Tuberculosis control and directly observed therapy from the public health/human rights perspective

Directly observed therapy, short course (DOTS) is the current international strategy for controlling tuberculosis. Decisions have been taken internationally about the increasing tuberculosis epidemic-what to do and why to do it. But do we know bow the DOTS strategy can be implemented most appropriately and what changes need to be made to ensure that it is effective? This paper uses the Public Health/Human Rights framework to discuss TB control from a human rights rather than the biomedical perspective. The aim is to introduce different approaches to the current DOTS strategy in order to find more effective and appropriate ways to treat and care for people with tuberculosis. The paper argues that key dimensions of social, economic and physical access to TB services need to be assessed and accounted for in programme design. This will require that TB control adopt a wider interdisciplinary and multisectoral perspective to complement the current biomedical orientation.