11 November 2009
Bimal Khatri, 35, lives in Nepal’s capital Kathmandu with his family. He has been on tuberculosis (TB) treatment for the last year and a half - first for simple TB and then for multidrug-resistant TB (MDR-TB).
Bimal’s treatment involves taking a daily cocktail of 16 tablets. He also wears a mask and must keep at arm's length from his children. "I love them," he says, "but I have to ask them to stay away."
Bimal takes his medicine at the local hospital, where a DFID-supported anti-TB programme operates.
Treatment courses for MDR-TB are expensive and difficult – they can last between two years and 32 months.
On top of his daily tablets, six days out of seven Bimal receives a painful injection which makes it difficult to walk for hours afterwards.
The programme is run by UNITAID, and has provided life-saving treatment for 600 patients with MDR-TB in the past two years.
A cure for all
Prior to 2005, Nepal didn't have free access to treatment for MDR-TB. “We used to say, 'Okay, you are diagnosed with MDR-TB, but I am very sorry, we don't have these medicines free of cost,' ” says local clinician Dr Bhawana Shrestha.
Only those in higher economic brackets could afford to purchase the medicines. “Maybe 1% of the population could afford them,” says Dr Shrestha. “But those who could not would be at risk of transmitting MDR bacilli to others.”
Now, thanks to the DFID-supported programme, Dr Shrestha is able to prescribe the medicine to all patients, regardless of income. “We are very happy to say 'we have medicine and you'll be cured'.”
Funding has also been provided to develop a test which reduces the time it takes to diagnose MDR-TB from three months to two days. Part of the challenge in treating this strain of TB is diagnosing it in the first place.
Over the last two years, the programme has helped 600 patients with MDR-TB gain access to life-saving treatment - patients like Bimal. "Before, I was very weak," he says. “Now I’ve been taking medicine for the past four months and I’m getting better."
Facts and stats
- There are 30,000 new cases of TB diagnosed every year in Nepal. In 2007 an estimated 9 million people contracted TB worldwide and 1.3 million people died from it.
- Worldwide, half a million people are infected with MDR-TB but only 8.5% are diagnosed and fewer than 4% are treated.
- The anti-TB programme mentioned above is led by UNITAID. DFID provided £20 million to UNITAID in 2008/09.
- UNITAID's mission is to increase access to treatment for people with HIV/AIDS, malaria and TB in poor countries.