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Bulletin of the World Health Organization

Print version ISSN 0042-9686

Bull World Health Organ vol.81 n.11 Genebra Nov. 2003 



Workforce crisis a major obstacle in global tuberculosis control



Tonelli's death coincided with the release of a draft report at a meeting of tuberculosis experts in the Hague on 7 October citing a growing "workforce crisis" as one of the major obstacles to successful global tuberculosis (TB) control. Poor pay and conditions, unhealthy and often unsafe working environments, together with HIVrelated illness among staff, are restricting progress towards the global target of detecting 70 per cent of all new infectious cases and curing 85 per cent of them by 2005, the report said.

Delegates from the DOTS [directly observed treatment strategy] Expansion Working Group, a group of TB experts from the Stop TB Partnership (a global network of individuals and organizations committed to eradicating TB), reviewed the current status of DOTS and its impact on the global targets. The report concluded that a rapid expansion of DOTS across the world is now required if the targets are to be reached. It also identified key constraints including the slow and ineffective recruitment and training of TB health workers in developing countries.

"We are clearly seeing a general 'workforce crisis' in the TB community," said Dr Mario Raviglione, Director of WHO's Stop TB Department. "The challenge we face with TB is too great for this to occur. Other priority health programmes will also face the same problem," he said. According to the report, 17 of the 22 high burden countries which account for 80% of the world's TB cases, said that their efforts to reach the 2005 targets are being hampered by staffing problems.

"We need to promote improved working conditions for TB control staff that are attractive and also an incentive for them to stay working in TB," said Dr Leopold Blanc, Coordinator of WHO's Stop TB Department. Other areas for action included enhancing political commitment by raising the position of TB on the development and poverty reduction agendas, intensifying advocacy, strengthening primary health care and accelerating the response to the HIV emergency by speeding up the delivery of antiretroviral treatment to patients co-infected with HIV and TB.

The final report will be released at the Stop TB Partners Forum in Delhi at the beginning of December 2003, when partners will gather to assess the status of global TB control.