The TB Europe Coalition (TBEC) is an advocacy network that brings together civil society representatives (individuals and organisations) from across the WHO European Region; in order to strengthen the role of civil society within the region response to tuberculosis (TB), and to increase the political and financial commitment required to effectively control the epidemic in the region.
The year 2017 is the 3rd year of the FPA and another critical year for the fight against tuberculosis (TB) in Europe. The latest evidence continues to affirm that the fight against TB, and particularly drug-resistant TB, is far from won in the region and sustained community advocacy, capacity building, and high-level advocacy are needed to achieve this goal.

Main specific objectives of the programme:
1) Increase understanding of the civil society contribution to TB response across 80% of the Region by the end of 2017;
2) By the end of 2017, maintain and strengthen the TBEC website as a regional platform serving 400 civil society stakeholders working within the TB response;
3) Provide access to TBEC support and representation to civil society stakeholders in at least 80% of countries within the Region by the end of 2017;
4) Strengthen the voice of civil society in all accessible EU, regional and international forums/consultations throughout 2017;
5) Manage TBEC’s governance and internal processes for the successful implementation of this work programme throughout 2017.

These objectives will be achieved via the delivery of key outputs:
- Mapping civil society stakeholders across the region;
- Facilitate access to information and resources for target groups;
- Conduct outreach to civil society across the region with the aim of expanding the network and building relationships with target groups;
- Engage with decision-makers to advocate on behalf of civil society across the region;
- Manage the network effectively to implement the three-year work programme.

The TB Europe Coalition (TBEC) was formed in 2009 by a group of TB advocates from across the WHO European Region. The consistent increase of already high rates of drug resistant TB coupled with limited funding and low awareness among general populations and policy makers in the region called for an urgent action. Unfortunately, the scarcity of civil society organisations and advocates working on TB in the region meant that there were very few organisations or individuals mobilised or capacitated to advocate for TB at national or regional level. Acknowledging the similarities of concerns amongst countries and recognising importance of civil society within an effective response to TB in the past, TBEC was formed to bring together organisations and individuals in order to raise awareness about TB and advocate for bolder policies to fight this disease at all levels.

During following years, TBEC expanded its network mainly through online networking and communication tools such as a bilingual website and listserve, as well as regular country visits to high burden countries in Baltics, Caucasus and Central Asia. The country visits turned to be the most efficient way not only identifying the relevant stakeholders working on TB in the country but also providing opportunities for them to meet each other often for the first time. Throughout the years, the country visits incorporated many advocacy training activities, thus, substantially strengthening the advocacy capacity and skill set on the ground.

In 2017 TBEC continued to strengthen its position as a key civil society network, working on TB issues in the WHO Europe region. The continuous financial support from the EC allowed TBEC Secretariat and Steering Committee members to actively engage with various international and regional stakeholders such as Eurasian Harm Reduction Network, the Union, Wolfheze, WHO, and the various EU institutions. Furthermore, the funding allowed TBEC staff to attend various meetings and conferences such as EU Symposium in Malta, high level meeting on Transition and Sustainability of TB and HIV in Estonia, Global Ministerial Conference on Ending TB in Russia, and the Union annual conference on lung health in Mexico.

Throughout the year, TBEC continued the effective engagement with EU, WHO and Global Fund on shaping TB policy, including transition, people-centred care, antimicrobial resistance and UN high level meeting on Tuberculosis through participation in meetings and conferences, as well as publishing policy reports. Furthermore, TBEC has also closely worked with the Global TB Caucus in order to strengthen ties between the CSOs and the parliamentarians, who are part of Global TB Caucus in EECA region in order to drive TB response at country level as well as regionally advocating for the update of new policies at the EU level.

TB Europe Coalition's key operational objectives are to adequately address the challenges and capitalise on the opportunities for civil society and communities to advocate for TB. TBEC must maintain access to relevant information, tools, resources and support for its members, expand the network’s membership to achieve a greater coverage of the region and continue to build the operational capacity of its Secretariat, to ensure the successful implementation its work programme.

