Tuberculosis and health systems

Tuberculosis (TB) is estimated to kill around two million people world-wide each year, and is the major cause of death in people living with HIV/AIDS. While most cases of TB can be treated within a six-month course of drugs, increasing numbers are proving resistant to treatment. Many people in developing countries fail to access treatment as a result of high drug process, cessation of symptoms after three to four weeks and non patient-friendly care.

DOTS (directly observed treatment, short-course) is cheap and effective, costing around US$ 10-20 per course of treatment, with high cure rates. It is one of the most tangible health interventions available, a valuable catalyst to strengthening health systems, and an effective strategy for poverty alleviation.

The literature on TB and DOTS reflects the important role of governments and the private sector in providing TB drugs and services. Evidence shows that health services need to be patient-centred and non-discriminatory. DOTS providers must continue to reach out and adapt DOTS to the needs of their TB patients. DOTS workers and the community must ensure the right to health for each patient even in remote communities and among minority populations.