Health Workers: Heroes in the Struggle Against Tuberculosis

Washington, D.C., March 23, 2005 (PAHO)—World Tuberculosis Day is being commemorated tomorrow with a tribute to the many health workers who struggle anonymously against the disease, which kills 5,000 people every day worldwide, including 150 people in the Americas. The slogan selected for World TB Day for 2005 is "Health-Care Providers: Heroes in the Fight against Tuberculosis."

Though TB is highly treatable and curable, using the "DOTS" strategy launched by the Pan American Health Organization in 1993, and the percentage of cases cured in the Region has been increasing in recent years, the TB situation is still very unequal between countries and even in different regions of a single country.

DOTS stands for Directly Observed Treatment, Short Course, and includes five main elements:

• Political commitment for TB control.
• Quality bacteriological diagnosis accessible to the population.
• Permanent provision of certified quality drugs.
• Treatment with standardized shortened regimens and taking medication under direct observation by a health worker.
• Record and information systems to monitor and evaluate the interventions.

Implementation of the DOTS strategy at the primary care level, making it accessible to the entire population, has demonstrated that it can cure more than 85 percent of the patients.

The role of the health worker is essential to make the strategy work, since he or she not only diagnoses TB cases, but also personally follows up with the patient, making sure the patient takes the correct medication and completes the treatment. Failure to complete the full treatment course can result in drug-resistant forms of TB, which are much harder and more expensive to treat.

Since the implementation of this strategy in the Americas more than 2 million cases of TB have been diagnosed, including 1 million highly contagious cases. In tandem with improving diagnosis, each year the percentage of patients cured has increased, reaching 81 percent in 2002. Successful application of the strategy in various countries has resulted in an annual 2.6 percent decrease in TB each year since 1995.

However, the situation is not uniform in all countries. Increases in poverty, rapid expansion of the HIV epidemic, and drug-resistant forms of TB are among the major reasons that TB continues to be a problem in many poor countries, snatching young and productive lives, leaving homelessness and misery, and creating more challenges for health systems.

PAHO was established in 1902 and is the world's oldest public health organization. PAHO works with all the countries of the Americas to improve the health and the quality of life of the people of the Americas. It serves as the Regional Office for the Americas of the World Health Organization (WHO). PAHO Member States today include all 35 countries in the Americas. France, the Kingdom of the Netherlands, and the United Kingdom of Great Britain and Northern Ireland are Participating States. Portugal and Spain are Observer States, and Puerto Rico is an Associate Member.