Tuberculosis, the most dreaded communicable lungs-infection disease of yester years that has claimed hundreds of lives since inception of the country is now under control with strong initiatives by the Ministry of Health and the World Health Organisation (WHO) for augmenting drive to overcome the spectrum.
The government took up the issue with missionary zeal and advanced Drug On Throat Short Course (DOTs) on war footing to check the menace effectively. USAID funding for Pakistan was $1.1 million in Financial Year 2004 and $1 million in Financial Year 2005 to fight against this ailment.
Ministry of Health persuaded donor agencies like WHO, USAID as a result of which US assistance focused on DOTS expansion in collaboration with the National Tuberculosis Programme (NTP) and WHO.
The support is aimed at strengthening TB control capacity at the provincial and district levels. USAID assistance targets the following activities and interventions including strengthening supervision and co-ordination at the provincial and district levels through national program officers and providing technical assistance for strengthening DOTS expansion at the federal level.
Supporting supervision and surveillance at district and provincial levels, conducting advocacy, communication, and social mobilisation through province-level sociologists and patronising public-private mix activities through non-governmental organisations in five cities Lahore, Faisalabad, Khanewal, Rawalpindi, and Karachi USAID Programme Achievements are also part of the campaign.
USAID assistance and the support of other partners for the NTP have contributed to the improvements in TB control in Pakistan and attained 100 percent DOTS population coverage in May 2005 by expanding DOTS activities in the public primary healthcare network.
The assistance increased the treatment success rate to 82 percent in 2005, close to the global target of 85 percent, with doubling of detected TB cases from 73,497 in 2003 to 141,741in 2005 and supported the development and utilisation of technical guidelines for TB control.
It also supported the laboratory network and initiated external quality assurance guidelines and collaborated with ongoing programmes, particularly the Lady Health Worker programme, in sharing technical resources Case Detection and Treatment Success Rates Under DOTS.
Pakistan ranks seventh among the 22 high-burden tuberculosis countries world-wide, according to the World Health Organisation (WHO) Global TB Report 2006.
Between 2000 and 2004, DOTS coverage increased in Pakistan from 9 to 79 percent. As the DOTS program expands, the quality of treatment must also improve.
Treatment success was just 75 percent in the 2003 cohort, but high proportion of patients were not subject to follow-up.
The sitting government declared TB a national emergency in 2001 that led to substantial increase in the budgetary allocation for Tuberculosis from $1.65 million in 2001 to $26 million in 2006.
In addition, the National TB Control Program (NTP) has received a $1.5 million grant from the Global TB Drug Facility. Despite improvements, the NTP still faces challenges. As TB planning shifts from the national to the district level, technical and managerial capacity at the provincial and district levels require strengthening.