M C Bosman1. 1. Royal Netherlands Tuberculosis Association, The Hague. bosmanm@who.ch
Abstract
SETTING: Zambia, 1995-1997. OBJECTIVE: To describe the process leading to the collapse of Zambia's National Tuberculosis Programme NTP). DESIGN: A descriptive analysis of health sector reform in Zambia and its effects on the NTP during the period 1995-1997. RESULTS: By the end of 1997 the NTP had stopped functioning. The main reason was that external support had ended, while the National Strategic Health Plan 1995-1999 had no budget for special programmes according to the policy to integrate these into the general health services. As a consequence, technical support for tuberculosis control to districts ended as staff was reduced to one officer responsible for the national coordination of AIDS/HIV, sexually transmitted diseases (STD), tuberculosis and leprosy. The most serious effect of the transition was the interruption of supplies of anti-tuberculosis drugs in 1998. CONCLUSIONS: The experience in Zambia demonstrates the urgent need for constructive dialogue between 'health reformers' and 'disease controllers'. The aim of this dialogue would be to develop a model that ensures that tuberculosis patients are properly diagnosed and cured in countries that are embarking on a reform of their health services.
SETTING: Zambia, 1995-1997. OBJECTIVE: To describe the process leading to the collapse of Zambia's National Tuberculosis Programme NTP). DESIGN: A descriptive analysis of health sector reform in Zambia and its effects on the NTP during the period 1995-1997. RESULTS: By the end of 1997 the NTP had stopped functioning. The main reason was that external support had ended, while the National Strategic Health Plan 1995-1999 had no budget for special programmes according to the policy to integrate these into the general health services. As a consequence, technical support for tuberculosis control to districts ended as staff was reduced to one officer responsible for the national coordination of AIDS/HIV, sexually transmitted diseases (STD), tuberculosis and leprosy. The most serious effect of the transition was the interruption of supplies of anti-tuberculosis drugs in 1998. CONCLUSIONS: The experience in Zambia demonstrates the urgent need for constructive dialogue between 'health reformers' and 'disease controllers'. The aim of this dialogue would be to develop a model that ensures that tuberculosispatients are properly diagnosed and cured in countries that are embarking on a reform of their health services.
Authors: Merrin E Rutherford; Rovina Ruslami; Melissa Anselmo; Bachti Alisjahbana; Neti Yulianti; Hedy Sampurno; Reinout van Crevel; Philip C Hill Journal: Bull World Health Organ Date: 2013-09-10 Impact factor: 9.408
Authors: M C S Motta; T C S Villa; J Golub; A L Kritski; A Ruffino-Netto; D F Silva; R G Harter; L M Scatena Journal: Int J Tuberc Lung Dis Date: 2009-09 Impact factor: 2.373