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The situation is no different in the countries of the Eastern Mediterranean Region, where tuberculosis is also a serious public health problem

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In the Name of God, the Compassionate, the Merciful

Address by

DR HUSSEIN A. GEZAIRY REGIONAL DIRECTOR

WHO EASTERN MEDITERRANEAN REGION to the

INTERCOUNTRY TRAINING WORKSHOP ON RESEARCH METHODS FOR TUBERCULOSIS

Alexandria, Egypt, 4–14 June 2000

Ladies and Gentlemen,

It is my great pleasure to welcome you all to this Intercountry Training Workshop on Research Methods for Tuberculosis. My special welcome goes to the facilitators of the workshop, who are affiliated with our two important partners in the field of tuberculosis, the International Union Against Tuberculosis and Lung Diseases and the UNDP/World Bank/

WHO Special Programme for Research and Training in Tropical Diseases. While the IUATLD has long been a most effective partner, TDR is a new partner in tuberculosis having included it in its programme of target diseases since last year.

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I am also proud to inform you that this is the first regional WHO workshop to focus on research methods for tuberculosis and am pleased, not only because it is the first such initiative in WHO but also because it covers a subject that has long needed to be addressed.

As we all know, tuberculosis remains the single biggest infectious killer of youth and adults in the world, causing between 2 and 3 million deaths each year. The situation is no different in the countries of the Eastern Mediterranean Region, where tuberculosis is also a serious public health problem. Every year in the Region, tuberculosis affects more than 600 000 people and kills around 140 000. In order to deal with the tuberculosis epidemic, the Regional Office has promoted the use of the DOTS strategy and has made good progress. All the countries have adopted the strategy and are working hard to implement it nationwide. We call this DOTS ALL OVER and all the countries are expected to accomplish DOTS ALL OVER by the end of this year, 2000, except for those with special circumstances. These are Afghanistan and Somalia, which have been suffering from civil strife, and Pakistan, which has an extremely large burden of tuberculosis and only recently introduced DOTS.

Even so, DOTS ALL OVER is just the beginning of tuberculosis control, and absolutely not the end. There is a number of important issues to be solved before the tuberculosis epidemic is brought under real control. These issues include: extent of the impact of tuberculosis on the community, including its gender-related impact; effective measures to control and eliminate tuberculosis; how to establish an effective partnership with the private sector for tuberculosis control; and a system for cost–effective management of drug-resistant tuberculosis.

Obviously, there is a need for knowledge, and hence for research, to address these issues. However, research capacity is still limited in the field of tuberculosis control, both in the Region and in many other parts of the world. This is the why we felt it very important to hold the first intercountry training workshop on research methods for tuberculosis here today.

The workshop has three main objectives. First, to introduce participants to research methods to enhance tuberculosis control in the Region. Second, to develop research protocols on selected topics of priority to tuberculosis programmes. And third, to carry out the research in an international, collaborative manner in the Region. To meet the objectives, the workshop will provide you with an opportunity to learn the elementary skills of designing, carrying out

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and analysing a scientific research project on a topic of importance to tuberculosis in the countries.

During the workshop, you are expected to develop a research protocol that will be carried out when you return to your countries. The research should be of international standard, collaborative, linking your programmes and your institutions together. You are expected to present your protocol to other participants and facilitators for their review. By the end of the workshop, you will be in possession of a completed research protocol, ready to be implemented. Workshop materials will serve as future reference material.

In order to facilitate the implementation of the protocol, I am pleased to introduce a special programme, which is called the Joint EMRO/TDR/CDS Small Grants Scheme for Control-Oriented Research on Tropical Diseases. It has been run by the Regional Office since 1992 and so far has concentrated mostly on research on malaria, leishmaniasis and schistosomiasis. In collaboration with WHO headquarters it has now been extended to include tuberculosis and I strongly encourage you to submit the protocol you will have completed in this workshop in application for this small grant competition. Indeed, we have modified the deadline for application this year to 1 July 2000 so that you can submit your protocol after the workshop.

Ladies and Gentlemen,

I am aware that you will have a full programme ahead of you. I sincerely hope that you will use your experiences and knowledge to achieve the objectives of the meeting. I look forward to seeing practical and feasible research protocols as the outcome, and I wish you a successful meeting and a pleasant stay in Alexandria.

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