KARACHI, April 2: Sindh Health Minister Ahsan Ahmad has emphasized the need that the DOTS programme to combat tuberculosis, which will kick off here next month, should be properly handled by the city government and all health officials.

He stated this at the inaugural ceremony of a two-day training workshop on district DOTS implementation plan for Karachi at Ojha Sanitorium on Tuesday.

The minister pointed out that DOTS (directly-observed treatment strategy) coverage had already risen to more than 25 per cent, which was less than 10 per cent two years ago.

He said a total financial outlay of Rs720 million was available for TB control at federal and provincial levels, while two years ago this amount was Rs240 million, with Rs95 million coming from the Sindh government.”

Although this massive flow of funds augured well for the success of the programme, nevertheless a lot depended on the performance of the care-providers and other staff at the lowest tiers of health services who execute the programme, he observed.

“Proper monitoring and supervision at district level is, therefore, viewed as a major determinant of success or otherwise for the programme in an environment which is highly favourable,” he remarked.

He said it was gratifying to note that the World Health Organization’s recent report on global T.B control had listed Pakistan as one of the seven high burden TB countries where major advances were expected in the year 2002, provided the required funds were available.

The challenge would be to show that DOTS expansion programme in these countries could significantly enhance case finding process, besides maintenance of high cure rates.

“This puts Pakistan in a highly challenging position, but I am confident that we would achieve our targets and put Pakistan on the map of countries that are rapidly expanding their DOTS coverage with good treatment results,” he observed.

The minister expressed satisfaction that a recent WHO mission after visiting Sindh and other parts of the country had noted that substantial progress had been made in the expansion of DOTS programme since they last visited Pakistan in May, 2001.

The mission appreciated the tempo of expansion with services being extended in the province accompanied by maintenance of high level of success in treatment, he added.

The expansion had been guided by careful strategic planning and sectoral coordination and the services had been successfully implanted within the existing health system, using the lady health workers to access the community,” he pointed out.

Director TB Control, Sindh, Ghulam Nabi Khokar, said while looking back we regret that we lost several years not responding adequately to the menace.

“Pakistan has the 5th highest TB burden globally and accounts for 44 per cent of the disease burden in the eastern Mediterranean region, which comprises 23 countries. The incidence of the disease stands at 177/1,00,000 and it is estimated that there are around 1.5 million patients in the country with 250,000 new cases surfacing every year,” he added.

He said although TB control was an ultimate responsibility of the government, yet efforts were being made to involve the private sector in assisting the government in this regard.

Dr Ashraf Sadiq, director of Ojha; Syed Karam Ali Shah, national programme manager TB control programme; Dr Ghulam Nabi Qazi of WHO; and EDO health Karachi, Dr Ali Nawaz Sheikh, also spoke.—PPI