The article discusses the importance of retaining vertical health programs, such as the World Health Organization's DOTS program for tuberculosis control, in the context of health sector reforms in developing countries. The author argues that these programs are crucial for maintaining economies of scale in drug procurement and ensuring effective monitoring and coordination. Without them, there is a risk of losing control over tuberculosis control efforts, which could lead to the development of multidrug resistance and create an untreatable pandemic. The author also highlights the need for gradual handover of responsibilities to local communities while maintaining professional oversight. The article is supported by a representative from Save the Children, who notes similar issues with child immunization programs in Uganda. The author concludes by emphasizing the importance of balancing health service reform with the retention of vertical programs to prevent the adverse consequences of their abolition.The article discusses the importance of retaining vertical health programs, such as the World Health Organization's DOTS program for tuberculosis control, in the context of health sector reforms in developing countries. The author argues that these programs are crucial for maintaining economies of scale in drug procurement and ensuring effective monitoring and coordination. Without them, there is a risk of losing control over tuberculosis control efforts, which could lead to the development of multidrug resistance and create an untreatable pandemic. The author also highlights the need for gradual handover of responsibilities to local communities while maintaining professional oversight. The article is supported by a representative from Save the Children, who notes similar issues with child immunization programs in Uganda. The author concludes by emphasizing the importance of balancing health service reform with the retention of vertical programs to prevent the adverse consequences of their abolition.