Addressing the Threat of Drug-Resistant Tuberculosis A Realistic Assessment of the Challenge: Workshop Summary (2009) / Chapter Skim
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5 Infrastructure and Health Care Delivery Systems
5 Infrastructure and Health Care Delivery Systems
Pages 59-66
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From page 59... ...
Vertical programs are donor driven and focus on a single disease, such as HIV or TB. Farmer stated that some in the global health community have criticized vertical programs, saying that they may fragment care, cannibalize funding and resources, and create inefficiencies, resulting in missed opportunities to treat multiple issues in an integrated fashion.
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From page 60... ...
0 THREAT OF DRug-RESISTANT TubERCulOSIS BOX 5-1 Universal Access for MDR Care: The Cambodian and Ethiopian Perspectives In Cambodia, the incidence of TB is currently approximately 500 per 100,000 population; MDR TB represents about 1.6 percent of new TB cases and accounts for about 2 percent of treatment-naïve coinfected TB/HIV patients. The Cambodian Health Committee (CHC)
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From page 61... ...
INFRASTRuCTuRE AND HEAlTH CARE DElIVERy SySTEMS 2006, the CAMELIA clinical trial was launched in collaboration with NIH, the Comprehensive International Program of Research on AIDS (CIPRA)
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From page 62... ...
Yet the counterargument is that building public health infrastructure takes too long, and in the interim treatment will be denied to those in need. Farmer suggested that this debate is unnecessary: vertical programs, including those funded by such sources as PEPFAR and the Global Fund, can accomplish their immediate disease-specific goals while at the same time strengthen health systems and primary health care.
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From page 63... ...
The objective of the project is to build a community of laboratories that can work collaboratively to help meet the challenges of building a national laboratory data sharing network. The laboratories recognized that each had different approaches and capabilities to generate diagnostic data for specific diseases because of differing public health priorities, disparate methodologies used by their scientists, and implementation of a variety of technology solutions depending on their budgets and expertise.
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From page 64... ...
Harnish Fraser of Brigham and Women's Hospital described a system developed in Peru to illustrate the challenges associated with building what was ultimately a successful medical record system for MDR TB used both by the nonprofit Socios En Salud and the Peruvian Ministry of Health. The standard laboratory structure in Peru is hierarchical.
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From page 65... ...
INFRASTRuCTuRE AND HEAlTH CARE DElIVERy SySTEMS developed for managing TB and MDR TB patients. This effort was part of a much larger initiative that is being supported by a number of organizations, including CDC, the Rockefeller Foundation, the Canadian International Development Research Centre, and a number of other funders, to create common standards and foster collaboration.
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