The unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” was revised, which was approved with the Order of the Ministry of Health of Ukraine dated 21.12.2012 No. 1091, does not conform to all components of “Stop TB” strategy. In particular, it provides for a possibility to hand over the drugs to a patient for a term of up to 10 days in case of very positive attitude to treatment (page 17). This contradicts the definition of DOT services according to WHO (WHO: Implementing WHO Stop TB Strategy: a handbook for national tuberculosis control programmes. 2008 (page 32) available at WHO web-site.
1. Understanding of and compliance with the Stop TB Strategy should be improved. Despite official adoption of the Strategy, there is widespread scepticism about its appropriateness and potential for successful implementation. Most doctors have their own personal approaches, resulting in a mixture of old and new interventions which may harm the clinical management of the individual patient and the overall public health impact of the NTP. The Ministry of Health should provide ample information on the do’s and don’ts in TB control – more than can be contained in a letter or a ministerial order. Doctors need an explanation of why the Ministry of Health is promoting a certain approach. A manual with guidelines and training are also necessary.