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April 2010
Global ID
New MDR-TB Treatment Program Has Early Success

Disease experts working in KwaZulu-Natal, South Africa, announced last month that the first six patients treated for multidrug-resistant tuberculosis TB (MDR-TB) through an innovative community-based program were successfully cured. This marks a major medical accomplishment and a remarkable personal turnaround for both the doctors and patients involved.

This new approach to treating MDR-TB grew out of a crisis. About four years ago, health care workers in KwaZulu-Natal were faced with a burgeoning epidemic that was overwhelming the local hospital; doctors were diagnosing more than 2,000 MDR-TB cases a year but only had 500 hospital beds available for treatment. The prolonged hospitalization required to treat MDR-TB patients—about six months—was not just a major burden on the health care system; it also took a heavy toll on the patients and their families.

In response, a coalition of American and South African health professionals joined with the KwaZulu-Natal Department of Health to devise a unique solution: treating patients in their homes, with care delivered by injection teams that visit each patient on a daily basis to administer medications, monitor progress, and provide support.

The project was spearheaded, in part, by the Tugela Ferry Care and Research Collaboration (TF CARES), a group of researchers and clinicians from several U.S. medical schools, including Yale University and Albert Einstein College of Medicine, and the Nelson R. Mandela School of Medicine – University of KwaZulu Natal (UKZN) in Durban, South Africa.

“This idea came by necessity,” said Claudio Marra, MD, of the Istituto Superiore di Sanita in Italy, who also works for the KwaZulu-Natal Department of Health. “You couldn’t treat all the patients in the hospital even if you wanted to.”

Read more about this unique program and other global health news at the Center for Global Health Policy’s blog, www.sciencespeaks.wordpress.com.

Other recent blog posts include:

  • A Q&A with Willard Cates Jr., MD, MPH, President, Research, Family Health International, who recently gave a provocative presentation at a Microbicides Trial Network meeting in Washington, D.C. He provided insights about the potential public health impact of microbicides if the scientific evidence demonstrates efficacy in preventing HIV transmission. Dr. Cates also spoke about the challenges of translating scientific data into real-world prevention gains.
  • An account of the growing crisis faced by HIV/AIDS patients living in post-earthquake Haiti, where less than 40 percent of Haitians who were receiving AIDS-related care prior to the earthquake are receiving it now. A Haitian delegation recently came to Washington to talk to policymakers about the need for dedicated funding to help respond to the AIDS pandemic. 
  • A compelling story about a Mississippi student’s two-year battle against MDR-TB, which he contracted on a backpacking trip through Southeast Asia. He spoke at a House of Representatives briefing to mark World TB Day on March 24. The Center for Global Health Policy released a new report, Death by Drug-Resistant TB and How to Stop It, at a companion Senate briefing that day.

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