Health sector reform and tuberculosis control: the case of Zambia.

  • 1 July 2000
    • journal article
    • review article
    • Vol. 4  (7) , 606-14
Abstract
Zambia, 1995-1997. To describe the process leading to the collapse of Zambia's National Tuberculosis Programme NTP). A descriptive analysis of health sector reform in Zambia and its effects on the NTP during the period 1995-1997. By the end of 1997 the NTP had stopped functioning. The main reason was that external support had ended, while the National Strategic Health Plan 1995-1999 had no budget for special programmes according to the policy to integrate these into the general health services. As a consequence, technical support for tuberculosis control to districts ended as staff was reduced to one officer responsible for the national coordination of AIDS/HIV, sexually transmitted diseases (STD), tuberculosis and leprosy. The most serious effect of the transition was the interruption of supplies of anti-tuberculosis drugs in 1998. The experience in Zambia demonstrates the urgent need for constructive dialogue between 'health reformers' and 'disease controllers'. The aim of this dialogue would be to develop a model that ensures that tuberculosis patients are properly diagnosed and cured in countries that are embarking on a reform of their health services.

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