The DOTS Expansion Working Group (DEWG) was established by the Stop TB Partnership in the year 2000 to address the major challenges of TB control. It is an inter-institutional arrangement between WHO, major financial and technical partners, national TB control programmes, the Global Drug Facility (GDF), and community representatives to expand access to TB diagnosis and treatment in line with the MDG and Stop TB Partnership targets.
Since the inception of the DEWG, a core team, secretariat and four subgroups have been established. The subgroups focus on specific elements of DOTS expansion and enhancement: Public-Private Mix (PPM), Childhood TB, Poverty, and laboratory capacity strengthening (now included into the Global Laboratory Initiative). In addition to DOTS expansion and enhancement, the DEWG also contributes to the implementation of other components and sub-components of the Stop TB Strategy.
The DOTS Expansion Working Group (DEWG) plan of action 2008-2009 contains the following two main objectives:
(i) To achieve and sustain performance beyond the "70/85" targets
(ii) To further advance towards universal access to quality TB care for all people with TB, adults and children especially the poor and vulnerable, in line with the Stop TB Strategy and the Second Global Plan to Stop TB (2006-2015).
The DEWG has identified five main priorities in different areas of work:
- Expanding service coverage, strengthening quality of DOTS implementation and increase access to services for children;
- Laboratory strengthening to expand quality assured microscopy, culture and Drug Susceptibility Testing (DST) (currently included in the GLI proposal);
- Human resources development plan including mapping of existing resources from different health care providers with a focus on the services to the poor;
- Linking existing health care providers to NTP including promotion of international standards for TB care (ISTC);
- Monitoring and evaluation including impact measurement.
Activities to address these main areas of work are grouped according to outputs, indicators and targets, and mapped to the responsible agencies within the DEWG.