Bulletin of the World Health Organization

Articles from Vol. 85, No. 5, May

A New Disease Reporting System Increases TB Case Detection in China
In the base paper, Enarson & Billo provide a critical evaluation of the Global DOTS Expansion Plan and addressed many of the challenges confronting global tuberculosis control. They did not, however, elaborate on one of the key challenges--the...
Barriers to Reaching the Targets for Tuberculosis Control: Multidrug-Resistant tuberculosis/Obstacles a la Realisation Des Objectifs De la Lutte Antituberculeuse: Tuberculoses multiresistantes/La Tuberculosis Multirresistente, Un Obstaculo Para Alcanzar Las Metas De la Lucha Antituberculosa
Introduction "The existence, in the lungs, of those peculiar productions to which the name of Tubercles has been restricted by modern anatomists, is the cause, and constitutes the true anatomical character, of Consumption" (Bishop, 1918). (1) ...
Building Political Commitment in Peru for TB Control through Expansion of the DOTS Strategy
In the context of public health, Peru has a long history in the fight against TB. (1,2) In 1990, the National TB Control Program became a national health priority, receiving government support to establish a programme that has been a model of efficiency...
Case Study: South Africa
For the past decade, a concerted effort to reform TB control in South Africa has resulted in changes in case-finding and treatment policies, standardization of recording and reporting systems, and monitoring of the performance of control programmes...
Critical Evaluation of the Global Dots Expansion plan/Evaluation Critique Du Plan Mondial D'elargissement De la Strategie DOTS/Evaluacion Critica del Plan Mundial De Expansion del DOTS
Introduction The recent Global Plan to Stop TB, 2006--2015 (1) takes into account the challenges identified during the five years of the Global DOTS Expansion Plan (GDEP), which ran from 2001 to 2005. At a workshop in Cairo in November 2000, national...
Cutting-Edge Science and the Future of Tuberculosis Control
Tuberculosis (TB) is presenting new challenges as a global public health problem, especially at a time of increasing threats due to HIV infection, multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis....
Did We Reach the 2005 Targets for Tuberculosis control?/Les Objectifs Pour 2005 De la Lutte Antituberculeuse Ont-Ils Ete atteints?/?Se Alcanzaron Las Metas De Control De la Tuberculosis Fijadas Para 2005?
Introduction Faced with the enormity of the global tuberculosis epidemic, and knowing that cost-effective methods for control were already available, (1-3) delegates to the WHO's 1991 World Health Assembly (WHA) set two targets for national tuberculosis...
DOTS Expansion and TB Control: The Case of Mali
Background Mall is a vast country in west Africa with a population of 13.1 million and a surface area of 1 241 000 [km.sup.2]. Poverty is a major problem, with 63.8% of population living below the poverty threshold. (1) Only 47% of population lives...
Fast Action Urged to Halt Deadly TB: Technology Holds the Key to Many of the Challenges Presented by a Particularly Virulent Form of Tuberculosis That Broke out in South Africa Last Year. Countries across the Region Are Making Progress in Keeping the Threat at Bay, but Not Fast Enough
Two new rapid diagnostic tests for multidrug-resistant tuberculosis (MDR-TB) are to be piloted in South Africa, dramatically cutting diagnosis time from two or more months to just two days. It will be the first time new technology is used to tackle...
Financing Tuberculosis Control: The Role of a Global Financial Monitoring system/Financement De la Lutte Antituberculeuse: Role D'un Systeme Mondial De Surveillance financiere/Financiacion De la Lucha Antituberculosa: Papel De Un Sistema Mundial De Vigilancia Financiera
Introduction Control of tuberculosis (TB), like health care in general, costs money. Although some components of diagnosis and treatment can be provided free of charge, such as patient support provided by community volunteers, most inputs--such...
Joint tuberculosis/HIV Services in Malawi: Progress, Challenges and the Way Forward
In the base paper, Laserson & Wells suggest that the greatest challenge to achieving global TB targets is the ever-expanding HIV epidemic and the resulting increase in HIV-associated TB, particularly in sub-Saharan Africa. Malawi, in southern Africa,...
