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The Greater Accra Regional Health Directorate has for the first half of this year, recorded 1,322 cases of Tuberculosis (TB) as against 1,675 cases recorded for the same period last year. In 2008, the region recorded a total of 2513 TB cases with Accra metro and Maamobi in particular, being the most endemic. Mrs. Dorothy Abudey, Regional TB Coordinator, told the Ghana News Agency that though there was a sign of decline in the cases comparing the first two halves of the last year and this year, it was early to conclude that a steady decline occur at the end of the year. She attributed the decrease to continuous awareness creation and intensive education in the communities by health teams though they had some challenges. She said the District was committed to reducing tuberculosis to the barest minimum as she urged patients to adhere to the Directly Observed Treatment Short course (DOTS) treatment regimen. Mrs. Abudey explained that the region was faced with challenges undermining all efforts put in place to ensure comprehensive treatment of TB. She cited transportation to the various communities for supervision, low motivation for volunteers who act as treatment supporters and the lack of funds to help the poor access good nutritional meals before taking drugs as some of the challenges and described the situation as "worrying". She noted that the enabler's package, an incentive that seeks to improve TB control programme by increasing motivation and performance of patient, providers and others engaged in the DOTS was too minimal to make the desired impact. "Under DOTS, there is the need to go round and supervise clients to ensure compliance of the treatment and when there are no vehicles to go round, the work becomes very difficult and frustrating especially, when the elite clients find it difficult coming to the hospital due to the stigma attached to TB". DOTS, is conducted to ensure regular drug supply, surveillance, building capacity for treatment and control, and directly supervise treatment. A visit by the GNA to Maamobi, Mamprobi and Adabraka polyclinics showed a decline in the activities of TB control. Health workers who spoke to the GNA shared the same views on the challenges in the areas of transportation and funds which were impeding progress in the treatment of TB in the region. Dr. Irene Agyapong, Greater Accra Regional Health Director, said the treatment success rate for the region had improved due to the increase in the detection rate. She said the region had received a cheque for the running of activities on TB in the region and was yet to disburse after she had met with the team in the region. Dr. Agyapong called on stakeholders to deepen their efforts in the control of TB in the region and hoped that a steady decline could be achieved by the end of the year. Dr Frank Bonsu, National Tuberculosis Control Programme Manager, told the GNA that Ghana had achieved 86.4 per cent rate of treatment success for TB, but was working to meet the global target of 85 percent treatment success rate. He explained that case detection was a general challenge with a rate of 36 per cent and was working hard in meeting the 70 per cent global case detection rate target. The National Programme Manager called for social mobilisation and urged civil society to engage in a robust and sustained public education on the disease. "We have improved diagnostic facilities to improve case detection and all we need is for the general public to report cases and we will follow up for treatment. TB generally affects people who live in abject poverty, those who are marginalized and socially isolated whilst social and economic determinants at individual, household and community levels affect a person's vulnerability. The burden of TB is far greater in urban settings than in rural areas due to sociological reasons with an increasing recognition of the fact that TB reduces patient's ability to work and earn a decent living.