Status of TB Operations

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Status of TB Operations (Region of the
Americas, 2004)
Regional Program on Tuberculosis
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Elements of the DOTS Strategy

• Political commitment
• Bacteriological diagnostic capacity
• Regular supply ofmedications and supplies
• Directly Observed Treatment Strategy
• Information system

Registries
Training, Supervision, IEC, Evaluation
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Trend of DOTS Coverage ( pop., 19992003)
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Current Status of the DOTS Strategy (Americas,
2002)
DOTS Coverage 73 of thepopulation
lt 10 coverage lt 10 -lt49 gt50-90 Total
coverage No DOTS
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Coverage of the DOTS/TAES Strategy(by country,
Americas, 2002)
Countries that have improved their coverage
within the same category
Countries in the same category without changes
Countries whose category has gone up
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Success in Treating TB BAAR Cases(Region of the
Americas, 2002)
OR 2.21 (IC2.15 2.28)
17
83
41
59
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Current Limitations for Controlling TB, Region of
the Americas

• Political support for National TB Programs.
• Health-sector reform process.
• Irregular drug supply.
• High staff turnover, need to improve training
  (management/supervision).
• Organization of laboratory network, insufficient
  quality control.
• Inconsistent registry system and delay in
  reporting.
• Insufficient monitoring and cohort analysis.

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Main Challenges

• Expand DOTS Strategy in the remaining countries,
  so as to achieve total DOTS coverage in 2005.
• Strengthen laboratory capacity.
• Strengthen regional capacity for country
  monitoring.
• Maintain and/or reinforce resistance
  surveillance.

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Main Challenges

• Coordinate joint strategies for HIV/AIDS-TB
  Programs.
• Increase access to and application of strategies
  for groups at high risk for TB.
• Minimize possible negative effects of the
  health-sector reform process..
• Maintain high levels of training and supervision
  at the country level.

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Millennium Development Objectives (2015)

• Goal 6
• Fight HIV/AIDS, Malaria, and other illnesses
  (TB).
• Objective 8
• Stop and begin to reduce the spread of HIV/AIDS.
  
• Stop and begin to reduce the incidence of
  malaria and other serious illnesses (TB).
• Indicators
• 23. Prevalence and mortality rates associated
  with tuberculosis.
• 24. Proportion of tuberculosis cases detected and
  cured under DOTS.

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Regional Action Plan (PAHO Regional Program on
TB, 20042005)

• The Plan of Action for the biennium will be
  structured on the basis of the magnitude of the
  TB problem in the countries and the challenges
  for implementing/expanding the DOTS/TAES
  Strategy.
• Objective
• To assist the countries of the Region of the
  Americas in the implementation and expansion of
  the DOTS/TAES Strategy, so as to achieve
  millennium objectives.

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Strategy and Goals

• Strategy
• Support to countries in the extension of the DOTS
  Strategy, via training, monitoring, and
  evaluation.
• Support to countries for surveillance of
  resistance of anti-tubercular drugs (MDR).
• Advocacy in the search for technical and
  financial partners.
• Goals
• For all countries of the Region to have
  implemented/expanded the DOTS/TAES Strategy on a
  national scale by the end of 2005.

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World TB Day 24 March 2004