Ethiopia, GHC

The Ethiopian GHC MDRTB treatment program conducted in partnership with the Ethiopian Ministry of Health, with support of the Jolie-Pitt Foundation and more recently a grant from the Eli Lilly MDR Partnership has made great strides in the last 21 months since the time of the initial enrollment of the first cohort of 9 patients (Feb 2009). As of December 2010, over 150 patients have begun MDRTB treatment, with none defaulting on therapy. Up to one-third of patients are coinfected with HIV and most patients present in the advanced stages of the disease, having cycled through several prior TB treatments. Though hospitalization is required to stabilize a proportion of these very ill and advanced group of patients, outpatient treatment initiation has also begun. The vast majority of patients are treated in the ambulatory setting once stabilized, following the community-based model of care delivery learned from GHC's many years of experience in Cambodia, adapted to the Ethiopian setting.

Laboratory capacity continues to expand, with the support of FIND diagnostics, and St Peter's Hospital is now processing culture specimens.

In addition, since August 2010, with a grant from the Frankel Foundation, the MDRTB treatment program has expanded to include Gondar, in the northern part of Ethiopia, with ongoing enrollment planned over the ensuing months and with the tenth patient recently initiated on therapy.

We continue to be inspired by the resilience of our patients, who have endured years of chronic illness, with many complications, yet who continue to hope for health with the prospect of MDRTB therapy now a reality in Ethiopia. We hope this program will be a model for scale up in Ethiopia and in Africa.