Cost components borne by NTPs, included in the Global Plan to Stop TB, 2011–2015.

Notes: In addition to DOTS, management of MDR-TB and TB/HIV, the Global Plan includes estimates of costs for co-trimoxazole preventive therapy (CPT) during DOTS, nutritional support, HIV serological testing and counselling for HIV-coinfected patients, and isoniazid-based preventive therapy (IPT) to prevent HIV-positive people with latent Mycobacterium tuberculosis infection from developing active TB disease [1]. Our projections do not include these added costs, which are relatively small for CPT (e.g. less than $10 per patient-year in Uganda [48]), difficult to express per TB patient for IPT, which concerns HIV-infected patients without active TB, and not necessarily borne by NTPs for nutritional support and for HIV testing and counselling. Globally, uptake of IPT remains low, in spite of efforts by normative and financing agencies to increase its implementation [49]. One factor contributing to this slow uptake is the absence of sensitive and specific tests distinguishing between active disease and latent TB [49]; other factors warrant further exploration by the major normative and financing agencies for TB control.