한국의 결핵관리와 보건소: 해방 후부터 1970년대 후반까지(†)

Tuberculosis (TB) was called “ruinous disease” in colonial Korea. However, it is no longer a threat to the lives of the Korean people. Public Health Centers (PHC) have played a role in the reduction of TB prevalence by providing free medical treatment and vaccination. PHCs are valued highly for suggesting the possibility of TB suppression. Despite these outcomes, the achievements of PHCs may be slightly overstated from a therapeutic perspective. PHCs could not prevent and treat TB well in their conditions at the time in Korea. The concept of PHC in Korea that emphasizes prevention rather than treatment came from the US. There is a need to reevaluate the achievements of PHCs in TB control. The South Korean government established an anti-TB network system named “Health-Net” in 1962. PHCs were the primary institutions against TB. The “100,000 Tuberculosis Patients Registration Program” was conducted by the government through PHCs, which was an effective anti-TB program. The success of the registration program was a result of the effort by PHCs and anti-TB private organizations. Free medications distributed by PHCs helped to decrease mortality due to TB. The implementation of the “Tuberculosis Prevention Act” in 1968 strengthened the management function of PHCs. A larger anti-TB budget by the law made new prescriptions possible, including second-generation medications. It also enabled the recruitmen of more manpower for TB control, finding TB patients, and BCG vaccination. However, there were some limits of PHCs’ therapeutic role in these achievements. At first, the lower cure rate in patients receiving medical care at PHCs was a main problem. The fact that PHCs accounted for nationwide TB patients was another problem. It is unclear that PHCs had an active role in TB management. There were no specific TB treatment programs except the follow-up treatment dependent on the only one medication. PHCs in the 1960s and 1970s achieved the results of patient registration and free treatment in TB control, but there was a limit to their therapeutic function.