From multidrug-resistant tuberculosis to DOTS expansion and beyond: making the most of a paradigm shift

Tuberculosis
J Y KimMercedes C Becerra

Abstract

This review examines the paradigm shift around multidrug-resistant tuberculosis (MDR-TB). This shift has centered largely on the activities of institutions participating in the World Health Organization's Working Group on DOTS-Plus for MDR-TB. We review the important milestones since 1995, namely, the emergence of new evidence, the construction of new mechanisms, and the building of consensus to support new policy guidelines. This paper offers a case study of the construction of a model of good global governance that--if the opportunity is taken--can improve access to effective TB care through improving and helping to expand the WHO-recommended DOTS strategy.

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