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Strategies for Tuberculosis Control from Experiences in Manila: The Role of Public-Private Collaboration and of Intermittent Therapy

INAUGURALDISSERTATION zur Erlangung der Würde eines Doktors der Philosophie

vorgelegt der Philosophisch-Naturwissenschaftlichen Fakultät der Universität Basel


Christian Auer aus Bottmingen (BL)

Basel, Mai 2003

Genehmigt von der Philosophisch-Naturwissenschaftlichen Fakultät der Universität Basel auf Antrag von

Herrn Prof. Dr. Marcel Tanner und Herrn Professor Dr. Klaus M. Leisinger

Basel, den 6. Mai 2003

Prof. Dr. Marcel Tanner Dekan


In memory of Aling Tess and Mang Tony, former neighbours of mine, victims of tuberculosis, the unrestrained killer that terminates daily the lives of 5000 people.

With the sincere hope and plea that some findings and thoughts of this dissertation will contribute to reducing tuberculosis and poverty.

“The appalling global burden of tuberculosis at the turn of the millennium, despite the availability of effective control measures, is a blot on the conscience of humankind. For developing countries, the situation has become desperate and the "cursed duet" of tuberculosis and AIDS is having a devastating impact on large sections of the global community. The vital question is, can despair be turned to hope early in the next millennium?”
John Grange and Almuddin Zumla, 1999


Acknowledgements Summary Zusammenfassung Abbreviations

i iii vii xi

PART I: Introduction and overview

Chapter 1: Background 1.1. Motivation for the thesis and overview ………………………………………………….….. 1.2. The burden of tuberculosis ………………………………………………………………..… 1.2.1. Public health indicators …………………………………………….……………….. 1.2.2. Economic indicators …………………………………………….…………….…….. 1.2.3. The burden of illness ……………………………………………….…………….….. 1.3. The control of…...

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