In some settings, such as some South African provinces in the apartheid era and Cambodia, these reforms helped integration of service delivery. However, the reforms undermined national tuberculosis control—eg, in Bangladesh, China, Kenya, Nepal, Zambia, Brazil, and Peru, and in several other Latin American countries with weakened governance, such as Colombia—resulting in reduced programmatic financing, diminished capacity of the health workforce, interrupted drug supplies caused by disrupted supply systems, and impaired case reporting and cohort analysis of treatment, leading to poor epidemic surveillance and monitoring of programme performance.