Rwanda

Rwanda is one of the countries highly affected by tuberculosis (TB) - every year more than 7,000 TB cases are reported. TB is one of the leading causes of illness and death in adults. As with TB disease, HIV/AIDS is a leading cause of illness and death in Rwanda. The overlap of TB and HIV epidemics creates a particular challenge for TB control in Rwanda. Rwanda has achieved a high level of treatment success aligned with strategic goals; however, case-detection remains quite low. Other challenges in Rwanda still remain including a low case-detection rate and inadequate surveillance and reporting from private practioners. Recovery from the effects of a civil war, leading to genocide, in 1994 is ongoing. 

Role KNCV Tuberculosis Foundation

KNCV TB Foundation has assigned senior staff from the international unit, TB CAP and the research unit to assist Rwanda with multiple projects for up to 8 weeks per year by each consultant with both field visits and desk support. This support will include general TB control as well as monitoring and evaluation, TB infection control, TB/HIV, MDR-TB, laboratory strengthening, grant writing and a focus on vulnerable groups, particularly prisoners, internally displaced persons, and orphans.

Achievements

Rwanda has made great strides towards more comprehensive TB control despite the many challenges that it faces. Rwanda has implemented country-wide the internationally recommended DOTS strategy for TB control. The national programme also has a Green Light Committee approved MDR-TB treatment site under internationally recognized standards, and succeeded in conducting a drug resistance survey in 2004-5. Rwanda has a strong central unit with regular support and supervision of the districts. In 2009, KNCV has supported the development of workplans and performance frameworks for Global Fund proposals as derived from from the 2009-2013 Rwandan TB strategic plan, assisted in writing two Global fund grants which were subsequently approved, supported in the development of a national laboratory strategic plan and facilitated the development of a plan for an African training center of Excellence for MDR-TB in Rwanda. Further, a routine data quality audit tool was piloted in Rwanda with technical assistance from KNCV. KNCV’s research unit is also collaborating with the Rwandan NTP on a prevalence survey (see link). 

Next steps

KNCV will support the Rwandan NTP to develop a protocol for a scientifically-sound prevalence survey. KNCV will also support the establishment of an African MDRTB training center of Excellence in Rwanda. Furthermore, other priority technical support will be discussed and agreed upon with the national TB programme (PNILT) during the course of 2010.