KARACHI, Jan 18: The Tuberculosis Control Programme in Sindh has entered into a very crucial phase and it is imperative that all out efforts are made to improve the quality of care provided to TB patients.

This was stressed by medical experts during a three-day workshop, organized by the National TB Control Programme in collaboration with the UK Department for International Development to develop a strategic plan for TB control activities in Sindh.

The participants of the workshop observed urgent need for a strong partnership in the fight against tuberculosis. In his key-note address, the Programme Officer of WHO-Sindh, Dr Ghulam Nabi Kazi, said that after accomplishing the formidable task of achieving universal TB-DOTS coverage in Sindh, it was necessary to strengthen public sector health facilities. He said that a meaningful and sustainable relationship with the non- governmental organizations would help strengthening health facilities.

He stressed that sustained political commitment since the year 2000 had resulted in giving tremendous impetus and momentum to the programme. However, he added, the programme could not rest on its laurels, as it would have to face greater challenges in order to achieve its targets.

Dr Kazi described the planning exercise as a very timely activity and thanked the organizers for having arranged it. However, he regretted that the programme could not achieve its targets in the past due to its verticality and undue reliance on donors' support. At present, he added, the programme was working in a highly efficient manner through direct government spending or grants from international organizations.

It was pointed out that integration of TB-DOTS services in the district health system would serve to eliminate the current weaknesses in the programme. He said that this would make DOTS process more patient friendly, especially with innovative approaches and operational research being carried out with WHO support.

Earlier, Sindh Director TB Control Dr Iqtidar Ahmed welcomed the participants, including senior government and WHO officers involved in TB control, representatives of NGOs and senior hospital administrators.

He emphasized the fact that the programme was engaged in enhancing the current case detection rate of smear positive cases from 50 per cent to 70 per cent by the year 2005 and treat at least 85 per cent of them successfully in order to reduce the prevalence and mortality due to the disease by 50 per cent by the year 2010.

Dr Iqtidar said that the provincial government had extended the TB Control Programme till June 2006 at a total revised cost of Rs149.035 million enabling the programme to achieve its objectives.

Director Ojha Institute of Chest Diseases Dr M. Ashraf Sadiq highlighted the role of his institute in initiating TB-DOTS services in 1996 in Pakistan. He thanked the organizers for arranging the meeting at the institute and called for integrating TB-DOTS services with general health services at district level.

Chairman Social Development Association Dr M. Amir Khan spelt out the objectives of the workshop that included defining the roles and responsibilities of various categories of health personnel; developing strategies to ensure uninterrupted supply of drugs, laboratory reagents, recording and reporting material, community mobilization, advocacy, mass awareness about TB; monitoring and supervision of the programme and carrying out effective public private partnerships.

He expressed hope that the strategic plan would also include scheduling of major activities and identify the inputs, requirements and deficiencies or gaps in the programme alongwith the means to address the same.

Among others, the workshop was attended by Medical Superintendent of Sindh Government Hospital, New Karachi, Dr Capt A. Majid; Deputy Directors TB Control, Dr Nazir Ahmed Shaikh and Dr Ismet Ara; WHO National Programme Officers, Dr Amanullah Ansari and Dr Javed Ahmed Shaikh; Dr Rozina Mistry of Aga Khan Health Services, Pakistan; Chairman Sindh Anti-TB Association, Dr Noor Muhammed Memon; Civil Surgeon Thatta, Dr Lal Mir Shah; Kolachi Focal Person for TB, Dr Nazir; and Medical Officer TB Control, Karachi, Dr Khowla Kazi. -APP