Evaluation of MSF OCA's Tuberculosis programme in the Chechen Republic
Since early 2004 OCA has been implementing in Chechnya a DOTS Tuberculosis program through “remote control” using TB facilities and staff of the Republican Ministry of Health TB Program. This DOTS TB program has been successful in its implementation, its phased expansion and its treatment outcome (persistent high success rates with low death, defaulter and failure rates). But questions are raised on the quality and relevance of this program in light of the limited support through the remote control implementation model while there is growing TB drug resistance of Mycobacterium Tuberculosis strains and increase in prescription of second-line TB drugs despite absence of laboratory facilities with capacity for culture and TB drug sensitivity testing (DST). This evaluation looks at the quality of the DOTS TB program with the aim to address the question whether the program is doing now more harm than good in light of this growing TB drug resistance.