India, China rapidly expand tuberculosis control, UN health agency reports

India and China, which account for more than one third of the world's tuberculosis (TB) cases, have achieved high rates of case-identification and cure by expanding the implementation of a strategy promoted by the United Nations World Health Organization (WHO).

The progress in both countries will be among the topics discussed at the 4th World Congress on TB that opened today in Washington, D.C.

According to two studies appearing in the WHO Bulletin, efforts to expand the Directly Observable Treatment System (DOTS) in both countries have been an effective strategy even in places where the technology and public health infrastructure have been inadequate.

"These studies clearly show that even in huge countries with a heavy burden of TB it is possible - with strong political commitment, adequate financial resources and sound technology - to achieve very high levels of cure," said Jong-Wook Lee, Director of WHO's Stop-TB Programme.

WHO and its partners have been leading the global effort against tuberculosis by expanding DOTS, which is now used in 148 countries, and has set two main targets for 2005: to identify 70 per cent of estimated new infectious TB cases, and to cure 85 per cent of cases identified.

While the two studies highlight the effectiveness of DOTS, they also underline the difficulties of implementing it. In both countries, nearly half the population is not yet covered by the strategy and case identification rates remain below the global target.

"This means that both programmes need to reach more TB patients in the areas they cover," says Mario Raviglione, WHO's head of TB Strategy and Operations. "For that, innovative approaches are needed, such as involving health workers in other settings in the care of TB patients, in hospitals in China, for instance, and private practices in India."