Stopping Tuberculosis in Sierra Leone

After years of civil war, health-care services in Sierra Leone are in disrepair, and few of the existing health facilities that are functioning offer directly observed treatment, short-course, (DOTS), the frontline intervention in the battle against tuberculosis. With nearly 16,000 cases of tuberculosis estimated in 2001 among a population of less than five million, there is evidence that Sierra Leone is experiencing an increase in the spread of tuberculosis, and its weak health infrastructure is unable to respond adequately to the high number of cases. Recently, the World Bank and the Sierra Leone Health Sector Reconstruction Development Project have undertaken efforts to improve access to DOTS in four of the country’s 14 districts. The government of Sierra Leone is working in partnership with the German Leprosy Relief Association on the expansion of DOTS services in six additional districts.

A grant from the Global Fund for nearly US$3 million will expand DOTS to the four remaining districts that would otherwise be left without effective medical services to stop tuberculosis. In two of these districts, DOTS treatment will be offered for the first time. In the other two districts, the Global Fund will finance the scaling-up of existing treatment centers. By the end of two years, 24 DOTS centers will be established within these four districts. Much of this construction rebuilds infrastructure destroyed during the civil war.

Financing from the Global Fund will also support training of community health workers and promote partnerships between non-governmental organizations and the private sector to build sustained, cross-sector responses to the spread of tuberculosis. Services have also been designed to build links to HIV voluntary counseling and testing centers, given the high rate of co-prevalence of HIV and tuberculosis infection.