Lessons from TB/HIV Integration in Cambodia
Background Cambodia ranks 22nd among countries with the highest burden of TB. (1) WHO estimates that in 2004, Cambodia's incidence rate for all forms of TB was 510/100 000, and for smear-positive pulmonary TB, 226/100 000. (1) Although HIV prevalence...
Lessons from the DOTS Expansion Plan in Indonesia: Highlighting Human Resource Development
Indonesia ranks third among the TB high-burden countries. A decade of TB control using the DOTS strategy has facilitated progress towards reaching the 2005 international targets for TB control. Indonesia reported a case detection rate of 68% for 2005...
New Tools for an Old Disease: A Range of Promising New Tools to Prevent, Detect and Cure Tuberculosis (TB), Which Kills Some 1.6 Million People Globally Every Year, Could Soon Be within Reach. but More Funding to Feed the Research and Development (R&D) Pipeline Is Needed If the Reinvigorated Fight against TB Is to Succeed
An array of new--and a few recombined--compounds and methods hold the potential to revolutionize the way TB is prevented, diagnosed and cured. Thanks to generous funding from donors, particularly the Bill & Melinda Gates Foundation, three public--private...
Planning to Improve Global Health: The Next Decade of Tuberculosis control/Amelioration De la Sante Dans le Monde: Planification Des Activites De Lutte Antituberculeuse Pour la Prochaine decennie/Planificar Las Mejoras De la Salud Mundial: La Lucha Antituberculosa En la Proxima Decada
Introduction "When the elephants fight, the grass gets trampled"--this aphorism exemplifies the vigorous debate over the best approach to planning for development. The debate positions Jeffrey Sachs, (1) a proponent of a comprehensive supply-side...
Promoting Adherence to Treatment for Tuberculosis: The Importance of Direct Observation
Since 1993, WHO has recommended a strategy through which national governments can meet their responsibility to treat patients and to prevent the spread of tuberculosis (TB). Four of the major elements of the strategy, which came to be known as DOTS,...
Promoting Adherence to Tuberculosis Treatment
Tuberculosis (TB) is a good test of a health system: addressing the problem requires the use of laboratories and X-rays, the input of skilled clinicians, a reliable supply of drugs, the use of health education, the provision of continuity of care as...
Public-Private Mix DOTS in India
The base paper highlights the challenge of maintaining the quality of TB services while working with multiple sectors, and this discussion is very relevant to the Indian setting. Despite having a large network of state government-owned public health...
Reaching the Global Tuberculosis Control Targets in the Western Pacific Region/Realisation Des Objectifs Mondiaux De la Lutte Antituberculeuse Dans la Region Du Pacifique occidental/Logro De Las Metas Mundiales De Control De la Tuberculosis En la Region del Pacifico Occidental
Background The Western Pacific Region bears a quarter of the world's tuberculosis (TB) burden, with an estimated two million incident cases annually. In 1999, only about 40% of the estimated smear-positive cases were detected and treated. (1) The...
Reaching the Targets for Tuberculosis Control: The Impact of HIV/Incidence Du VIH/sida Sur la Realisation Des Objectifs De la Lutte antituberculeuse/Logro De Las Metas De Control De la Tuberculosis: Impacto del VIH
Introduction In 1991, the 44th World Health Assembly (WHA) recognized the importance and previous neglect of tuberculosis (TB), and set two key global targets to be reached by 2000: 70% case detection of acid-fast bacilli smear-positive TB patients...
Roles of Laboratories and Laboratory Systems in Effective Tuberculosis programmes/Roles Des Laboratoires et Des Reseaux De Laboratoires Dans L'efficacite Des Programmes De Lutte antituberculeuse/Contribucion De Los Laboratorios Y Los Sistemas De Laboratorio a la Eficacia De Los Programas Antituberculosos
Introduction The laboratory has always played a critical role in diagnosing tuberculosis (TB) and monitoring its treatment. In the new millennium, the strength of the laboratory network is often a direct reflection of the success of TB control programmes....
