In Ghana an estimated 12,000 of the country's 20 million people are infected with tuberculosis annually, and for many of them access to treatment has not always been easy. So the Global Fund is sponsoring a new program to help those who cannot afford treatment. The plan seems to be working.
The program, based on the World Health Organization's strategy of Direct Observation Therapy, Short Course, or DOTS, is being tried out in two regions of Ghana. Its aim is to provide the widest possible access to prevention, care, support and treatment for all those affected by tuberculosis.
With money from the Global Fund, more municipal and private sector healthcare workers have been trained and tuberculosis treatment centers expanded.
The program also introduces home visits to tuberculosis patients.
Kingsley Agbenu is a healthcare assistant with Health Concern Ghana, one of the local NGOs involved in the project.
Though tuberculosis treatment is free in Ghana the general poverty level among the population is a major challenge, according to Mary Aboagye, the executive direct of Health Concern Ghana.
"It's a daily kind of program for eight months, so it's not easy affording transportation and then it's not easy affording nutritious meals," she said. "So these are some of the challenges that we face as we give the free treatment. How do we help these people to come to the health facility?"
To help some of the neediest patients, the program includes the so called "enablers' package."
Each package is tailored to the needs of the patient. Some include money to help defray the cost of travel to the center, others include a meal at the clinic.
Dr. Frank Bonsu, program manager of the National Tuberculosis Control Program, says it was necessary to motivate and assist both the patient and the care provider to reduce dropout rates.
"There was the risk of developing the multi-drug resistance tuberculosis which everybody is afraid of," he said. "So we needed to come out with ways of convincing patients to continue treatment and health providers themselves to want to work as partners with the patients to continue treatment so that we reduce the number of patients or clients who fall out during the course of treatment."
After HIV/AIDS and malaria, tuberculosis is third on the Ghanian government's list of health care priorities.
The annual tuberculosis treatment rate in Ghana has gone from 16 percent a decade ago to 72 percent today. Dr. Bonsu says the two areas where the DOTS program is being implemented are scoring between 88 and 94 percent treatment rate.
"In tuberculosis we say cure is the best for prevention, so as our cure rates go high, then it means we are protecting the society," he said. "The source of the infection is the people who have the disease, so if you cure as many of these sources of infection, then you are preventing the disease also from carrying on, so at the moment our treatment success rate is high and we are proud of it."
Ghana's health officials say expanding the program throughout the country will cost more than $14 million. Two-thirds will come from the Global Fund and rest from the government treasury.