ABSTRACT

Political commitment is a crucial condition for the implementation of effective tuberculosis-control programs (1). "Commitment" usually entails that national health care providers ensure adequate funding of the various program components, in order to maintain a sufficient supply of drugs and diagnostic materials, the regular training and supervision of staff at all levels, and an effective information and program evaluation system on a long-term basis. Tuberculosis-control programs worldwide have fared rather badly in obtaining this level of commitment. During decades of public neglect of the disease, the programs have often been regarded as pariahs within national health care structures. As a result, underfunding often made the provision of effective interventions impossible. The lack of adequate financial support can be seen as one of the reasons for the reemergence of the disease during the 1980s (2).