"When "The Program is Good, But the Disease is Better

Lessons from Peru on Drug-Resistant Tuberculosis

Bibliographic Data

ID2151572
AuthorsSandy Smith‐nonini (0000-0002-3307-9742, Elon University, corresponding author), Sandy Smith-Nonini
Year2005
Volume24
Issue3
Pages265-296
Publication date2005-07-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Anthropology (JOURNAL)
Journal identifiersISSN: 0145-9740 • E-ISSN: 1545-5882
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/01459740500189548
PMID16081336
OpenAlexW2069983990
LanguageEN
Citations received4
References cited22

This is a qualitative study of the politics of public health surrounding a resurgent tuberculosis epidemic in Lima, Peru during the 1990s. The paper traces the role of debt and neoliberal economics in creating conditions for the epidemic, and the reforms that turned Peru's TB program into a model for treating drug-susceptible disease by 1996. Despite this success, public health officials were blind-sided by the appearance of drug-resistant TB in the late 1990s when their "good" program turned out to be not good enough. The study follows the conflict, and eventual collaboration, that ensued between the Ministry of Health and a local NGO affiliated with Boston-based Partners in Health, which undertook a radical program of community-based directly-observed therapy (DOTS-Plus) to treat drug-resistant patients who otherwise would have died. Lessons from this case are relevant to many international settings where "hot-spots" of drug-resistant TB currently exist and go untreated, posing a threat to the success of national TB control programs

Christian ministry · Disease · Economic growth · Economics · Environmental health · Pathology · Political science · Politics · Public health · Tuberculosis · HIV/AIDS Impact and Responses · Law · Medicine · Nursing · Pneumocystis jirovecii pneumonia detection and treatment · Tuberculosis Research and Epidemiology

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