The
new Stop TB Strategy addresses the current challenges facing countries in
responding to TB how to continue scaling-up TB control activities while also
addressing the spread of TB and HIV coinfection and multidrug-resistant TB (MDR-TB).
Both TB/HIV, especially in
Africa
, and MDR-TB, particularly in eastern Europe, are seriously hampering global
control efforts to reduce the 1.7 million deaths caused by TB every year.
At
the strategys core is DOTS, the TB control approach launched by WHO in 1995.
Since its launch, more than 22 million patients have been treated under
DOTS-based services. The new six-point strategy builds on this success, while
recognizing the key challenges of TB/HIV and MDR-TB. It also responds to access,
equity and quality constraints, and adopts evidence-based innovations in
engaging with private health-care providers, empowering affected people and
communities and helping to strengthen health systems and promote research.
DOTS
remains central to TB control. Without it we would have no TB control. But with
DOTS programmes now established in 183 countries, the new Stop TB Strategy
injects new energies to make efforts more comprehensive and effective, said
Dr Mario Raviglione, Director of WHOs Stop TB Department. The Stop TB
Strategy aims to ensure access to care for all TB patients, to reach the 2015
Millennium Development Goal for TB and to reduce the burden of TB worldwide.
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:
1.
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.
2.
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).
3.
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.
4.
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.
5.
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.
6.
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, 20062015, 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.
Details
of the new Stop TB Strategy are published in this weeks issue of the Lancet
as part of a special TB essay focus prior to World TB Day, which is held every
year on 24 March.
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