MSF: 'DOTS for All' strategy
24 March 2000
On World Tuberculosis (TB) Day, International humanitarian organization MSF calls for the increased awareness of tuberculosis in Uzbekistan, and highlights the need for the implementation of well managed DOTS programmes Press release, March 24, International TB Day - Owing to a lack of awareness about tuberculosis, a lack of global political commitment and poorly managed medical programmes throughout the world, tuberculosis is causing more preventable deaths today than any other infectious disease despite the fact that there is an internationally accepted cure, DOTS (Directly Observed Treatment Short Course). To meet the need for better DOTS programmes and TB control in the Aral Sea area - where the incidence of TB is the worst in all of Uzbekistan - MSF today, in conjunction with the Ministry of Health in Uzbekistan and Karakalpakstan, officially launches its 'DOTS FOR ALL' strategy. The strategy will lead to the complete coverage of the Aral Sea Area in DOTS TB control. MSF also opens a Regional Training Centre (RTC) in Nukus on this day, which will facilitate the fulfillment of MSF's 'DOTS FOR ALL' strategy. The RTC will consolidate the training, which MSF has already completed within pilot sites, where it has been working since 1998. Using WHO DOTS Training Modules and adapting them for all cadres of staff involved in the DOTS strategy, logisticians, health care and laboratory workers through to managers and administrators will be trained. DOTS, the TB treatment protocol recommended by the World Health Organization, is already being used in over 102 countries worldwide and has proven to be effective, efficient and cost effective in treating new cases of tuberculosis. In 1999, MSF completed a cost-effectiveness study, which compares the current treatment modality (traditional strategy), and the DOTS strategy. The results of the analysis show that if only new patients diagnosed in one year would receive DOTS this would result in almost $5 million USD in savings for the Republic of Uzbekistan. Although new cases of TB are completely curable, large numbers of people continue to become ill and die from the disease. Many cases remain undiagnosed due to a lack of awareness on the part of the patient and health staff. It is estimated that less than half of TB patients worldwide, are detected by the health care system. Moreover, many patients, after having started on treatment, do not complete their full course of medicines. This contributes to the development multidrug-resistant tuberculosis (MDR-TB) which is very difficult to treat and for which, treatment costs, between $US 5 000 and $US 8 000 per patient. This compares to the inexpensive treatment costs of $US 40 for one case of drug sensitive tuberculosis. In 1999, MSF launched an 'International Campaign for Access to Essential Medicines.' Over the years MSF has realised that increasingly there are fewer and fewer effective drugs being developed for dealing with tropical and infectious diseases. In addition, the costs of certain drugs - due to international trade barriers are prohibitively expensive, even when they are available. Considering the extent of the TB problem in the Aral Sea Area, with possible high rates of Multi-drug resistance, this campaign is directly important for Uzbekistan. MSF, the recent winner of the Nobel Peace Prize, is an independent non-profit medical relief organization working in over 80 countries all over the world. In the Aral Sea Area, MSF has been working in close co-operation with the Ministry of Health and National Health Workers in the fight against TB. Besides treating TB, MSF is also involved in the prevention and treatment of diarrhea diseases and acute respiratory infections in children, training of national staff and health education. MSF has an extensive operational research program to determine how the environmental disaster of the Aral Sea Area is affecting the health of the population. They are actively advocating for international community and donor attention to the issues of the Aral Sea.