An MDR patient who was started on MDR TB drugs as an outpatient by the CHC team receives his morning dose of medications at a isolation shelter attached to his home his home that CHC helped him to build with the assistance of his patient supporters and the CHC team in the background. The Patient supporters are community volunteers or family members who help the patient take the 2 year long therapy necessary for cure.

The emergence of drug-resistant pathogens, especially multidrug-resistant tuberculosis (MDR-TB), has become a major public health problem around the globe. MDR-TB bacteria are resistant to the two first-line antibiotic treatments commonly used to treat TB. Curing MDR-TB requires treatment with more toxic antibiotics for up to 2 years as opposed to the 6 months it takes to treat conventional TB.

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 and implementing the countrywide plan for treating MDR-TB. The CHC MDR-TB Treatment Expansion Project involves 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 is providing a powerful new international model for MDR-TB treatment that we hope to apply to the MDR problem in other countries in Asia and Africa, beginning in Ethiopia and Vietnam.

With the support of the Annenberg Foundation and MDR TB drugs from UNITAID, the CHC has started desperately needed treatment for 230 MDR-TB cases. 20% of Cambodian MDR TB cases initiate therapy at home using the powerful community based approaches that CHC has pioneered for TB therapy with the assistance of patient supporters and CHC and NTP TB staff.