SPS will continue its work in Brazil to—
Brazil adopted DOTS in 1998, the World Health Organization-recommended approach to identifying and treating TB, but it wasn’t until 2003 that DOTS expansion began in earnest. That year, the RPM Plus Program began working with Brazil’s primary TB partners, the Hélio Fraga National TB Reference Center and the National Institute of Quality Control (INCQS/Fiocruz).

As patient numbers increased, the national TB epidemiological surveillance model needed to be decentralized to local settings. Much of our work has supported decentralization efforts, especially to build facilities’ capacity to manage TB program information. Our activities have included creating a web-based surveillance system that allows state and regional TB reference centers to track multidrug-resistant TB (MDR-TB) and share information among themselves and with the national reference center. The system has helped strengthen diagnosis and treatment of MDR-TB patients—increasing case detection by 20 percent and cure rate by 12 percent.

In addition, we helped establish a quality control system for TB pharmaceuticals, including building the capacity of laboratory staff members and institutionalizing a testing program for samples gathered from health system delivery points.