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DOTS Treatment Strategy Helps Fight Tuberculosis in India


The World Health Organization says a treatment strategy is stemming tuberculosis in India, and saving tens of thousands of lives.

India has the highest number of tuberculosis cases in the world. The figures are staggering. In India, 1.8 million people develop tuberculosis every year, and 1,000 people die every day, or one every minute.

The disease, despite being curable, ran rampant in India because most illiterate and impoverished patients could not afford the recommended 6-month treatment. Many stopped taking the drugs halfway through the treatment, and as a result, tuberculosis recurred in a more deadly, drug-resistant form.

Five years ago, the Indian government and the World Health Organization began a large-scale approach called "Directly Observed Treatment," or DOTS, which has been successful in other countries.

Directly Observed Treatment means that no drugs are handed out to patients. Instead, health clinics identify tuberculosis patients, then insist they walk to the nearest free clinic three times a week and take their medicine while a health worker watches. Two million people are currently being treated under DOTS.

Leopold Blanc is a WHO coordinator for tuberculosis control. He recently visited five Indian states and is upbeat about what he found, saying the new strategy seems to be working. "The patient is properly diagnosed," said Mr. Blanc. "There are drugs available free of charge. The patient treatment is monitored carefully. There is regular monitoring of what is going on. Reports are sent up to the national level. And, I think these are the very, very important elements." Health experts say the cure rate has increased dramatically. WHO expert Fabio Luelmo estimates 450,000 Indians will be saved by the end of this year.

"Mortality is being reduced already," he said. "And certainly transmission is being reduced, and, therefore, the children in the next generation will have much less tuberculosis than in this generation."

Right now, the program covers about three-quarters of India's one billion-plus population. WHO is urging the government to expand the program to the rest of the population to completely wipe out the disease.

WHO officials say, if the program continues on the right track, India could cut the incidence of tuberculosis by half in six-to-seven years.

Tuberculosis is one of the world's deadliest infectious diseases, and has recently made a comeback in rich, industrialized nations. The dramatic upsurge prompted WHO to declare the disease a global emergency in 1993.

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