The World Health Organization (WHO) launched a new strategy to fight tuberculosis last week with a renewed call for expansion of directly observed therapy (DOTS), together with an increased focus on TB/HIV coinfection and on multidrug resistant TB.
The Stop TB Strategy, published in the 17 March issue of The Lancet medical journal, was developed during a consultation process involving international health partners over a two-year period. Its six components are:
- Pursuing high-quality DOTS expansion and enhancement. Making high-quality services widely available and accessible to all those who need them, including the poorest and most vulnerable, requires DOTS expansion to even the remotest areas.
- Addressing TB/HIV, MDR-TB and other challenges. Addressing TB/HIV, MDR-TB and other challenges requires much greater action and input than DOTS implementation and is essential to achieving the targets set for 2015, including the United Nations Millennium Development Goal relating to TB (Goal 6; Target 8).
- Contributing to health system strengthening. National TB control programmes must contribute to overall strategies to advance financing, planning, management, information and supply systems and innovative service delivery scale-up.
- Engaging all care providers. TB patients seek care from a wide array of public, private, corporate and voluntary health-care providers. To be able to reach all patients and ensure that they receive high-quality care, all types of health-care providers are to be engaged.
- Empowering people with TB, and communities. Community TB care projects have shown how people and communities can undertake some essential TB control tasks. These networks can mobilize civil societies and also ensure political support and long-term sustainability for TB control programmes.
- Enabling and promoting research. While current tools can control TB, improved practices and elimination will depend on new diagnostics, drugs and vaccines.
The new Stop TB Strategy underpins the Global Plan to Stop TB, 2006–2015, an ambitious US$ 56 billion action plan launched in January. If fully implemented, the Global Plan will treat 50 million people for TB, halve TB prevalence and death rates and save 14 million lives.
“We must involve a much broader array of actors in TB control and adapt DOTS to HIV coinfection, MDR-TB and other special challenges if we're going to achieve the 2015 targets of the Global Plan, which is exactly what the new Stop TB Strategy calls for,” said Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership. “The strategy is robust and is also inclusive.”