Collaboration across sectors to evaluate TB advocacy efforts

Over the past decade incremental advances have been documented in awareness, research and development efforts, and the recognition of the global threat posed by increasingly drug resistant tuberculosis. Suddenly, however, efforts have stalled and hard earned progress trends are reversing, even as advocacy capacity building efforts have increased. Clearly, new advocacy approaches are required.

As is turns out, small TB advocacy initiatives are already independently and successfully having impact on outcomes ranging from community participation to training health care workers on infection control and intensified case finding to influencing national health sector strategic plans. What each of these TB advocacy initiatives has in common is that they make advocacy partners of long-standing advocacy targets. Rather than simply pointing out what is wrong, these advocates came with ideas for solutions, partnering with grateful institutions or communities to accomplish goals that neither could have accomplished independently.

By purposefully employing a collective impact approach, which these TB activists did intuitively, sustainable, high level impact can be made against the threat posed by TB. This purposeful process involves the development of collaborative advocacy partnerships consisting of key stakeholders who are publicly supportive of accelerated actions to eliminate TB as a global public health threat. To successfully implement a collective impact approach, standardized tools and methodologies are used to clarify a theory of change that underlies partnership actions, to track partnership influence and to monitor and evaluate a limited number of impact indicators. Incremental changes are regularly monitored through qualitative interviews and outcome diaries and larger scale changes of a limited number of highly informative impact indicators are monitored and evaluated through publicly available, web-based, interactive data portals.

Collective impact doesn’t happen overnight. It is a long term commitment requiring consistent action that persistently and incrementally can change the apparently intransigent.