Towards ending tuberculosis: what gets measured gets done


A problem-solving culture of innovation

In dealing with these dramatic new threats, WHO and its partners had much to build on. In 2006, a new Stop TB Strategy was launched by WHO following intensive exploration and discussion with the managers of TB control programmes in high-burden countries and their partners, including technical agencies and donors. At that time, broad adoption of the WHO DOTS strategy, or directly-observed treatment, short course, had produced remarkable progress in TB control for nearly a decade. The new strategy was designed to pursue DOTS expansion while adding five new lines of action judged essential for meeting the MDG TB target.

Hirpessa Geleta (left) and Angasu Dhuguma (middle) are community volunteers in Wolisso, Ethiopia
Community volunteers working on TB, Ethiopia
WHO/N. Tesfaye

Ways to tackle TB/HIV co-infection and MDR-TB were included together with strategies for strengthening health systems, engaging all care providers in the private and public sectors, empowering people and communities, and promoting targeted research. To support the new strategy, WHO issued a fully costed Global Plan to Stop TB 2006–2015.

WHO had already established a culture of innovation. The Stop TB Partnership, hosted and housed at WHO, demonstrated a remarkable ability to solve problems through the creation of innovative new facilities and mechanisms, including the establishment of a dedicated global drug facility. By procuring drugs at competitive prices and consistently ensuring that their quality met WHO’s stringent standards, the global drug facility brought order to a market previously characterized by chaos .

"The global drug facility brought order to a market previously characterized by chaos."

Dr Chan, WHO Director-General

To address the many problems raised by the emergence of MDR-TB, WHO established a Green Light Committee in 2000 to ensure the supply of second-line drugs, oversee the proper and rational use of drugs, and make them more affordable. Before releasing second-line drugs, the committee rigorously reviewed country proposals to ensure that their use would not further promote drug resistance. That requirement had the additional advantage of transferring high-level expertise in drug management from WHO to national control programmes. The Global Fund backed the initiative by issuing a requirement that all funds for the purchase of second-line drugs must be approved by the Green Light Committee.