15 Years of DOTS Has Saved 8 Million Lives

December 10, 2009
by John Fawcett, Global Legislative Director, RESULTS

New data from the World Health Organization (WHO) demonstrate the success and promise of effective tuberculosis (TB) control programs. Since the WHO embraced the DOTS strategy in 1994, 36 million people have been cured of TB and 8 million deaths have been averted.

DOTS — or Directly Observed Therapy, Short-course — is a standard regimen for TB where patients are monitored by a health worker or other community member to ensure treatment is completed. TB treatment typically lasts 6 months and can cause difficult side effects, so observed therapy plays an important role in supporting patients to comply with their treatment. Interrupting or stopping TB treatment early can allow the disease to return, often as amore dangerous drug-resistant strain. The WHO also reports that the cure rate for treated patients is now 87 percent, surpassing the global target of 85 percent for the first time since it was established in 1991.

Expanding access to DOTS is the backbone of the global Stop TB Strategy. While tremendous progress has been made, WHO’s new report also demonstrates the challenges ahead. In 2008 there were 9.4 million cases of TB reported and 1.8 million deaths. The report notes progress in the number of TB patients tested for HIV, but a half million TB deaths are still associated with TB-HIV co-infection. There are particularly troubling gaps in treating multidrug-resistant (MDR) TB. Of the estimated 500,000 patients with MDR-TB in 2008, only 6,000 were receiving proper treatment according to WHO standards.

The WHO’s new report comes as the Obama Administration is finalizing both its fiscal year 2011 budget request and its 6-year Global Health Initiative. Both are critical opportunities for the U.S. to show bold leadership in accelerating progress toward eliminating TB.

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