“We look forward to a world free of TB which we know we will achieve with the right political, technical and financial will.”

“We look forward to a world free of TB which we know we will achieve with the right political, technical and financial will.”

Dr Christopher Zishiri, Director of The Union Zimbabwe Office, has a positive view of the future, much of which stems from the confidence he has in his team: “The Union in Zimbabwe is a vibrant team of resident experts who give valuable technical support to the national TB response.”

Highly valued by the National Tuberculosis (TB) Programme, The Union Zimbabwe Office runs a number of projects, the biggest being the USAID-funded Challenge TB. Dr Zishiri explains: “We have four strategic areas of work with the Challenge TB grant which are: finding and treating the people with TB who are missing; providing TB-HIV integrated services; undertaking programmatic management of drug-resistant TB; and ongoing operational research, monitoring and evaluation.”

The Union Zimbabwe Office also implements active case finding activities among high risk communities, using mobile trucks equipped with digital X-rays and GeneXpert machines, with support from the Global Fund, and through a door-to-door approach in the community to find missing people with TB, with support from the Department for International Development (DFID).

In this work, The Union has been able to provide new evidence and technologies which have influenced policy-making in the national TB response. Dr Zishiri said: “The Union led the work on the country’s treatment guidelines for TB, carrying out the national TB prevalence survey, the national TB drug resistance survey and we are currently working in collaboration with the World Health Organization (WHO) on the TB treatment catastrophic costs faced by our patients.” There are also many examples of how evidence is guiding improvements in diagnoses and treatment. The Union recently demonstrated how improvements in the local use of TB data in the country were resulting in improved data quality and better TB care.

“The Union has also put TB on the political and media agenda in Zimbabwe through working with members of parliament and health journalists respectively.”

The Zimbabwe Office’s busy schedule means Dr Zishiri must hold technical and leadership positions, manage national and global relations, and coordinate responses to various calls for funding.

But despite his busy schedule, Dr Zishiri is determined to bring the focus back to the patients and communities and is keen to relay his team’s mantra: “We wake up every day to serve the people who remain at the heart of our work.”

All of the projects in progress are person-focused, with a significant emphasis on finding and treating people with TB who are undiagnosed, many of whom are located in hard-to-reach communities. In this respect, the work of The Union has proven very successful, as Dr Zishiri quantifies: “The country used to miss more than 70 percent of all those with TB at the time The Union came into Zimbabwe about 10 years ago. So far, that number is down to about 30 percent of people who continue to go undiagnosed. This is a great improvement, but clearly there is more to be done.”

Progress such as this, according to Dr Zishiri, is “due to good leadership and management skills, a rigorously selected office team and partnership working.” Dr Zishiri brings his own unique skill set to the team, much of which has been obtained from working in two very different environments. Prior to joining The Union in 2013, Dr Zishiri had been working in the United Kingdom as a consultant in public health medicine with Birmingham City Council.  There, he had gained the position of medically qualified Fellow of the Faculty of Public Health Medicine after five years of specialist training.

Before that, Dr Zishiri had done more than twelve years of clinical and public health work in Zimbabwe, where he served as Provincial Medical Director for the Ministry of Health and Child Care in one of the country’s ten provinces. He was also the national focal person for tobacco control in Zimbabwe and leader of the Zimbabwe delegation to the WHO Intergovernmental Negotiating Body on the Framework Convention for Tobacco Control negotiations in Geneva, Switzerland.

Dr Zishiri also piloted, on behalf of WHO, the national response to TB, HIV and Malaria in Bubi district and made recommendations for national response priorities in Zimbabwe. It was whilst focusing on TB as one of the major public health priorities in Zimbabwe that the disease became an area of great interest for him.

Such a broad experience base has enabled Dr Zishiri to cope with the hectic daily schedule of The Union Zimbabwe Office, which has expanded under his helm. He thrives on the busy environment he is immersed in and prides himself in his team’s ability to provide continual high standards of service delivery. He puts much of this down to high levels of team comradery: “The Zimbabwe team continually encourages and uplifts each other’s spirits: We are in The Union together.”

Yet we all need ‘time out’, and in this respect, Dr Zishiri choses a completely different tack; he is a Boer goat farmer, a breed of goat that was developed in South Africa in the early 1900s for meat production.  When he is not providing technical support to the national TB response, he can be found at his farm developing robust breeds with his family.

Looking ahead, Dr Zishiri remains staunchly positive: “There are many challenges ahead of us and the world of TB has a very high level of uncertainty. This environment will bring my leadership capacity to the test, but as a member of The Union, I am proud and confident that we can manage this change. We look forward to a world free of TB which we know we will achieve with the right political, technical and financial will.” 

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