MSF-USA: Field News 11/12/2003 - Treatment Begins for Multi-drug Resistant TB in Uzbekistan

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NEWS UPDATE

November 12, 2003
Treatment Begins for Multi-drug Resistant TB in Uzbekistan

MSF has started a pilot project for the treatment of multi-drug resistant tuberculosis (MDR-TB) in Karakalpakstan, Uzbekistan to show that the disease can be treated in poor countries.

Dr. Lee Jong-wook, Director General of the World Health Organization (WHO), conducted the official opening, saying the project, in which MSF and Uzbekistan's Ministry of Health work closely together, as an "opportunity for patients to get treatment and prove that it can be done here so that the program can be expanded throughout Central Asia in the future."

The first patients suffering from a form of TB that cannot be cured effectively with the first line medicines already started treatment, and a total of 100 patients will be enrolled in the program. A hospital and a laboratory have been equipped by MSF for the pilot project.

Treating MDR-TB takes between 18 and 24 months, with medicines that have severe side effects and are much more expensive than those used in standard TB treatment.

There is also the danger that super resistant strains of TB could develop if MDR-TB treatment is not conducted properly. For these reasons, there has been a reluctance to initiate treatment in poor countries. Instead many argue for solely focusing treatment on drug susceptible cases. MSF feels it is time to work towards overcoming this reluctance.

MSF has worked in Uzbekistan since 1998 to combat tuberculosis using the Directly Observed Treatment Short course (DOTS). Unfortunately some patients have not responded to the first line drugs used in the DOTS program. So in 2002 MSF conducted a survey profiling TB drug resistance.

The results showed Karakalpakstan to have the highest levels of MDR-TB - 13% - in the region. Many patients had never been treated for TB while 40% of those who received treatment have MDR-TB.

Drug resistance arises from the improper use of antibiotics, including the prescription of inappropriate treatment regimens and/or the failure of patients to adhere to a full course of treatment.