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Lucica Ditiu: putting people at the forefront of tuberculosis care
Perspectives
A visit to the doctor was a special event in Lucica Ditiu’s childhood. “In our household there was a high regard for doctors as being important and powerful individuals in the way they looked after people. A medical visit was one of the only times we would wear our best clothes!” Ditiu went on to become a doctor and is now the newly appointed Executive Secretary of the Stop TB Partnership—a network of global partners working towards eliminating tuberculosis as a public health problem. A native Romanian whose parents were factory workers, Ditiu grew up during a turbulent period when the country was under the rule of Nicolae Ceausescu. “I grew up largely on the streets because my parents were poor”, Ditiu recounts. But she studied hard and scored highly in the medical entrance exams that secured her a place at Bucharest’s University of General Medicine and Pharmacy. After graduating, in 1992, she completed specialty training in pulmonology. But Ditiu found it hard to survive on her US$30 per month salary and so she also worked as a journalist for a glossy Romanian magazine. “I love people and I love communicating and nearly gave up medicine to do journalism full time, but as I got more immersed in the field of tuberculosis, and saw for myself that DOTS treatment when organised and done properly leads to good health outcomes, I did not give up and it is why I am still in tuberculosis today.” Her commitment is inspirational, says Giovanni B Migliori, one of her mentors and a tuberculosis expert for WHO: “Lucica’s story shows that it is possible for a young woman, from an emerging country and not a traditional academic to reach a top position in the fight against tuberculosis. To me it is a message of hope for a young generation of specialists.” Ditiu began her career with WHO in 2000, as a medical officer for tuberculosis in Albania, Kosovo, and Macedonia. She has been the driving force behind many initiatives that have raised the profile of tuberculosis control in the region, such as establishing national tuberculosis programmes and guidelines, strengthening tuberculosis/HIV integration, and creating a special Laboratory Task Force. Working closely with the Global Fund to Fight AIDS, Tuberculosis and Malaria since its creation in 2002, Ditiu also provided technical support to countries with their applications for financing. Her dedication went as far as finishing a Global Fund application whilst delivering her baby and signing the proposal just after giving birth. “My doctor thought I was mad, but we got $45 million which made such a difference in Romania”, she says. Today, however, Ditiu laments how much there is still to do in the region where vertical programmes, weak infrastructure, and poor infection control have all hampered progress. “What is really missing in Europe is that medical education does not focus on how you communicate, engage, and respect the patient, and follow them through their www.thelancet.com Vol 377 March 26, 2011
diagnosis and treatment. The medical staff are disengaged from the patient. Our tuberculosis patients are not always the nicest in the world but there has to be more focus by the medical community to understand their needs and work with them. Then there is the absence of a strong tuberculosis community and this is a problem globally. We need to make patients understand the power they have to mobilise action at a national level, and how they can help each other to stop stigmatisation and more practically, deliver treatment.” Ditiu believes it is time to focus on tuberculosis as a broader health and development problem. “A few years ago tuberculosis and tobacco were fashionable, then tuberculosis and health systems. Next year it will be tuberculosis and blue eyes! We can’t keep randomly linking. Tuberculosis is a disease that needs to be looked at contextually in the country. It is time for us to broaden the mindset around tuberculosis, demystify it, and strengthen the approach towards a patient who has tuberculosis amongst other illnesses,” she urges. To gain global attention for tuberculosis, Ditiu wants the partnership to have a unified voice and focus on advocacy and communication. ”I want to see more engagement from our partners. The big guns in tuberculosis must share the challenges and problems as well as the benefits of the partnership. We need to strengthen our collaboration with the Global Fund and ensure countries are really supported, but we should look to engaging new potential donors and partners in tuberculosis control like the BRICS countries who will put money in their own countries directly rather than handing it over to Geneva”, she explains. This year’s theme for World TB Day is innovation. “It is of course about new tools and research—discovering and using them—but is also about using what we have now and thinking more creatively”, Ditiu says. “Look at case detection which has stagnated around 60% for the past several years. How do we reach the difficult cases and engage them into treatment?” Her experience leading the TB REACH initiative—awarding grants of up to $1 million to organisations for innovative ways of reaching the poor and vulnerable—has yielded impressive solutions. Ditiu’s humane approach to TB care and control is her unique strength. Muhwa Jeremiah Chakaya, from Kenya’s Ministry of Health and a Stop TB member, remarks: “Lucica has bags of passion and mountains of energy, just what we need at the Stop TB Partnership. I hope her passion will spread like wildfire, for the enemy, tuberculosis, is regrouping and becoming more ferocious. This enemy can only be tamed by a passionate and truly energised group of warriors, and I am glad that Lucica will be among the generals in this war.”
