Drug-resistant TB Treatment Training and Care

The GHC / Ethiopian Federal Ministry of Health partnership program for drug-resistant TB has recently reported the best treatment outcomes in Sub-Saharan Africa, with ~80% of patients being cured of the disease. The Ethiopian GHC drug-resistant TB treatment program conducted in partnership with the Ethiopian Ministry of Health, with the support from the Jolie-Pitt Foundation, the Annenberg Foundation, the Eli Lilly drug-resistant TB Partnership, and the Lilly Foundation has made great strides since the initial enrollment of the first cohort of nine patients in February 2009.

As of April 2016, 1454 patients have begun drug-resistant TB treatment, with approximately a quarter of the patients co-infected with HIV and a fifth of the patients being children and teens. Most patients present in the advanced stages of the diseases, having cycled through several prior TB treatments. The program’s partners are St. Peter’s TB Specialized Hospital in Addis Ababa and Gondar University Hospital in the north of country in Gondar, and Hossana and Irgalim Hospitals in the south.

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.

From the initiation of the Ethiopian countrywide program for drug-resistant TB in 2009, the Global Health Committee (GHC) has treated 1,988 patients as of October 2018. This program, conducted in partnership with the Ethiopian Ministry of Health (MOH), has achieved the best cure and treatment outcomes (~80%) for patients with drug-resistant TB in sub-Saharan Africa--raising the bar for all programs. From its original program base at St. Peter’s Specialized TB Hospital in Addis Ababa, GHC expanded to the north and south of the country in Gondar, Irgalim, Hosanna, and Arba Minch. A quarter of the patients beneting from the GHC program are co-infected with HIV and drug-resistant TB. Since 2011, GHC has served as one of the clinical sites for the international STREAM trial, which will provide denitive data in the coming years on the ecacy of shorter drug regimens for drug-resistant TB. In addition, in 2018 GHC provided technical assistance to the Ethiopian Ministry of Health in preparation of national implementation of new TB drugs and shorter treatment regimens. All of these eorts are in service of GHC’s vision of eradicating drug-resistant TB.