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Free Content Health sector reform and tuberculosis control: the case of Zambia [Country Case Report]

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SETTING: Zambia, 1995–1997.

OBJECTIVE: To describe the process leading to the collapse of Zambia's National Tuberculosis Programme (NTP).

DESIGN: A descriptive analysis of health sector reform in Zambia and its effects on the NTP during the period 1995–1997.

RESULTS: By the end of 1997 the NTP had stopped functioning. The main reason was that external support had ended, while the National Strategic Health Plan 1995–1999 had no budget for special programmes according to the policy to integrate these into the general health services. As a consequence, technical support for tuberculosis control to districts ended as staff was reduced to one officer responsible for the national co-ordination of AIDS/HIV, sexually transmitted diseases (STD), tuberculosis and leprosy. The most serious effect of the transition was the interruption of supplies of anti-tuberculosis drugs in 1998.

CONCLUSIONS: The experience in Zambia demonstrates the urgent need for constructive dialogue between ‘health reformers’ and ‘disease controllers’. The aim of this dialogue would be to develop a model that ensures that tuberculosis patients are properly diagnosed and cured in countries that are embarking on a reform of their health services.

Keywords: Zambia; health sector reform; tuberculosis control

Document Type: Miscellaneous

Affiliations: Royal Netherlands Tuberculosis Association, The Hague, The Netherlands

Publication date: 2000-07-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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