Peru
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Although tuberculosis (TB) remains a serious public health threat in Peru, the country
is no longer included in the World Health Organization’s (WHO’s) list of countries
with a high TB burden. Peru was the first high-burden TB country to successfully
implement DOTS (the internationally recommended strategy for TB control) which
resulted in a sharp decline in TB incidence from 1991 to 1999. By also pioneering new
DOTS approaches to combat multidrug-resistant (MDR) TB, the country has
developed a highly capable specialized health research community. Although Peru
accounts for only 3 percent of the population of the Americas, it has 12 percent of the
region’s TB cases. According to the WHO Global TB Report 2009, Peru had more
than 35,000 reported TB cases in 2007, a decline of 5.3 percent from 2006. The
reported incidence rate in 2007 was an estimated 126 cases per 100,000 population.
MDR-TB represents 5.3 percent of all new TB cases, and extensively drug-resistant
(XDR) TB has been confirmed in Peru since February 2007.
In the past few years, Peru’s National TB Program (NTP) has been hindered by serious
administrative and funding problems in the Ministry of Health (MOH). These problems
led to a deterioration of the TB situation, and in 2004, a reorganization of the MOH
created the National Sanitary Strategy for the Prevention and Control of Tuberculosis
(ESNTBC) to replace the NTP.
USAID Approach and Key Activities
USAID and the ESNTBC are working together to further strengthen both Peru’s
DOTS program and its capacity to address MDR-TB. In fiscal year 2008, USAID funds
for TB programming in Peru totaled almost $600,000. USAID’s assistance includes
support for:
- Building capacity for diagnostic laboratory capabilities (including MDR-TB
diagnostics)
- Providing technical assistance and training to ESNTBC staff
- Supporting information, education, and communication activities
- Strengthening surveillance
- Supporting operational research
USAID Program Achievements
In 2005, USAID supported a study of the TB situation in Peru that is helping the MOH
to solve institutional weaknesses in its system. USAID also supported efforts to
strengthen the control and management of TB cases through technical assistance to the
DOTS program in five target regions and to the MOH for upgrading national TB
guidelines. USAID’s achievements have included the following:
- Trained over 1100 clinicians and health workers in fiscal year 2007 in updated
protocols for TB treatment, DOTS and MDR-TB infections. USAID also
trained 148 health workers in monitoring and evaluating TB programs, in
order to improve service quality
- Provided technical assistance for a nation-wide communication strategy to
mobilize the public for TB prevention and control
- Supported ESNTBC in the creation of a Stop TB committee
- Funded the revision of technical norms for TB control in accordance with
current protocol from the World Health Organization
- Held workshops for health care personnel to reduce stigma and
discrimination toward TB patients
- Supported regional health authorities to develop regionally-based TB control plans that include staffing analyses,
upgraded information systems, and expanded community outreach plans
- Strengthened infection control and trained clinical laboratory staffs in early diagnosis of MDR- TB
- Supported training and implementation of DOTS and of MDR-TB treatment at the subnational level
- Supported the implementation of USAID’s regional South American Infectious Diseases Initiative, which has included
sampling of anti-TB drugs in Callao and Lima for quality
Case Detection and Treatment Success Rates Under DOTS
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Note: DOTS treatment success rate for 2007 will be reported in the WHO Report 2010.
Source: Global Tuberculosis Control WHO Report 2009 |
Partnerships
Partnerships have been an important component of combating TB in Peru. Stakeholders, such as the Pan American Health
Organization and Partners in Health and USAID, are collaborating with the ESNTBC on TB prevention and control activities.
Partners in Health will continue to focus on treatment and control of MDR-TB. Other partners include the CDC, the Johns
Hopkins Bloomberg School of Public Health, the University of Alabama, and Universidad Peruana Cayetano Heredia. Peru
received grants from the Global Fund to Fight AIDS Tuberculosis and Malaria in Round 2 ($20.2 million), Round 5 (13.6 million)
and Round 8 ($14.7 million).
June 2009
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