The emergence of drug-resistant pathogens, especially multidrug-resistant tuberculosis (MDR-TB), has become a major public health problem around the globe.  MDR-TB pathogens are resistant to the two first-line antibiotic treatments commonly used to treat TB. Curing MDR-TB requires treatment with more toxic antibiotics for longer times than conventional TB. In Cambodia, there are currently 100 suspected cases of MDR-TB, but the true number of cases could be three times higher. The incidence of extensively drug-resistant TB (XDR-TB), where the tuberculosis pathogen has gained additional resistance to second-line antibiotics is still unknown, but one case was recently identified.  

With the support of private donors, the CHC and NTP have started desperately needed treatment for 32 confirmed MDR-TB cases. Recently, the World Health Organization GLC (Green Light Committee) approved CHC's application on behalf of Cambodia to receive low cost drugs to treat 100 additional patients with MDR-TB that have failed the usual antibiotic treatment.

Management of MDR-TB treatment is particularly difficult in resource-poor settings, and Cambodia is a prime example. Given the CHC´s experience at the forefront of TB patient care, and its successful approaches to TB and AIDS, the Cambodian NTP (National Tuberculosis Program) has entrusted the CHC with developing the countrywide plan for treating MDR-TB. The CHC MDR-TB Treatment Expansion Project will involve the clinical management of patients with MDR TB as well as patients co-infected with the AIDS virus.  The project also includes MDR infection control, and training of physicians, nurses and community health workers in MDR diagnosis, treatment and prevention. An equally important goal is to build the capacity of the Cambodian National TB Program (NTP), to run this program independently in the future. Besides its immediate benefit to the Cambodian people, the CHC program will provide a powerful new international model for MDR-TB treatment that we hope to apply to other impoverished countries in Asia and Africa.