To date, more than 2,000 health-care workers have been trained in the DOTS strategy and 22 laboratories have been established or upgraded with the assistance of MSF.

After many months of intensive work, involving close collaboration with the Ministry of Health (MoH) and medical industry, MSF can ensure that a population of more than one million people in the Dashouguz Velayat region of Turkmenistan will have access to effective tuberculosis treatment. So far 4,700 tuberculosis patients have been registered in MSF-supported hospitals. MSF now coordinates tuberculosis treatment programmes in eight facilities across seven districts in the Dashouguz region.

Latest MoH data (2000) indicates an ongoing tuberculosis epidemic in this region, with an incidence rate of 113 new cases per 100,000 population per year. In reality, this figure is much higher, with WHO data suggesting that only 54% of smear positive cases are currently being detected in Turkmenistan (WHO 2001).

MSF are using the DOTS treatment programme (Directly Observed Treatment, Short course), an internationally recognized treatment strategy recommended by WHO, that enables rapid diagnosis and complete treatment of people with tuberculosis as well as careful monitoring of the epidemiology of the disease throughout the region.

The approach to DOTS implementation used by MSF has been to work in close collaboration with MoH and existing tuberculosis services in order to create a programme that is sustainable beyond MSF's presence in the region.

To date, more than 2,000 health-care workers have been trained in the DOTS strategy and 22 laboratories have been established or upgraded with the assistance of MSF. The main focus for MSF for the rest of this year and next is the hand-over of the programme to the Turkmenistan MoH, planned for December 2003.