Report on a joint review of tuberculosis in Ukraine

The tuberculosis (TB) epidemic in Ukraine has reached emergency proportions. Drug-resistant TB is increasing rapidly. The economic decline following independence has led to increased poverty and difficulties in maintaining treatment services. There is also a growing epidemic of HIV. Against this background, the Government of Ukraine requested assistance from WHO, with a team of international and national experts, in conducting a review of the TB situation in December 1999. The team noted the clear commitment to the directly observed treatment, short course (DOTS) strategy (the WHO recommended TB control strategy) at every level in Ukraine, including in prisons. Successful implementation of this strategy will require radical changes to the financing of TB control services and to current policies for diagnosis, treatment and monitoring. The team recommended that a plan should be drawn up for nationwide coverage by DOTS by 2003, including the designation of pilot sites in Kiev city and Chernigev and Donetsk oblasts, the development of technical and operational guidelines based on the DOTS strategy, the identification of sources of funding, the appointment of a WHO medical officer to give technical assistance, the establishment of appropriate management personnel and systems, and the holding of a national TB drug resistance survey