January Congressional Staff Delegation to Bangladesh and India a Success
Jen Maurer, Sr. Policy Associate
February 01, 2010
In January, RESULTS Educational Fund organized an educational trip to Bangladesh and India for congressional staffers who work on global health and foreign affairs. The purpose of these educational trips is to provide congressional staff with a firsthand experience of the progress and challenges faced by developing countries trying to addressing these issues, as well as the impact of U.S. government support for these programs. The trip included field visits and discussions with officials from the governments of Bangladesh and India, relevant U.S. government officials, and civil society organizations and advocates.
Bangladesh
Bangladesh faces many health and development challenges, but it has achieved many remarkable successes as well. Our visit focused on TB and the Global Fund, as Bangladesh is ranked sixth among countries with the highest numbers of new TB cases each year and fifth in terms of total numbers of MDR-TB cases.
We had the extreme fortune to visit with BRAC (Bangladesh Rural Advancement Committee), the world’s largest — and probably most impressive — NGO. It’s playing a critical role in reducing poverty in Bangladesh: its programs reach 110 million of the 150 million Bangladeshis. We spent a day with BRAC visiting a rural area outside of Dhaka to see their TB and microfinance programs, but first were lucky enough to meet with Mr. Fazle Abed, the founder and chairperson of BRAC and a truly inspiring man who is globally honored and recognized as a leader in fighting poverty). Mr. Abed and BRAC firmly believe that public health and social services should be provided by the government; as a result, BRAC’s goal is not to replace government services, but to support and expand services in partnership with the government. For example, BRAC is spearheading a successful and innovative national TB control effort in conjunction with the government. An interesting note: BRAC first started working on TB because it realized that the prime reason its microfinance clients were defaulting was due to TB illness in their family.
Mr. Abed told us that when they first wanted to expand TB services on a national scale, they requested funding from the World Bank, but were denied, with Bank staff explaining there just wasn’t money for TB. However, once the Global Fund was created, there was finally funding to support expansion of TB programs in Bangladesh. Thanks to the Global Fund and BRAC’s work with the government, Bangladesh has made great strides; for example, TB case detection rates have increased from 49 percent to 78 percent and from 46 percent to 73 percent in BRAC and government programs, respectively, between 2003 and 2009!
Never an NGO to rest on its laurels, BRAC continues to expand and improve its services in Bangladesh (its programs are too numerous to list here!) and now globally: started after the civil war with Pakistan ended in 1971, BRAC is taking its post-conflict development expertise to other countries in need, including Afghanistan, Pakistan, Sri Lanka, Sierra Leone, southern Sudan, and Liberia.
Lady fortune was smiling upon us, as we were also able to spend some time with Grameen Bank, visiting with microfinance clients, as well as meet with Prof. Muhammad Yunus, founder of Grameen Bank and Noble Peace Prize laureate. Prof. Yunus was incredibly generous with his time and engaged us in a discussion on microfinance as well as his social business model, which challenges the way we frame and engaged in both business and development work.
India
After 2.5 days in Bangladesh, we flew to New Delhi to meet with ACTION India partners. India is ranked first among countries with the highest numbers of new TB cases each year, but also has had one of the most massive and successful scale-ups of TB efforts anywhere in the world. Despite this success, it still faces many challenges, particularly an increase in multidrug-resistant TB — it ranks first in terms of total numbers of MDR-TB cases. This news is made all the more dire because India also has a very large number of people infected with HIV/AIDS; given the deadly synergy of these two diseases, there is increasing urgency to improve early detection and treatment of TB and HIV/AIDS. TB programs can provide one of the best entry points for HIV testing and counseling and act as models and structures for expanding HIV and other services.
One of the most powerful visits was with a small HIV and TB service provider in the Delhi slums, where we met with their committed staff and visited the bedsides HIV positive patients suffering from TB meningitis (brain) and other advanced cases of the disease. We then visited with a TB health care volunteer who lives in another slum. She is HIV-positive and a former TB patient; she lost her husband, who was also HIV-positive, to TB, and one of her children is HIV-positive and had TB. She is an active member of the Indian Network for People Living with HIV/AIDS (INP+, an ACTION partner) and works to raise awareness of both diseases and encourage her community members to get tested and seek help. Visiting with these patients and health care workers brought home the stark reality of the deadly synergy of these two diseases and reinforced the urgent need to tackle both together through cross-testing and treatment.
It was a successful trip, and we are grateful for the opportunity to powerfully educate congressional staffers on these issues.
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