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Tuberculosis Treatment in Developing Nations-Reply

Mario C. Raviglione, MD; Paul P. Nunn; Arata Kochi, MD, MPH; Dixie E. Snider Jr, MD, MPH
JAMA. 1995;274(2):125-126. doi:10.1001/jama.1995.03530020043017.
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In Reply.  —We agree with Mr Kocs on the need to broaden our approach to tuberculosis. Kocs condemns the imbalance between disease burden and research that has been best described by the Commission on Health Research for Development: 95% of health research is done in industrialized countries, whereas 93% of the disease burden is in the developing world.1 This must be addressed by the world health and research community.Kocs rightly points out the need to attune tuberculosis control to local societies and cultures. Of course, far more operational research would help greatly in this regard. However, each year nearly 3 million people die of tuberculosis in the developing world. Since cost-effective techniques for treating tuberculosis in low-income countries are well established and the strategy for their implementation is known, the priority must therefore be intervention, and rapidly. The control strategy adopted by the World Health Organization has been


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