Yasir A.W. Skeiky, Mark R. Alderson, Pamela J. Ovendale, Yves Lobet, Wilfried Dalemans, Ian M. Ormec, Steven G. Reedd, Antonio Campos-Neto

Received 9 September 2004; received in revised form 28 January 2005; accepted 3 March 2005
Available online 30 March 2005

Summary


Background: Directly observed therapy (DOTS) is the main strategy for prevention and control of tuberculosis orldwide. However, its effect on tuberculosis transmission in populations with moderate rates of drug-resistant isease is not known.

Methods: This population-based prospective study in southern Mexico between March, 1995, and February, 2000, was based on passive case finding and detection of acid-fast bacilli in sputum samples to diagnose pulmonary tuberculosis. We also used cultures, drug-susceptibility testing, bacterial genotyping, and monitoring of treatment outcomes.

Jan A.M. Langermansa, T. Mark Dohertyb, Richard A.W. Vervennea, Tridia van der Laanc, Konstantin Lyashchenkod, Rena Greenwaldd, Else Marie Aggerb, Claus Aagaardb, HorstWeilere, Dick van Soolingenc, Wilfried Dalemansf, Alan W. Thomasa, Peter Andersen

Received 24 June 2004; received in revised form 15 October 2004; accepted 9 November 2004
Available online 15 December 2004

Lynn P Freedman, Ronald J Waldman, Helen de Pinho, Meg E Wirth, A Mushtaque R Chowdhury, Allan Rosenfield

Ambitious quantitative goals for reducing mortality and increasing access to health interventions are nothing new to the areas of child, maternal, and reproductive health. They are the standard fare of global declarations and national 5-year plans. They come. They go. What makes he Millennium Development Goals (MDGs) different? ith health firmly embedded in this wider povertyreduction nitiative, which has garnered unprecedented onsensus and support from governments and ultilateral organisations, the global health community as a rare opportunity to break through to new ways of hinking about the obstacles now blocking improvements n the health of women and children and to translate that hinking into bold new steps to meet goals 4 and 5 (table). or the UN Millennium Project Task Force on Child Health and Maternal Health, the potential breakthrough lies in putting health systems at the centre of MDG strategies and in addressing these systems, not only as delivery mechanisms for technical interventions but also as core social institutions—as part of the very fabric of social and civic life. In high-mortality countries today, especially for the poorest populations, health systems are frequently the source of catastrophic costs, humiliating treatment, and deepening social exclusion. But a different way is possible. Health systems can be a vehicle for fulfilling rights, for active citizenship, and for true democratic development—poverty reduction in its fullest sense.

The Magic Bullets And Tuberculosis Drug Targets

Abstract: Modern chemotherapy has played a major role in our control of tuberculosis. Yet tuberculosis still remains a leading infectious disease worldwide, largely owing to persistence of tubercle bacillus and inadequacy of the current chemotherapy. The increasing emergence of drug-resistant tuberculosis along with the HIV pandemic threatens disease control and highlights both the need to understand how our current drugs work and the need to develop new and more effective drugs. This review provides a brief historical account of tuberculosis drugs, examines the problem of current chemotherapy, discusses the targets of current tuberculosis drugs, focuses on some promising new drug candidates, and proposes a range of novel drug targets for intervention. Finally, this review addresses the problem of conventional drug screens based on inhibition of replicating bacilli and the challenge to develop drugs that target nonreplicating persistent bacilli. A new generation of drugs that target persistent bacilli is needed for more effective treatment of tuberculosis.

Jamie Bartram, Kristen Lewis, Roberto Lenton, Albert Wright

A silent humanitarian crisis kills some 3900 children every day and thwarts progress towards all the Millennium Development Goals (MDGs), especially in Africa and Asia. The root of this unrelenting catastrophe lies in these plain, grim facts: four of every ten people in the world do not have access to even a simple pit latrine; and nearly two in ten have no source of safe drinking water.1 To help end this appalling state of affairs, the MDGs include a specific target (number 10) to cut in half, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation.

Attachments:
Download this file (192_PUBL_Lanc_Focusing_on_improved_water_and_sanitation_forhealth.pdf)Focusing on improved water and sanitation for health[Millennium Project]51 kB

SUMMARY:

The global targets for tuberculosis (TB) control were postponed from 2000 to 2005, but on current evidence a further postponement may be necessary. Of the constraints preventing these targets being met, the primary one appears to be the lack of adequately trained and qualified staff. This paper outlines: 1) the human resources and skills for global TB and human immunodeficiency virus (HIV) TB control, including the human resources for implementing the DOTS strategy, the additional human resources for implementing joint HIV-TB control strategies and what is known about human resource gaps at global level; 2) the attempts to quantify human resource gaps by focusing on a small country in sub-Saharan Africa, Malawi; and 3) the main constraints to human resources and their possible solutions, under six main headings: human resource planning; production of human resources; distribution of the workforce; motivation and staff retention; quality of existing staff; and the effect of HIV/AIDS. We recommend an urgent shift in thinking about the human resource paradigm, and exhort international policy makers and the donor community to make a concerted effort to bridge the current gaps by investing for real change.

Don J Melnick, Yolanda Kakabadse Navarro, Jeffrey McNeely, Guido Schmidt-Traub, Robin R Sears

Ensuring environmental sustainability is essential to achieving all the Millennium Development Goals. Longterm solutions to problems of drinking-water shortages, hunger, poverty, gender inequality, emerging and reemerging infectious diseases, maternal and childhood health, extreme local weather and global climate changes, and conflicts over natural resources need systematic strategies to achieve environmental sustainability. For this reason, the UN Millennium Project Task Force on Environmental Sustainability has concluded that protection of the environment is an essential prerequisite and component of human health and wellbeing.1 Economic development and good health are not at odds with environmental sustainability: they depend on it.

Sobre a REDE-TB

A Rede Brasileira de Pesquisa em Tuberculose (REDE-TB) é uma Organização Não Governamental (ONG) de direito privado sem fins lucrativos, preocupada em auxiliar no desenvolvimento não só de novos medicamentos, novas vacinas, novos testes diagnósticos e novas estratégias de controle de TB, mas também na validação dessas inovações tecnológicas, antes de sua comercialização no país e/ou de sua implementação nos Programa de Controle de TB no País.


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