Pharmaceutical Management for Tuberculosis. Assessment Manual. (Revised Edition 2005)
(2005; 162 pages)

Rational Pharmaceutical Management (RPM) Plus Program. 2005. Pharmaceutical Management for Tuberculosis Assessment Manual. Edited by A. Zagorskiy, C. Owunna, and T. Moore. Submitted to the U.S. Agency for International Development by the RPM Plus Program. Arlington, VA: Management Sciences for Health.


The World Health Organization (WHO) recommends DOTS as a cost-effective treatment strategy for detection and cure of TB. DOTS consists of five main elements: sustained political commitment; access to quality-assured sputum microscopy; standardized short-course chemotherapy for all cases of TB under proper case management conditions, including direct observation of treatment; uninterrupted supply of quality-assured drugs; and a recording and reporting system to enable outcome assessment of all patients and assessment of overall program performance.

Global initiatives such as the Stop TB Partnership, the Global TB Drug Facility (GDF), the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), and the Green Light Committee (GLC), as well as WHO working groups (DOTS expansion, DOTS Plus, TB/HIV, TB laboratory), were established in response to the escalating prevalence of the disease.

However, while it was proved that tuberculosis could be successfully treated with modern medicines and treatment regimens, many countries fail to reach the WHO global targets of cure rates of at least 85 percent and 70 percent detection of patients with sputum smear-positive pulmonary TB. This situation is largely due to lack of political commitment and funding, failure to manage cases adequately, and inconsistent supply of TB medicines to patients. TB intervention strategies should be continuously monitored to identify gaps in national TB control programs exhibiting low cure rates.

In 2000, the Rational Pharmaceutical Management Plus (RPM Plus) Program, supported by the U.S. Agency for International Development (USAID), prepared the Drug Management for Tuberculosis (DMTB) Assessment Manual to assist TB program managers, governments, and partners in evaluating pharmaceutical system capacity to provide a constant supply of TB medicines. This update, renamed the Pharmaceutical Management for Tuberculosis (PMTB) Assessment Manual, was completed in 2004.

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