Médecins Sans Frontières (MSF) handed over its multidrug-resistant tuberculosis (MDR-TB) activities in Abkhazia in August 2014, and focused on patients with extensively drug-resistant forms of the disease in the capital Tbilisi.
Despite a very significant decrease in the number of TB cases in Georgia over the last 20 years, prevalence remains high. Every year around 500 patients are found to have MDR-TB and are offered treatment; approximately 10 per cent of these prove to have the extensively drug-resistant form of the disease (XDR-TB). Treatment is not successful in more than 60 per cent of patients diagnosed with XDR-TB and a significant number of them subsequently die. These statistics from the Georgia Ministry of Health clearly show the need for improved treatment regimens. Two new drugs – bedaquiline and delamanid – have recently become available to some patients who have no other treatment options left. These are authorised by the manufacturers on a case-by-case basis.
In September 2014, MSF started supporting the National Center for Tuberculosis and Lung Diseases in Tbilisi. Training and technical support were provided to hospital staff to improve detection and clinical care of XDR-TB patients, and to facilitate their early access to new drugs. As of December, 18 XDR-TB patients were benefiting from bedaquiline. Clinical trials for new and improved treatments for MDR-TB should start taking place at the hospital in 2016. The trials will aim to identify new treatment plans combining old and new TB drugs, and will include assessments of their toxicity and effectiveness. A grant for activities in Tbilisi was under discussion with UNITAID at the end of 2014.
Handing over activities in Abkhazia
In August, MSF handed over its access to care programme for elderly and vulnerable people, as well as its TB and MDR-TB activities in Abkhazia, to a local NGO set up by former MSF staff. Support for patients with chronic diseases included home-based care, ophthalmologic consultations and provision of equipment such as wheelchairs. MSF continues to facilitate the transportation of sputum samples from Abkhazia to the culture laboratory in Tbilisi.
No. staff in 2014: 28 | Expenditure: €0.8 million | Year MSF first worked in the country: 1993 | msf.org/georgia