CDC History of Tuberculosis Control - Medical and Public Health ...

Modeling the global fight against TB, 1978-
1991
In 1978, in response to a request from the
Minister of Health of Tanzania, the IUAT
proposed the establishment of a National TB
Program under the direction of the
government and with support and
coordination of the IUAT. This proposal was
the basis of a new program of Technical
Assistance of the IUAT and became the basis
in 1979 for the first edition of the TB Guide.
Such assistance eventually extended to nine
low-income countries and became the basis of
the current DOTS Strategy of the WHO.
In 1981, the IUAT became the first
organization to adopt a policy that its
meetings be designated “non-smoking”
conferences. In 1982, the Koch centenary was
celebrated at the 25 th conference in Buenos
Aires, where the Koch Medal of the IUAT
was awarded to Drs. Johannes Holm and
Wallace Fox. That same year saw the
establishment of World TB Day on March 24
each year, following a proposal by the Mali
Association. In 1984 the IUAT was officially
registered with USAID, a very rare privilege
for a non-US agency. The IUAT officially
changed its name in 1986 to the IUATLD to
reflect the inclusion of other lung diseases in
its mandate. In 1987, a delegation from the
IUATLD visited WHO to encourage it to
consider the problem posed for TB by the
emergence and spread of HIV infection that
had been noted in the collaborative projects.
TB Control at the Millennium
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In 1989, the Burden of Health Study carried
out by Harvard University was pivotal in
demonstrating the cost-effectiveness of the
IUATLD model, which was instrumental in
convincing planners and policymakers to
adopt the strategy as a part of the general
health services.
A global fight, 1991-present
The principles of the model National TB
Program, outlined on the occasion of the
retirement of Dr. Styblo in 1991, were
subsequently enumerated as the “DOTS”
Strategy, promoted as the official policy of the
WHO. In that year, the international TB
training course of the IUATLD was first held
in Arusha, Tanzania, to illustrate the
principles of the model program. From 1993
to 1996, the training and technical support
activities of the IUATLD were extended from
a largely African base to represent every
region of the world. In 1996, the IUATLD
entered into a formal agreement to provide
training fellowships with support from the
International Fogarty Foundation.
By 1998, field activities involved 10 countries
in the Eastern Region, 5 in the Middle East, 10
in Africa, 15 in Europe, 8 in Latin America,
and 2 in North America. The network of
courses in management included Tanzania,
Benin, Nicaragua, and Viet Nam, and the
courses on research methods included Turkey,
Kenya, South Africa, Mexico, Chile,
Argentina, Brazil, Peru, Malaysia, and China.
During this period, more than 1 million
patients with TB were cared for in the context
of the collaborative programs of the IUATLD.
In 1998, the IUATLD joined with the WHO
and other international partners to form the
“Stop TB” Initiative in the hopes of extending
the model to all countries of the world.
These activities were made possible thanks to
funds entrusted to the Union from richer
associations and by governments of a number
of affluent countries.