Sri Lanka’s own path for TB control
Sri Lanka already had a specialist TB service; WHO community integration met chest-clinic resistance and local politics.
Source
Policy Innovation and Policy Pathways: Tuberculosis Control in Sri Lanka, 1948-1990
What they did
The paper follows the 1966–72 attempt to move the WHO/Indian National Tuberculosis Programme model into Sri Lanka, using WHO advisers, the NWP pilot, and CNAPT debates.
What they found
Madras domiciliary trials underwrote a community model that became DOTS later. Sri Lanka was not India: infrastructure and a chest-clinic culture already existed. Clinicians warned that sputum-only case-finding missed many active cases.
The limits
What it doesn't show
This is a policy-transfer history, not a modern incidence study. It does not re-run the Madras trials or score today’s Sri Lankan TB programme.
Key terms
- DOTS
- 1990s WHO Directly Observed Therapy strategy whose short-course roots lie in 1960s Madras and related trials.
- Domiciliary chemotherapy
- Home drug treatment shown in Madras to match expensive hospital or sanatorium regimens.
- Integration
- Putting TB work into general health services rather than specialist chest clinics.
- CNAPT
- Ceylon National Association for the Prevention of Tuberculosis, a key local critic and partner.
Flashcards
Research intelligence for this paper
See its role on concept claims, tensions it is part of, placement history, and related discoveries.
Quiz yourself
The 1964 WHO report wanted TB services?
Common questions
Why not just copy India?
Sri Lanka already had infrastructure, literacy, and a specialist TB programme.
What did Madras show?
Domiciliary chemotherapy could match hospital treatment, if patients completed drugs.
Jayasuriya’s objection?
Sputum-positive-only treatment missed many active, still-infectious-to-be cases.
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