, molecular
tools, serologic tests
Late breakers sessions
TB
TBHIV and DM
Students work featured