The immediate challenges arise from the integration and decentralization processes. With integration, the NTP might risk losing its core identity and experience a weakening of its authority. Drug supplies may be interrupted and quality control diminished. There is also a risk that TB services will decline, given the limited number of managerial and administrative staff able to control TB at the municipal level. The DOTS strategy formally adopted and implemented.
Technical leadership is strong and has fostered change in political commitment.
Political commitment supports national plan development. The national plan includes innovative incentive schemes. Health Sector Reform can have major negative impacts if TB control requirements are not acknowledged and taken into account. Establish more reference laboratories. Strengthen quality assurance and coordination mechanisms.