The operational objectives below have been developed in response to the above situational analysis and in relation to the multi-annual work programme of the network (2015-2017):

Strategic Objective 1.1: Increase understanding of the civil society contribution to TB response across 80% of the Region by the end of 2017;
Strategic Objective 2.1: By the end of 2017, maintain and strengthen the TBEC website as a regional platform serving 400 civil society stakeholders working within the TB response.
Strategic Objective 3.1: Provide TBEC support and coordination of civil society stakeholders in at least 80% of countries within the Region by the end of 201

The objectives were achieved via the delivery of key outputs that form the annual work programme by:

1) Mapping civil society stakeholders across the WHO European Region,
2) Facilitating access to information and resources for capacity building for target groups,
3) Conducting outreach to civil society across the region with the aim of expanding the network and building relationships with target groups,
4) Engaging with decision-makers on behalf of civil society across the region, and
5) Managing the network effectively to implement the three-year work programme.

In 2017 TBEC continued to strengthen its position as a key civil society network, working on TB issues in the wider European region. Throughout the year, TBEC carried out various advocacy activities on various TB policy aspects such as:
o transition and sustainability;
o people-centred care;
o antimicrobial resistance;
o investment in TB R&D;
o integrated health systems;
o upcoming UN High-level meeting on TB;

The continuous financial support from the EC allowed TBEC Secretariat and Steering Committee members to actively participate in various regional and international conferences such as EU Health Symposium, Wolfheze 2017, the Union conference on Lung Health, Call to Action Conference, Global Ministerial Conference and EU Health platform annual meeting amongst others. The grant also allowed to closely engaging with various international and regional stakeholders such as the EU (EU Global Health Policy Forum, European Parliament working groups, permanent representations of the EU MS to the EU, CHAFEA, DG SANTE amongst others), WHO (annual meetings of Green Light and TAG TB Committees) and the Global Fund. Furthermore, TBEC strengthened the regional partnerships with Eurasian Harm Reduction Association through joint country visit to Bulgaria, and worked closely with the Global TB Caucus in order to strengthen ties between the CSOs and the parliamentarians, and TBPeople, with specific focus on EECA engagement.

Conferences, meetings and policy consultations
- EU Health Symposium, Malta, January;
- Wolfheze, the Netherlands, May;
- TB EECA Summit, Georgia, August;
- 48th Union conference on Lung Health, Mexico, October;
- Call for Action conference, Germany, October;
- Global Ministerial Conference on TB, Russia, November;
- EU Health Policy platform meeting, Belgium, November;

- WHO TAG TB annual meeting, Denmark, February;
- WHO Green Light Committee for the WHO European Region, Denmark, July;
- C20 meeting ahead of G20 in Argentina in 2018, Germany, August;
- Meeting on Transition and Sustainability, Estonia, December;
- EU Civil Society Forum on HIV, TB/Hep C, Belgium, throughout the year;
- EU Global Health Policy Forum on access to medicines, Belgium, throughout the year;
- Bureau Meeting of the European Parliament Working Group (EPWG) on Innovation, Access to Medicines and Poverty Related Diseases, Belgium, throughout the year;
- Meeting with Estonian Perm Rep for the Estonian EU Presidency high level meeting on Transition and Sustainability, Belgium, throughout the year;
- Various meetings with MEPs on European Parliament resolution on the EU's response to HIV, TB and Hepatitis, Belgium, throughout the year;

- Submission for mid-term evaluation of 3rd EU Health Programme;
- Submission to the AMR public consultation;
- Submission to Horizon 2020 mid-term review;
- TBEC consultation on the UN High-level meeting on TB;

Engagement in detail:
Global Ministerial Conference on TB
Member of TBEC Steering Committee attended two-day global conference of the Ministers of Health in Moscow in November 2017. At the end of the conference, Ministers from 100 countries signed the Moscow Declaration to End TB and re-committed to end the TB epidemic by 2030. The Ministers committed to: first, scale up TB prevention diagnosis, treatment and care; second, ensure sustainable and sufficient financing of national, regional and global TB programmes; third, accelerate research and development (R&D) for new tools to fight TB, and fourth, to develop a new multi-sectorial accountability framework. This is an important stepping-stone ahead of the UN High Level meeting on TB in 2018.

