Tuberculosis control and directly observed therapy from the public health human rights perspective

Directly observed therapy, short course (DOTS) is the current international strategy for controlling tuberculosis. Decisions have been taken internati onally about the increasing tuberculosis epidemic-what to do and why to do it. But do we know how the DOTS strategy can be implemented most appropriat ely and what changes need to be made to ensure that it is effective? This p aper uses the Public Health/Human Rights framework to discuss TB control fr om a human rights rather than the biomedical perspective. The aim is to int roduce different approaches to the current DOTS strategy in order to find m ore effective and appropriate ways to treat and care for people with tuberc ulosis. The paper argues that key dimensions of social, economic and physic al access to TB services need to be assessed and accounted for in programme design. This will require that TB control adopt a wider interdisciplinary and multisectoral perspective to complement the current biomedical orientat ion.