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Evolución de las políticas de la OMS para el control de la tuberculosis, 1948-2001
1Tuberculosis Strategy and Operations, StopTB, WHO, Geneva, Switzerland. raviglionem@who.it
Lancet (London, England)
|March 13, 2002
Resumen
La Organización Mundial de la Salud es la Organización Mundial de la Salud.
Área de la Ciencia:
- Salud Pública La salud pública.
- Política de salud global Política de salud global.
- Gestión de enfermedades infecciosas Gestión de enfermedades infecciosas.
Sus antecedentes:
- Análisis histórico de las políticas de control de la tuberculosis de la Organización Mundial de la Salud (OMS) desde 1948-2001.
- Las estrategias de control vertical iniciales resultaron ineficaces en entornos de escasos recursos, lo que requirió la integración del servicio de salud general.
- La estrategia de Curso Corto de Tratamiento con Observación Directa (DOTS, por sus siglas en inglés) surgió en 1989-1998 como una prioridad de salud pública.
Objetivo del estudio:
- Analizar la evolución de las políticas de control de la tuberculosis de la OMS.
- Proponer un nuevo marco para acelerar la expansión del control de la tuberculosis.
- Identificar los elementos clave para una futura gestión eficaz de la tuberculosis.
Principales métodos:
- Revisión histórica de las políticas de gestión de la OMS para el control de la tuberculosis.
- El análisis de las políticas cambia de enfoques verticales a estrategias integradas y multisectoriales.
- Evaluación de la expansión y la efectividad de la estrategia DOTS.
Principales resultados:
- El control vertical de la tuberculosis fue exitoso en las naciones desarrolladas, pero fracasó en áreas con recursos limitados.
- La adopción de la estrategia DOTS aumentó, pero el acceso completo se mantuvo limitado (23% de los casos en 1999).
- Los enfoques multisectoriales que involucran a las comunidades y a los profesionales privados están surgiendo como cruciales.
Conclusiones:
- El futuro control de la tuberculosis requiere un sistema de gestión pragmático e integrado combinado con la colaboración multisectorial.
- Abordar la tuberculosis asociada al VIH y multirresistente a los medicamentos es una prioridad.
- Las asociaciones mundiales y nacionales son esenciales para una expansión exitosa del control de la tuberculosis.
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