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112 CHAPTER 5 ■ Tuberculosis: Keys to Success in Peru

for outreach and included prisoners, patients in mental institutions, retirement
home dwellers, and homeless people sleeping in shelters. As patients were iden-
tified, they then became the target for drug therapy, as well as those currently
taking the medications, to ensure a complete and timely completion.
Midstream efforts, reaching out to those with the ability to influence others
in the target markets’ community, recognized the need for community involve-
ment in detecting new cases, including family members, neighbors, co-workers,
and friends of those at risk. As will be shared in the strategy section, community-
based surveillance groups were established on a more formal basis to organize
activities to identify and support patients and their families. Working with
healthcare providers and their staffs was essential as well, with efforts focused on
strategies that would increase the identification of those infected, as well as get-
ting those identified into programs that would help treat and cure the disease.
Upstream efforts recognized the importance of policy makers, communities,
the media, and the commercial sector. Policy makers at the national as well as local
levels were critical in order to secure funding to ensure the availability of drugs,
laboratory supplies, and communication outreach programs. The media would be
instrumental in creating high visibility for major events and to stimulate public
and political will. Pharmaceutical drug representatives were also considered a tar-
get, recognized as a potential distribution channel for communications, as well as
a partner for potential price reductions or free drugs.

MAR KETI N G G OAL S AN D O B J E C TIVE S

Marketing goals and objectives for the effort were clear and bold. In 1991, when
the NTCP adopted the WHO Global Targets, the road ahead looked long and
steep, and Peru was one of a handful of high-burden TB countries to take it on.
Peru committed to diagnose 70% of pulmonary TB cases and, once diagnosed, ac-
cepted the challenge to cure at least 85% of cases; at the time, they were curing
only 50%, representing a 70% increase. Peru also wanted to decrease the treatment
abandonment; at the time, 12.1% of those being treated were abandoning their
treatment (Llanos-Zavalaga et al., 2004).

B E HAVI O R O B J E C TIVE S

Downstream there were four clear behavior strategies to accomplish with target
markets:
• Influence those with symptoms to get diagnosed.
• Influence those who have been diagnosed to accept treatment.