The five elements of DOTS
An effective drug supply and management system
An uninterrupted and sustained supply of quality-assured anti-TB drugs is fundamental to TB control. For this purpose, an effective drug supply and management system is essential. A reliable system of procurement and distribution of all essential anti-TB drugs to all relevant health facilities should be in place. The TB recording and reporting system is designed to provide the information needed to plan, procure, distribute and maintain adequate stocks of drugs.
Anti-TB drugs should be available free of charge to all TB patients, both because many patients are poor and may find them difficult to afford, and because treatment has benefits that extend to society as a whole (cure prevents transmission to others). Legislation related to drug regulation should be in place, and use of anti-TB drugs by all providers should be strictly monitored. The use of FDCs of proven bioavailability and of innovative packaging such as patient kits can help to improve drug supply logistics as well as drug administration, promote adherence to treatment and prevent development of drug resistance.
The Global Drug Facility and the Green Light Committee offer countries with limited capacity the benefit of access to quality-assured TB drugs at reduced prices and also facilitate access to training on drug management6.
6 4 million treatments in 4 years. Achievement report - special edition. Geneva, World Health Organization, 2005 (WHO/HTM/STB/2005.32)