Studies conducted in OR courses lead to national and international policy changes
Since 2009, 93 researchers from over 40 countries have been through rigorous operational research courses developed and conducted by the International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières–Brussels Operational Centre, Luxembourg (MSF). Close to 90% have met the course "milestones" – resulting in 92 scientific papers documenting their research projects. Of these, 54 are already in press or published. Even more importantly – their research is resulting in changes of health care policy and practice, both nationally and internationally.
For each project that is completed, The Union and MSF document whether policy and/or practice have been affected, since this type of outcome is the ultimate goal of operational research. Examples of some of the changes brought through the OR course participants' research are:
• MALAWI & SOUTH AFRICA: Pilot studies showed that electronic pharmacy records in South Africa and Malawi can be successfully used to monitor use of antiretroviral therapy and track patients lost to follow-up. These systems have now been adapted to routine use in those clinics that have such technology.
• PERU: In Peru, Use of the MODS [microscopic-observation drug susceptibility assay] system for culture and drug sensitivity testing in TB patients was found to be satisfactory, confirming to the National TB Programme that it does not have to consider moving to more sophisticated and expensive systems.
• INDIA: In India, an assessment of data related to patients with HIV-associated tuberculosis and antiretroviral therapy provided evidence to support the national adoption of the WHO 2010 ART guidelines.
• LIBERIA: An evaluation of an MSF clinic in Liberia that was providing services for survivors of sexual violence showed that minors were poorly served, leading to a change in practice guidelines.
• INTERNATIONAL: From time to time, all participants and facilitators on a course co-author a viewpoint article on a subject considered of interest internationally. One such article on the inappropriate language used in TB control (such as "TB suspect") was supported by several patient and activist groups and led the World Health Organization (WHO) to conduct a global consultation on this issue. As a result, WHO is developing an international language guide for those involved in the fight against tuberculosis.