Stop TB Partnership
Profile Lucica Ditiu: putting people at the forefront of tuberculosis care
Published Online March 24, 2011 DOI:10.1016/S01406736(11)60397-8 For Stop TB Partnership see http://www.stoptb.org
Pamela Das [email protected]
1067
A visit to the doctor was a special event in Lucica Ditiu’s childhood. “In our household there was a high regard for doctors as being important and powerful individuals in the way they looked after people. A medical visit was one of the only times we would wear our best clothes!” Ditiu went on to become a doctor and is now the newly appointed Executive Secretary of the Stop TB Partnership—a network of global partners working towards eliminating tuberculosis as a public health problem. A native Romanian whose parents were factory workers, Ditiu grew up during a turbulent period when the country was under the rule of Nicolae Ceausescu. “I grew up largely on the streets because my parents were poor”, Ditiu recounts. But she studied hard and scored highly in the medical entrance exams that secured her a place at Bucharest’s University of General Medicine and Pharmacy. After graduating, in 1992, she completed specialty training in pulmonology. But Ditiu found it hard to survive on her US$30 per month salary and so she also worked as a journalist for a glossy Romanian magazine. “I love people and I love communicating and nearly gave up medicine to do journalism full time, but as I got more immersed in the field of tuberculosis, and saw for myself that DOTS treatment when organised and done properly leads to good health outcomes, I did not give up and it is why I am still in tuberculosis today.” Her commitment is inspirational, says Giovanni B Migliori, one of her mentors and a tuberculosis expert for WHO: “Lucica’s story shows that it is possible for a young woman, from an emerging country and not a traditional academic to reach a top position in the fight against tuberculosis. To me it is a message of hope for a young generation of specialists.” Ditiu began her career with WHO in 2000, as a medical officer for tuberculosis in Albania, Kosovo, and Macedonia. She has been the driving force behind many initiatives that have raised the profile of tuberculosis control in the region, such as establishing national tuberculosis programmes and guidelines, strengthening tuberculosis/HIV integration, and creating a special Laboratory Task Force. Working closely with the Global Fund to Fight AIDS, Tuberculosis and Malaria since its creation in 2002, Ditiu also provided technical support to countries with their applications for financing. Her dedication went as far as finishing a Global Fund application whilst delivering her baby and signing the proposal just after giving birth. “My doctor thought I was mad, but we got $45 million which made such a difference in Romania”, she says. Today, however, Ditiu laments how much there is still to do in the region where vertical programmes, weak infrastructure, and poor infection control have all hampered progress. “What is really missing in Europe is that medical education does not focus on how you communicate, engage, and respect the patient, and follow them through their www.thelancet.com Vol 377 March 26, 2011
diagnosis and treatment. The medical staff are disengaged from the patient. Our tuberculosis patients are not always the nicest in the world but there has to be more focus by the medical community to understand their needs and work with them. Then there is the absence of a strong tuberculosis community and this is a problem globally. We need to make patients understand the power they have to mobilise action at a national level, and how they can help each other to stop stigmatisation and more practically, deliver treatment.” Ditiu believes it is time to focus on tuberculosis as a broader health and development problem. “A few years ago tuberculosis and tobacco were fashionable, then tuberculosis and health systems. Next year it will be tuberculosis and blue eyes! We can’t keep randomly linking. Tuberculosis is a disease that needs to be looked at contextually in the country. It is time for us to broaden the mindset around tuberculosis, demystify it, and strengthen the approach towards a patient who has tuberculosis amongst other illnesses,” she urges. To gain global attention for tuberculosis, Ditiu wants the partnership to have a unified voice and focus on advocacy and communication. ”I want to see more engagement from our partners. The big guns in tuberculosis must share the challenges and problems as well as the benefits of the partnership. We need to strengthen our collaboration with the Global Fund and ensure countries are really supported, but we should look to engaging new potential donors and partners in tuberculosis control like the BRICS countries who will put money in their own countries directly rather than handing it over to Geneva”, she explains. This year’s theme for World TB Day is innovation. “It is of course about new tools and research—discovering and using them—but is also about using what we have now and thinking more creatively”, Ditiu says. “Look at case detection which has stagnated around 60% for the past several years. How do we reach the difficult cases and engage them into treatment?” Her experience leading the TB REACH initiative—awarding grants of up to $1 million to organisations for innovative ways of reaching the poor and vulnerable—has yielded impressive solutions. Ditiu’s humane approach to TB care and control is her unique strength. Muhwa Jeremiah Chakaya, from Kenya’s Ministry of Health and a Stop TB member, remarks: “Lucica has bags of passion and mountains of energy, just what we need at the Stop TB Partnership. I hope her passion will spread like wildfire, for the enemy, tuberculosis, is regrouping and becoming more ferocious. This enemy can only be tamed by a passionate and truly energised group of warriors, and I am glad that Lucica will be among the generals in this war.”
Stop TB Partnership
Profile Lucica Ditiu: putting people at the forefront of tuberculosis care
Published Online March 24, 2011 DOI:10.1016/S01406736(11)60397-8 For Stop TB Partnership see http://www.stoptb.org
Pamela Das [email protected]
1067