Russian Oblast Is Model in Fight against TB: The Chaos Following the Collapse of the Soviet Union in 1991 Triggered a Tuberculosis (TB) Epidemic across the Russian Federation. A Decade and a Half Later, the Russian "Oblast" or Region of Orel Is Reporting Progress in Fighting Killer Strains of Mycobacterium Tuberculosis That Are Resistant to Common TB Drugs
By the end of the 1990s, the tuberculosis epidemic had reached alarming proportions across the Russian Federation. Orel oblast, in the south-western part of the country, was no exception. "The TB situation in the region was very bad, especially from...
Stronger Health Systems to Beat TB
Jorge Sampaio graduated in law in 1961 at Lisbon University in his native Portugal. At university and later, Sampaio took part in political action against the military dictatorship in Portugal until the revolution in 1974. In 1978, Sampaio joined Portugal's...
Targets for Tuberculosis Control: How Confident Can We Be about the data?/Objectifs De la Lutte Antituberculeuse: Quelle Confiance Pouvons-Nous Accorder Aux donnees?/Metas De Control De la Tuberculosis: Que Fiabilidad Tienen Los Datos?
Introduction Tuberculosis (TB) is an important cause of illness and death globally, accounting for an estimated 8.8 million new cases and 1.6 million deaths each year. (1) Mycobacterium tuberculosis, the organism that causes TB, is found almost...
TB-DOTS in the Philippines: Impact of Decentralization and Health Sector Reform
The base paper by Enarson & Billo includes a thoughtful account of the DOTS programme's development, from its inception following the Declaration of Amsterdam, the World Health Assembly resolution, and the workshop of National TB Programme Managers...
The Global Drug Facility: A Unique, Holistic and Pioneering Approach to Drug Procurement and management/Le Dispositif Mondial D'approvisionnement En Medicaments Antituberculeux : Une Approche Unique, Globale et Novatrice Pour L'accluisition et la Gestion De medicaments/El Servicio Farmaceutico Mundial, Un Mecanismo Singular, Holistico E Innovador Para la Adquisicion Y Gestion De Medicamentos
Introduction The Global Drug Facility (GDF) for tuberculosis (TB) was launched on World TB Day 2001; it grew out of a declaration made a year earlier by countries attending the Ministerial Conference on TB and Sustainable Development in Amsterdam....
The International TB Control Targets
Tuberculosis (TB) is one of the major causes of illness and death in many countries and a significant public health problem worldwide. Its importance as a barrier to socioeconomic development is recognized in the Millennium Development Goals, and combating...
The New Stop TB Strategy and the Global Plan to Stop TB, 2006-2015
Even though they were not reached everywhere, the international tuberculosis (TB) control targets set in 1991 for 2005 led to stronger government programmes based on sound approaches (1) and impressive improvements in many countries. (2) The new Stop...
The Philippines Case Study
Most TB patients in the Philippines are treated by private practitioners who do not conform to the international standard of TB care. (1) We established a private-public mix DOTS (PPMD) centre to engage private physicians in the DOTS strategy. (2)...
The "Vertical-Horizontal" Debates: Time for the Pendulum to Rest (in Peace)?
"Historia magistra vitae" said Cicero: history is the teacher of life. (1) It is an inevitable law of nature that unless there is a solid foundation of the past, no secure edifice of the future can be raised. q-hose who do not look at the past cannot...
Treatment and Management of MDR-TB in Latvia
Background Latvia has consistently ranked among the countries with the highest rates of MDR-TB in the world. In the first Global Tuberculosis Drug Resistance Survey (1996), 14.4%, or 1 out of 7, of all newly diagnosed sputum smear-positive tuberculosis...
Tuberculosis in Rwanda: Challenges to Reaching the Targets
Introduction Rwanda has a generalized HIV epidemic: 3.1% of adults are living with HIV/AIDS. (1) Care, treatment and prevention services for the approximately 183 558 adults and 13 901 children living with HIV/AIDS have been rapidly scaled up over...
Tuberculosis in the Dominican Republic: Addressing the Barriers to Sustain the Achievements
The base paper calls for urgent implementation of activities to achieve the targets for TB control set by the 1991 World Health Assembly, the 2015 Millennium Development Goals and the Stop TB Partnership. Laserson & Wells conclude that the greatest...