The Union World Conference on Lung Health
The Union World Conference on Lung Health is the world’s largest assembly of clinicians and public health workers, health programme managers, policymakers, researchers and advocates working to end the suffering caused by lung disease, with a focus specifically on the challenges faced by the low- and m

In 2017 TBEC continued to strengthen its position as a key civil society network, working on TB issues in EECA region. The continuous financial support from the EC allowed TBEC Secretariat and Steering Committee members to actively engage with various international and regional stakeholders such as Eurasian Harm Reduction Association, the Union, Wolfheze 2017, G20, WHO Europe Regional Collaborative Committee on TB Control and Care and various EU institutions.

However, the key achievements this year was: first of all, TBEC governance revamp, which included three day meeting in Kiev (to discuss and create TBEC Strategy 2017-2020) in February 2017, and the annual TBEC Steering Committee meeting in Brussels in October 2017. During 2017, it was also agreed that TBEC would be registered as an official network in the Netherlands in 2018; secondly, development of proposal and subsequent approval for CHAFEA Operational Grant for 2018-2021, which foresees variety or advocacy and capacity building activities such as development of training modules and active engagement with GTBC with regards to the UN HLM on TB; third, participation in the TB REP project (TB in Eastern Europe and Central Asia on Strengthening Health Systems for Effective TB and DR-TB Control) which is implemented with the financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria in the countries of Eastern Europe and Central Asia through 2016-2018. With the primary recipient of the Global Fund being PAS Centre, Moldova, and under the technical leadership of WHO EURO a wide range of partners are involved in the TB-REP project implementation. TBEC, with international charitable foundation “Alliance for Public Health” (Ukraine), as a technical implementer is responsible for supporting the civil society organizations in their grass-root advocacy efforts in the TB-REP countries through capacity development, progress monitoring and information exchange.

Throughout the year, TBEC continued the effective engagement with EU, WHO and Global Fund on shaping TB policy, including transition, people-centred care and antimicrobial resistance through participation in meetings and conferences, as well as publishing policy reports. Furthermore, TBEC Secretariat members continued to chair the WHO Regional Collaborative Committee (RCC) on TB, continuously increasing collaboration with WHO Europe and other technical partners. TBEC has also closely worked with the Global TB Caucus in order to strengthen ties between the CSOs and the parliamentarians, who are part of Global TB Caucus in EECA region.

Since January 2017, TBEC has:

Published over 65 blog articles and 12 newsletters in both languages, and witnessed increased use and interaction from members of TBEC listserve and social media accounts. (target: 12 newsletters);

TBEC increased its online reach via Facebook page, with 430 permanent followers, including key national civil society organisations and regional networks and Twitter, with average 10 original tweets and up to 20 retweets per month, and 628 followers. (target for Twitter and Facebook - at least 350);

Produced a mapping report of 45 target countries in the EU, in order to provide information about civil society stakeholders working in specific country contexts. (target: 15 countries each year). The mapping information was uploaded on TBEC website, with 100% member access.

Reached 66% of WHO European Region countries that are represented within the TBEC network. This has been shared with the membership on the website. (target: 80%)

TBEC published 3 key policy papers - “UN High-level meeting on TB”, “Tuberculosis – the cornerstone of AMR threat” and “Moving to people-centred care: achieving better TB outcomes”, as well as TBEC Strategy 2017-2020;

TBEC organised 2 webinars - first on UN High-level meeting on TB in EN/RU in October and second on media engagement in EN/RU in September.

