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Ideas & Opinions
Tuberculosis Care and Doctors Without Borders/Médecins Sans Frontières (MSF)
March 18, 2004
MSF has been confronted with tuberculosis (TB) since its first day of operation more than 30 years ago. In the past few years, MSF has expanded TB treatment to include more patients, and the focus has shifted from disease control to patient care.
MSF presently treats approximately 20,000 patients for TB in 32 MSF projects in 17 countries, including Afghanistan, Angola, Burma, DRC, Ethiopia, Georgia, Guinea, India, Ivory Coast, Azerbaijan, Kenya, Malawi, Sudan, Somalia, Turkmenistan, Thailand and Uzbekistan.
In addition to treating patients in traditional developing country settings and TB programs, alternative models have been found to treat migrants or nomadic people who are extremely difficult to follow.
Fifteen MSF projects now treat TB patients in chronic conflicts, including work in Abkhazia, Afghanistan and in South Sudan. An increasing number of patients receive TB care through MSF in general health centers, e.g. in Afghanistan, South Sudan and Angola.
MSF recently completed the report Running out of breath? TB Care in the 21st Century, an examination of the shortcomings of the global TB strategy, and TB diagnostic tests and drugs. The report concludes:
Expanding the current WHO-recommended global TB strategy, DOTS, or Directly Observed Therapy - Short Course, is not the only answer to TB. Improving DOTS is key if we are going to try to effectively treat the growing number of TB patients.
Vigorous action for improved, more inclusive DOTS and for resources to develop new tools to fight TB is needed.
MSF recommends the following points for action:
Revision of the global TB strategy
WHO should lead the process of revising a global TB strategy that adequately addresses the HIV/AIDS pandemic and its consequences for TB care.
Boost development and validation of new diagnostic tools
Quicken the pace of developing new, easier-to-use drugs and make them available at affordable prices
1. TB indications of existing drugs.
2. New compounds.