[Tuberculosis control in the world: results and challenges].
The modern tuberculosis control strategy, which focuses on identifying and curing infectious cases, has made remarkable progress in recent years. This strategy, known as DOTS, receives significant support from bilateral and multilateral donors, in particular from the recently created Global Fund against AIDS, Tuberculosis and Malaria. Although case finding rates are still far too low everywhere in the world (45%), cure rates among infectious cases (target 85%) are progressing, but are still too low in Africa (71%). Nevertheless, the spread of the HIV/AIDS epidemic had led to a dramatic increase in the number of tuberculosis cases, even in countries where tuberculosis programmes have been functioning well for several years; in those countries that are heavily affected by HIV/AIDS, tuberculosis seems to be difficult to control if no progress is made in controlling the HIV epidemic. Health services are often too centralised, particularly in the big cities, and all health structures need to be involved in fighting tuberculosis. Treatment possibilities are limited; new research has been initiated to find new anti-tuberculosis drugs, but it is extremely important to take care to avoid the development of resistance to those drugs that are available. The main challenge in vanquishing tuberculosis is still that of development, mainly of the health services, and particularly their human resources. Tuberculosis elimination is necessarily a long-term goal that will require constant effort spanning several decades.
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Union Internationale Contre la Tuberculose et les Maladies Respiratoires, Paris. ATrebucq@iuatld.org
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control; D003695:Delivery of Health Care / Q000458:organization & administration; D004196:Disease Outbreaks; D014943:Global Health; D006801:Humans; D017053:Infection Control; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control*