15 years of DOTS programmes

February 7, 2010 by sarahloubailey

2010 marks the 15 year anniversary of the launch of the World Health Organisation (WHO)-recommended tuberculosis (TB) control strategy, directly observed treatment short-course (DOTS) and offers an appropriate time to reflect on its impact.

According to WHO reports, TB remains one of the top 10 causes of death worldwide. More than 2 billion of the world’s population are infected with TB bacilli. However, recent WHO data show DOTS is beginning to change this. DOTS is responsible for the cure of 36 million people with TB and has averted up to 8 million TB deaths, revealing that the DOTS Strategy (1995 – 2005) and its successor the Stop TB Strategy (2006 – present) is the most cost-effective approach to TB management.

DOTS combines five components for the comprehensive management of TB: political commitment with increased and sustained financing, case detection through quality-assured bacteriology, standardised treatment with supervision and patient support, an effective drug supply and management system, and a standardised monitoring and evaluation system that allows assessment of treatment results.

The world as a whole is on target to reach the Millennium Development Goal (MDG) 6c, to halt and begin to reverse the incidence of TB by 2015. TB eradication remains a long way off but the progress made with DOTS is commendable. Despite poor resources, many communities worldwide are becoming equipped to manage TB. Could DOTS be an effective framework to adapt to the management of other diseases – including non-communicable diseases – in resource-poor settings?

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