Suchergebnisse

This is a conference paper. ; This paper presents a case study of five organizations from five countries: Haiti, El Salvador, India, the Philippines and Pakistan, demonstrating that knowledge transfer can be a catalyst for locally-driven water programs for the poor. Each organization received training and technical consulting from the Centre for Affordable Water and Sanitation Technology on Project Implementation for the Biosand Filter. Each then established an independent project resulting in cleaner water for 156,000 people in six years, and widespread biosand filter acceptance among users. Lessons learned are that knowledge transfer can result in effective, sustainable and scaleable technology implementation; transfer takes place one person at a time, making education at all levels crucial; pilots/demonstrations are essential motivators to technology adoption; involvement of mainstream government can result in faster implementation and widespread acceptance; and technology training is not enough. Organizations need to learn how to plan, implement and monitor programs.

This work was funded by the UCLH/UCL NIHR Biomedical Resource Centre (grant number BRC/176/III/JB/101350) and the PATHSEEK European Union's Seventh Programme for research, technological development and demonstration (grant number 304875).

Two decades ago, WHO declared tuberculosis a global emergency, and invested in the highly cost-effective directly observed treatment short-course programme to control the epidemic. At that time, most strains of Mycobacterium tuberculosis were susceptible to first-line tuberculosis drugs, and drug resistance was not a major issue. However, in 2013, tuberculosis remains a major public health concern worldwide, with prevalence of multidrug-resistant (MDR) tuberculosis rising. WHO estimates roughly 630 000 cases of MDR tuberculosis worldwide, with great variation in the frequency of MDR tuberculosis between countries. In the past 8 years, extensively drug-resistant (XDR) tuberculosis has emerged, and has been reported in 84 countries, heralding the possibility of virtually untreatable tuberculosis. Increased population movement, the continuing HIV pandemic, and the rise in MDR tuberculosis pose formidable challenges to the global control of tuberculosis. We provide an overview of the global burden of drug-resistant disease; discuss the social, health service, management, and control issues that fuel and sustain the epidemic; and suggest specific recommendations for important next steps. Visionary political leadership is needed to curb the rise of MDR and XDR tuberculosis worldwide, through sustained funding and the implementation of global and regional action plans. This is the fifth in a Series of six papers about tuberculosis.