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4 lessons learned fighting tuberculosis in Syria

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Lessons LearnedTuberculosis patients displaced by conflict may lose access to health services, causing an interruption in treatment that increases their risk of developing multi-drug resistant strains of TB. Photo: UNDP Syria

Tuberculosis thrives on war and suffering. In theory, Syria offers the perfect breeding grounds for the disease. A lack of access to adequate medical services and poor and crowded housing conditions have created conditions ripe for the spread of tuberculosis.

 Yet, TB has been largely kept in check. Some 3,479 people were placed on treatment in 2015, a 150 percent increase compared with 2013. The TB treatment success rate has also been maintained at 80 percent during the conflict. 

UNDP has been supporting Syria to tackle TB since 2007, in partnership with the Global Fund. The onset of war in 2011 made this highly complex and has required a range of innovative approaches. 

The experience highlights four vital lessons, which could work in other crisis countries:

The courage and innovative thinking of front line health workers is critical. 

Syrian health workers and volunteers are striving to keep services going, despite a crumbling health system and exceptional security threats. Theirs is a story of heroism in a country that has lost 750 health workers since the start of the crisis. They work bravely and ingeniously so services reach all areas, even those controlled by ISIS. Using mobile applications like WhatsApp, they reach patients, coordinate medicine supplies, monitor stock levels and transmit lab results. 

International support must work with remaining local health services.

Peace will eventually return to Syria, and the health system will recover. Setting up parallel humanitarian arrangements works to the detriment of longer-term sustainability. Continued support for local health services and workers during this protracted conflict is the most far-sighted approach to fighting TB in contexts such as Syria.

International support must reach all people, not just the displaced. 

Syrians who remained and whose access to health services is also compromised are equally important. Virtually all internally displaced people live in host communities and informal settlements, not in organized refugee camps. They live together, share the heightened risk, and have the same rights to prevention and treatment services. 

Maintain vigilance in spotting multi-drug resistant strains.

Curing tuberculosis requires months of daily medication and medical supervision. Displaced patients may lose access to services and interrupt their treatments, increasing the risk of developing multi-drug resistant strains. The number of patients ‘lost’ to treatment in Syria has been limited, but this risk is growing.

These lessons from Syria are important for the global response to TB. Now is not the time to stop the momentum. Progress made in the midst of war is fragile and must be nurtured. The courageous people of Syria need continued support and resources to do their job.

A longer version of this post was originally published on Devex.

Blog post Syrian Arab Republic Health Crisis response Håkan Björkman

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