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Discovering TuberculosisA Global History, 1900 to the Present$
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Christian W. McMillen

Print publication date: 2015

Print ISBN-13: 9780300190298

Published to Yale Scholarship Online: January 2016

DOI: 10.12987/yale/9780300190298.001.0001

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Prevention versus Cure

Prevention versus Cure

The Neglect of HIV/TB and Multidrug-Resistant TB

(p.202) 12. Prevention versus Cure
Discovering Tuberculosis

Christian W. McMillen

Yale University Press

DOTS came to be compete with another intervention—chemoprophylaxis or isoniazid preventive therapy—in the fight over allegedly limited resources in the battle against TB. DOTS won. However, pitting the two against each other meant a failure to keep in mind that one was designed to prevent TB and the other to cure it. In a world where only the cheapest solution would be supported, DOTS—already proven to be the most cost effective intervention for TB—took the upper hand. Meanwhile, HIV/TB and multidrug-resistant TB continued to be ignored. The chapter examines how the two interventions were pitted against one another and then how isoniazid preventive therapy seemingly came back from the dead once HIV/TB could simply no longer be ignored.

Keywords:   World Bank, DOTS, chemoprophylaxis, isoniazid preventive therapy, World Health Organization, multidrug-resistant tuberculosis, cost effectiveness

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