Lack of cross-border referral agreements hinders TB fight


By Faith Kamtambe, In Livingstone Town, Zambia:

Lack of Cross- Border Referral System (CBRS) agreements between countries in Southern African Development Community (Sadc) region has been cited as a setback when it comes to providing required tuberculosis (TB) treatment to people that contract the disease in other countries.

According to Malawi National TB Control Programme (NTP), people that contract TB in other countries are sometimes put on different treatment in their countries because of lack of data-sharing agreements between countries in the region.


NTP Programme Manager, James Mpunga, said there is need for stakeholders to agree on a framework.

“We, as Sadc, agreed to have what is called CBRS and this was supported by the World Bank as well as Global Fund. But, as Malawi, and [this] even [applies to] other countries, we do not think we are seeing progress on that because we have spoken about this for three years but that system is not seeing the light of the day,” he said.

Malawi has an agreement with Mozambique, Tanzania and Zambia, meaning that the three countries can send patients to each other’s territory.


“However, challenges arise when it comes to dealing with countries that are far away from Malawi, [countries] such as the Democratic Republic of Congo (DRC) and South Africa,” he said.

Representatives from four countries where the Southern Africa TB and Health Systems Support Project (SATBHSS) is being implemented are meeting in Zambia.

Among other things, they are discussing strategies that may be used to scale up the fight against TB. The officials are also discussing ways of fighting TB among people working in mines.

SATBHSS Coordinator in Zambia, Fwasa Singongo, echoed Mpunga’s sentiments.

He said when Malawians who are diagnosed with TB in Zambia go back to their home country, it becomes difficult to monitor adherence to medical advice.

“Again, doctors [in Malawi] may not know the kind of treatment the person was receiving while in Zambia,” Singongo said.

East, Central, Southern Africa Heath Community Project Coordinator, Martin Matu, urged countries to be on the lookout, warning that lapses in treatment may pave the way for multi-drug resistant TB, “which is more difficult to treat”.

SATBHSS is being implemented in four countries in Southern Africa. These are Lesotho, Malawi, Mozambique and Zambia.

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