Planning to Improve Global Health: The Next Decade of Tuberculosis control/Amelioration De la Sante Dans le Monde: Planification Des Activites De Lutte Antituberculeuse Pour la Prochaine decennie/Planificar Las Mejoras De la Salud Mundial: La Lucha Antituberculosa En la Proxima Decada

Introduction "When the elephants fight, the grass gets trampled"--this aphorism exemplifies the vigorous debate over the best approach to planning for development. The debate positions Jeffrey Sachs, (1) a proponent of a comprehensive supply-side blueprint, against William Easterly, (2) a proponent of more specific solutions that respond to local demands. In the trampled grass lies an approach to planning that combines the benefits--and minimizes the drawbacks--of both these approaches. Amartya Sen recommends using an optimal planning process whereby interventions that can potentially be supplied are matched against ground-level explorations of what is feasible. (3) This is exemplified by the global planning for tuberculosis (TB) control over the next decade that has been undertaken by the diverse coalition of stakeholders in the Stop TB Partnership. The Stop TB Partnership is a global movement to accelerate social and political action against tuberculosis. The network of partners includes international organizations, countries, donors (from both the public and private sectors), individuals and governmental and nongovernmental organizations. The partnership was established in 2000 to realize the goal of eliminating tuberculosis as a public health problem by 2050. The partnership's secretariat is housed within WHO. The partnership has seven working groups, each providing a focus for coordinated action in a particular area of activity (Box 1). Box 1. The Stop TB Partnership's working groups Working group Purpose DOTS expansion To expand the coverage of DOTS, WHO's recommended strategy for tuberculosis control Multidrug-resistant TB To integrate surveillance for drug resistance and the management of multidrug-resistant TB into routine components of TB control by providing access to diagnosis and treatment for all patients and engaging all health-care providers TB/HIV To reduce the global burden of HIV-related TB by implementing effective collaboration between TB and HIV programmes and communities, and by promoting evidence-based collaborative activities to control TB and HIV Advocacy, communication To achieve TB-free communities by using and social mobilization global and country-level advocacy, as well as communication and social mobilization techniques New TB diagnostics To implement research, advocacy and/or operational activities to develop tools to diagnose TB and to meet the aims of the partnership New TB vaccines To bring together the wide range of international groups with an interest in developing a TB vaccine, to accelerate the identification and introduction of the most effective vaccination strategy New TB drugs To ensure that scientists, academics, pharmaceutical companies, donors, multilateral agencies and patients are working together to speed the development of new drugs for TB As a road map both for policy makers and managers of national programmes, the Global Plan to Stop TB 2006-2015 (4) sets out the key actions needed to implement interventions to control tuberculosis, such as case-finding, treatment and preventive treatment for high-risk groups, (5) as well as actions needed for research and development of improved tools such as diagnostics, drugs and vaccines. …