CHC patient supporters provide medicines to MDR patient in rural Svay Rieng

The WHO and UNITAID, have paired with the CHC in the battle to fight against MDR TB (Multi Drug Resistant TB), a potentially lethal form of TB which does not respond to standard treatment. The WHO GLC (Green Light Committee) approved CHC's application on behalf of Cambodia to receive low cost drugs to treat the hundreds of patients that are suffering from this potentially lethal disease.

At the request of the Cambodian NTP (National Tuberculosis Program), the CHC is providing technical expertise to the NTP in the development of the countrywide MDR management plan. This involves clinical management of patients with MDR as well as patients who are co-infected with the AIDS virus. It also includes MDR infection control, training of physicians, nurses and community health workers in MDR diagnosis, treatment and prevention. In addition to working with the NTP, the MDR work is being carried out in partnership with MSF-Belgium and MSF-France. A major goal of CHC's efforts has been to pioneer a new community-based approach to diagnose, treat and prevent spread of MDR TB based on CHC's successful approaches to TB and AIDS, which are now being taken to Africa. An equally important goal is to build the capacity of the Cambodian National TB Program (NTP), to lead this activity independently in the future.

Phat Sokean and her mother during a home visit by CHC health workers in her home near Siem Reap. Sokhean developed MDR-TB after undergoing 3 unsuccessful courses of TB therapy. After 2 months of home treatment with the proper drug regimen, she has gained weight and has started to work a bit.

"In Cambodia we have developed a community-based approach to MDR-TB that is working extremely well and that compliments hospital based MDR care. We currently have 80 patients on MDR therapy and have achieved 4 cures," says Dr. Sok Thim, CHC's Executive Director, who has extensive experience in treating and managing MDR-TB cases from the Thai-Cambodian border in the 1980s to the present. "We imagine however that the actual number of cases in the country may be threefold higher.”

By building a strong partnership with governmental organizations, people working at the grass roots, WHO, and UNITAID, and harnessing CHC's experience, Thim notes that,"The CHC aims to provide universal access in Cambodia for MDR TB. The CHC's experience in treating MDR TB at the level of the community and in Centers of Excellence for TB and HIV care can provide a powerful new international model."