Wednesday, January 16, 2008

Recent article highlights DOW's efforts to build local capacity for TB Control in Kosovo

This month’s issue of the journal Respiratory Medicine features an article co-authored by HealthRight International (formerly Doctors of the World-USA) on implementing the WHO-recommended Directly Observed Treatment, Short-course (DOTS) strategy for TB control in post-war Kosovo. While DOTS has been proven highly effective in many countries around the world, little has been done to investigate its efficacy in a transitional, post-war environment.
Following the 1999 conflict in Kosovo and Serbia, political and economic instability resulted in the deterioration of health infrastructure and increased barriers to health care access. High rates of TB morbidity and mortality plagued Kosovo.  A new National Tuberculosis Program (NTP) to implement DOTS was launched under the leadership of the United Nations Mission in Kosovo. The WHO named HealthRight, who began implementing TB control programs in Kosovo in 1994, as the lead implementing partner. 
HealthRight and the NTP developed a five year TB Action Plan to implement DOTS and to increase access to health care, particularly for minority populations such as the Roma and Serb communities.  The plan required the long-term dedication of a number of partner organizations aside from HealthRight: Fogarty International Center/National Institutes of Health-USA, Fondazione S. Maugeri, S. Raffael Hospital, and Supranational Reference Laboratry-SRL, Italy. Close collaboration and communication between the partners allowed the NTP and HealthRight to track and review progress and maximize efficiency. The action plan emphasized human resource development and capacity building; NTP officials and partners took part in technical trainings and conferences, and the laboratory network was overhauled according to international recommendations.  
Today, Kosovo has reached two World Health Assembly targets – a 75% case detection rate and a treatment success rate of over 85% – and the number of positive TB cases has continuously decreased. This successful initiative in an unstable, post-war setting can be applied to strengthening TB control in other transitional and post-war settings. Based on the experience of HealthRight and its partners in Kosovo, the article recommends the identification of an authoritative agency (e.g., WHO) and a lead implementing agency (e.g., HealthRight) to work in partnership through the NTP, frequent and regular communications between partners, strong management of and investment in human resources, and dedicated, long-term partners to ensure efficient and thorough implementation. 
Learn more about HealthRight’s work in Kosovo.