Tuberculosis Intersectoral Action: Protecting Children and Communities

A Universidade de Heidelberg, a Fraunhofer-Gesellschaft e Universidade Ludwig-Maximilian de Munique realizam no dia 13 de novembro, na Fundação Oswaldo Cruz (Fiocruz), no Rio de Janeiro, o simpósio Tuberculosis Intersectoral Action: Protecting Children and Communities. A pauta do evento é debater como evidências científicas sobre pobreza, moradias precárias e desnutrição – determinantes estruturais da tuberculose – podem ser traduzidas em políticas públicas concretas, com foco especial em crianças e populações vulneráveis.

O evento é co-organizado pelo Centro Alemão de Ciência e Inovação (DWIH) São Paulo, que estará presente e fará uma sessão sobre oportunidades de financiamento de pesquisa na Alemanha. O simpósio acontece às margens da Conferência Mundial de Saúde Pulmonar 2026, que acontece dos dias 17 a 20 de novembro na capital fluminense.

Os pesquisadores alemães e brasileiros, membros do Grupo de Trabalho sobre Tuberculose Infantil da OMS, representantes do Comitê Interministerial brasileiro para a Eliminação da Tuberculose (CIEDDS) e membros de comunidades afetadas pela doença, irão trabalhar juntos para gerar um mapa sistêmico das interações que criam as condições para o surgimento de casos de tuberculose e identificar alvos prioritários de intervenção. Entre os parceiros brasileiros estão a Fundação Oswaldo Cruz (Fiocruz) e as universidades federais do Rio de Janeiro e do Paraná.

A programação do evento inclui a criação de grupos de trabalho a partir de cenários de infecção, o testemunho de quem conseguiu superar a doença, a validação dos primeiros rascunhos do mapa e uma discussão geral sobre os resultados.

Programação

Time	Session Title	Detailed Activity Description & Operational Process	Person
08:00 – 08:30	Arrival & Registration	Welcome coffee, registration, distribution of name tags, and assignment to breakout tables.
08:30 – 08:40	Formal Welcome	Attendees are officially welcomed to the meeting and introduced to the meeting purpose and intended outcomes. Housekeeping regarding bathrooms, translations, lunch etc	Anna Carvalho [PT]
08:40 – 08:45	Guidelines for the Day	Explanations are given that introductions will occur after the next activity, as the aim is to start the meeting with “expertise equality” – no one is making assumptions about how much or what other people know. The funder and host institutions are thanked, and general housekeeping (timelines, bathrooms, activities) are explained.	Laura Olbrich [PT]
09:45 – 9:00	What is a Systems Dynamics Map?	What is a systems dynamics model, why do we need one and what can they do? Presenting a worked example of the power of identifying interventions using a Systems Map.	Mikaela Coleman [EN]
09:00 – 10:30	Part 1: Blind Scenario Mapping (Warm-up)	Attendees sit at assigned tables (each table features a dedicated facilitator and interpreter). Each group receives a highly specific, written scenario tracking a unique ‘TB patient journey’ through the Brazilian social and health landscape. Task: Groups must analyze the scenario and visually map the wider system failures and community-level vulnerabilities that facilitated this specific case of tuberculosis. Groups draw their causal maps on large physical poster paper using markers and sticky notes. Presentations: Each table spends 5 minutes presenting their scenario map to the entire room, highlighting key structural breakdowns.	Group Navigators: A. Laura Olbrich [PT/EN] B. Clemax Sant Anna [TB/EN] C. Ezio Filho [PT] D. Betina Gabardo [PT] E. Anna Carvalho [PT/EN]
10:30 – 11:00	Part 2: Survivor Testimonies	Table introductions are formally conducted. Reflections: The TB survivor takes the floor as the primary expert. They reflect on the drivers mapped by the group, explicitly validating accurate assumptions, correcting misconceptions, and embedding nuanced personal realities (e.g., stigma, fear of income loss, child care constraints) into the physical model.	Chair: Laura Olbrich
11:00 – 11:15	Morning Break	Networking coffee break. Facilitators preserve the physical tables and collect the initial scenario maps for synthesis. People are formally introduced.	Chair: Laura Olbrich
11.15 – 11:30	DWIH Funder Address	DWIH introduces funding scheme, purposes of the programme and support for initiatives. (Length of funder timeslot to be confirmed)	DWIH Representative TBC
11:30 – 13:00 (1.5 Hours)	Part 3: Map Validation & Variable Elicitation	Review: Introduce the pre-built ‘Draft Map of Forces’ developed during online meetings 1 & 2. Integration & Critique: Participants assess whether this larger map effectively accommodates the real-world forces exposed in the morning survivor exercise. Variable Elicitation: Tables zoom into designated clusters to add hyper-detailed variables. Focus heavily on expanding operational specificities: precise social safety net metrics (e.g., Bolsa Família compliance pathways), housing parameters, and specific clinical/diagnostic metrics for Child TB (pediatric diagnostics, nutritional support lines).
13:00 – 14:00	Lunch Break	Catered lunch at Fiocruz or nearby.
14:00 – 14:15	WHO Intersectoral Health Systems	Hannah Monica Dias leads multisectoral engagement and accountability at the WHO Department for HIV. TB, Hepatitis and STIs. She coordinates the WHO Flagship Initiative to End TB, focusing on driving cross-sector policies, public-private partnerships, and national adoption of the WHO Multisectoral Accountability Framework (MAF-TB). As the architect of WHO’s push to address TB drivers outside health ministries, she will provide the high-level framework showing why intersectoral action is essential	Hannah Monica Dias
14:15 – 14:30	Using Systems Models to Find Target Interventions		Mikaela Coleman
14:30 – 16:00	Part 4: Interventional Elicitation & Leverage Points	Systemic Diagnostic: Shift focus entirely from mapping vulnerability to co-designing structural interventions. Review the detailed map to isolate components that work well versus elements that seem to be “weak links” driving systemic failure. Intervention Design: Tables break out to formulate actionable policy solutions targeting leverage points on the map (nodes that have many connections, upstream drivers, important proximal nodes, feedback loops etc). Move away from vague ideals (e.g., ‘eliminate poverty’) and drill into precise operational levers i.e. re-budgeting municipal community health programs, implementing universal paediatric TB screening within social welfare/peri-natal visits, modifying housing ventilation codes etc. Policy Tuning: Structure these findings into highly concrete, polished micro-pitches tailored explicitly for the upcoming policymaker panel.
16:00 – 16:30	Part 5: Pitching Interventions & Group Discussion	Feedback 3 interventions identified in each group to the wider floor, noting overlapping interventions and emergent themes.
16:30 – 17:25	Part 6: Wrap-Up & Political Mobilization	Consolidate table outputs onto three overarching interventions. Formally elect representatives to deliver the opening presentation and anchor the high-level policy dialogue at the Child and Adolescent TB Working Group Meeting on the following Monday. Indicate next steps to facilitate uptake by high-level actors.
17:25	Thank You and Close		Anna Carvalho

Informações sobre o evento

13 de novembro de 2026, 08:30 até 17:00

Av. Brasil, 4365 – Manguinhos, Rio de Janeiro – RJ | Fiocruz
Organizador: LMU | Universität Heidelberg | Fraunhofer ITMP