TBEC carried out research on best case studies in Tajikistan and Bulgaria (social enterprise and engagement with Roma communities);

Facilitated an advocacy workshop (30 participants, 7 collaborative relationships) and meetings with stakeholders and decision makers in Bulgaria, as part of TBEC series of country visits and national advocacy workshops for local civil society. (target: 10 participants, 3 collaborative relationships established);

Participated in the Union Global Conference on Tuberculosis and Lung Health in Mexico (supported 2 civil society representatives, and organised 3 community sessions), Wolfheze 2017 in the Netherlands, WHO TAG TB and Green Light Committees, and the EU, specifically, CHAFEA, EC and the Estonian presidency (target: 4 meetings);

Organised Annual Steering Committee meeting (13 out of 16 participated) and produced the report (target: 80% attendance at Steering Committee meeting);

Conducted Annual Member Survey, with 80% believing that TBEC represents Civil Society Organisations across the region (target: 80%);

Further improved membership outreach and strengthened the Secretariat;

The work programme activities and outcomes were disseminated across the network’s communication channels to ensure broad public exposure and increase levels of awareness of both the issue and the network’s role in the response. These channels include the TBEC newsletter, listserve, social media – Facebook and Twitter, and the website in both English and Russian, to ensure maximum accessibility for target groups across the region. In addition, hard copies of policy resources were distributed to Secretariats in London, Brussels and Kiev, Steering Committee members and key stakeholders across the region during conferences, meetings, workshops, etc.

Dissemination - website, social media and listserve

TBEC website structure has been simplified and the content rewritten to mirror TBEC governance revamp and Strategy 2017-2020. TBEC has published over 65 blog articles and 12 newsletters in EN/RU in 2017. TBEC has also issued 3 press releases on World TB Day, G20 Communiqué and Global Ministerial Conference. TBEC Secretariat organised a coordination meeting on communications, establishing ground rules for TBEC website, listserve, social media (Facebook/Twitter) and communication with TBEC SC.

TBEC increased its online reach via Facebook page, with 430 permanent followers, including key national civil society organisations and regional networks and Twitter, with average 10 original tweets and up to 20 retweets per month, and 628 followers. (target for Twitter and Facebook - at least 350);

Electronic versions of the TBEC Steering Committee annual meeting report, TBEC Annual Report, TBEC Strategy 2017-2020, TBEC infographics on economic impact of TB, TBEC Thematic Report, TBEC policy resources on AMR, UN HLM on TB and People-centred care are published on the website, distributed via TBEC member Google listserve and social media, as well as mailed to the Secretariats in Brussels and Kiev and interested TBEC members to reach out to larger pool of members in order to strengthen their awareness of actions at EU and regional levels that have significant relevance to their work at national level. All the reports have been translated in RU, with exception of TBEC SC Committee annual meeting report, where to Executive Summary was translated in RU.

Complementary to these reports, the website hosted case studies, funding opportunities, technical assistance programmes, a calendar of events and other information to support members’ advocacy in response to the TB epidemic.

The TBEC logo and the emblem of the EU/CHAFEA 3rd Health Programme with disclaimer have been visible on all reports publicly disseminated by the network. These have been presented on the TBEC website and newsletters to ensure maximum visibility and recognition of support.

Evaluation/monitoring

The implementation of the work programme was monitored throughout the year, with monitoring data gathered monthly. The internal monitoring data reports were shared with the Steering Committee regularly. Qualitative data were gathered through evaluation questionnaires, de-briefings after meetings, and annual survey to measure outcome.

The evaluation was focused on assessing the effective completion of the activities, the production of the deliverables included in the activity plan and the achievement of the proposed targets. It included participants’ evaluations, conducted to determine the impact of specific activities for 2017 - Survey, specific evaluations was carried out for both the advocacy training with national CSOs and for other events organised during the country visit. Participants of these events were asked to complete a questionnaire and give feedback on the quality, effectiveness, relevance and likely impact of the activities and make improvements to content as necessary. The questioners and de-briefings were mainly used for the workshop/training participants and the annual survey targeted all TBEC members.

Survey results:
- The TBEC survey had 39 parti