Health systems in the Republic of Congo: challenges and opportunities for implementing tuberculosis and HIV collaborative service, research, and training activities.
The Republic of Congo is on the World Health Organization (WHO) list of 'high burden' countries for tuberculosis (TB) and HIV. TB is the leading cause of death among HIV-infected patients in the Republic of Congo. In this viewpoint, the available data on TB and HIV in the Republic of Congo are reviewed, and the gaps and bottlenecks that the National TB Control Program (NTCP) faces are discussed. Furthermore, priority requirements for developing and implementing TB and HIV collaborative service activities are identified. HIV and TB control programs operate as distinct entities with separate case management plans. The implementation of collaborative TB/HIV activities to evaluate and monitor the management of TB/HIV co-infected individuals remains inefficient in most regions, and these activities are sometimes non-existent. This reveals major challenges that require definition in order to improve the delivery of healthcare. The NTCP lacks adequate resources for optimal implementation of control measures of TB and HIV compliance and outcomes. The importance of aligning and integrating TB and HIV treatment services (including follow-up) and adherence support services through coordinated and collaborative efforts between individual TB and HIV programs is discussed. Aligning and integrating TB and HIV treatment services through coordinated and collaborative efforts between individual TB and HIV programs is required. However, the WHO recommendations are generic, and health services in the Republic of Congo need to tailor their TB and HIV programs according to the availability of resources and operational feasibility. This will also open opportunities for synergizing collaborative TB/HIV research and training activities, which should be prioritized by the donors supporting the TB/HIV programs.
Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo; Centre de Recherche Biomoleculaire Pietro Annigoni (CERBA), Labiogene, Université de Ouagadougou, Ouaga, Burkina Faso.
Laure Stella Ghoma
LS
Linguissi
Chantal Biya International Reference Centre, Yaoundé, Cameroon; Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Luc Christian
LC
Gwom
Chantal Biya International Reference Centre, Yaoundé, Cameroon; Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon.
Celine Nguefeu
CN
Nkenfou
UNZA-UCLMS Project, University Teaching Hospital, Lusaka, Zambia.
Matthew
M
Bates
Institute of Clinical Medicine, University of Aarhus, Denmark; The Royal Hospital, Muscat, Oman.
Eskild
E
Petersen
Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK; National Institute of Health Research Biomedical Research Centre at UCL Hospitals, London, UK.
Alimuddin
A
Zumla
Fondation Congolaise pour la Recherche Médicale, Cité OMS, villa D6, Djoué, Brazzaville, Republic of Congo; Faculty of Sciences and Techniques, University Marien Ngouabi, Brazzaville, Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany. Electronic address: fntoumi@fcrm-congo.com.
Francine
F
Ntoumi
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000458:organization & administration*; D015023:Democratic Republic of the Congo; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration*; D015397:Program Evaluation; D012106:Research; D014376:Tuberculosis / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D014944:World Health Organization
Collaborative; HIV; Health systems; Implementation; Republic of Congo; Research; TB; Training