Patient receiving Home Based treatment for drug resistant TB from a Community Patient Supporter and his wife.
Launching Drug Resistant-TB Care in Cambodia
In 2006, CHC secured WHO Green Light Committee (GLC) approval to obtain low cost drugs to treat 30 Cambodian patients with multidrug (MDR, or Drug Resistant (DR)) TB. A second GLC application from CHC rapidly followed in 2007, enabling CHC and the Cambodian National TB Program (NTP) to expand treatment.
With support from Wallis Annenberg and the Annenberg Foundation, CHC and the Cambodian National TB Program launched Cambodia’s first National MDR-TB program. Treatment began at the Khmer Soviet Friendship Hospital in Phnom Penh—where CHC renovated the country’s first dedicated DR-TB ward—and later expanded to establishing 65 isolation rooms across 11 referral hospitals nationwide.
To date, CHC has delivered treatment for drug resistant TB to over 2,100 patients across Cambodia in collaboration with the National TB Program.
Scaling MDR-TB Care from Community to Countrywide
CHC successfully adapted its community-based TB model to treat people with multidrug-resistant TB (MDR-TB)—offering eligible patients the option to begin or continue treatment at home, supported by trained local staff and patient supporters under close medical supervision.
In 2012, Cambodia’s National TB Program (NTP) assumed overall management, while CHC continued to lead clinical follow-up, treatment support, patient education, home infection control, and technical assistance.
In 2018, CHC reported a 10-year analysis of the program showing 77% treatment success—with patients treated at home doing as well as those hospitalized. This demonstrated that community-based care for DR-TB is both effective and scalable, providing a robust model for Asia and for NGO-Ministry of health partnerships.
CHC’s community-based MDR-TB model—like its earlier TB Community DOTS (and HIV) innovations—was successfully transitioned into the national program, with CHC continuing to deliver clinical management of the program in a highly effective partnership with the National TB Program, helping to redefine how MDR-TB care is delivered in resource-limited settings.
MDR-TB Impact at a Glance
National Pioneer: CHC launched Cambodia’s first MDR-TB program in 2006, pioneered community-based MDR-TB treatment initiation and care at home, and transitioned the national leadership to the NTP by 2012.
Lives Reached: As of Dec 2024, 1,900+ patients have received MDR-TB care with high cure and completion rates.
Innovative Treatments: Introduced and scaled up short-course regimens and treated patients with pre-extensively drug resistant (XDR)- and XDR-TB.
Proven at Home: Community-based care with patient supporters and local health staff is safe, scalable, and effective.
Strong Partnership: The CHC–National TB Program model is a replicable public–NGO partnership for MDR-TB control.
Global Influence: CHC’s model supported Ethiopia and Vietnam in launching their national MDR-TB programs—proving the power of South-to-South collaboration.
Urgent Challenge 2025: USAID Grant Termination Jeopardizes DR-TB Treatment in Cambodia
On January 25, 2025, CHC received a sudden cease-work order from USAID, terminating support for DR-TB care for the country of Cambodia despite receiving a successful grant renewal through 2029 based on teh immense success and accomplishments of the program. At that time, 239 patients—including men, women, and children—were in the midst of treatment under CHC’s clinical management across the country.
This grant also supported 31 CHC staff, many with over two decades of service to CHC, is responsible for the entire country’s DR-TB clinical care, including follow-up, education, side-effect management, infection control, and technical support to the National TB Program.
The termination of funds puts patients at severe risk of treatment failure, death, and the spread of new drug-resistant infections in their communities.
Since February 2025, with the generous support of donors (Holly Myers & Kirk Neely, Cathi & Albro Lundy, Barbara & Peter Sereda, Deirdre & Jedd Frees, and Mimi Frankel), CHC has continued essential clinical care, including home visits, remote monitoring, and emergency food support.
Your support is urgently needed to keep care going, save lives, and stop new infections while we look for a replacement of the USAID support (see below).
CHC MDR-TB staff just outside the isolation ward at the Khmer-Soviet Friendship Hospital in Phnom Penh just after it was opened in 2006.
The CHC/National TB Program (NTP) collaborative team at the National TB Program Clinical (CENAT) Ward for DR-TB, where very ill or unstable patients are hospitalized who live in Phnom Penh. Dr. Sam Sophan (far left), the CHC Clinical Coordinator manages clinical and program issues for the collaborative Cambodian DR-TB program. Nurse, So Rassi (far right), is the CHC Manager of the DR-TB Ward at CENAT. They are gathered in the staff work room, October 2024.
On a Home Visit, CHC examines a close contact of a DR-TB patient (a brother) who was concerned about abdominal pain, to check for signs or symptoms of TB.
A drawing of a patient who initiates treatment for drug resistant TB as an outpatient. The family has constructed a separate area for the patient while he or she is still infectious in which to sleep and spend their days while under treatment. The Community-based daily observed therapy (DOT) worker and patient supporter makes sure the patient takes all of their doses and contacts the healthcare team if there are any issues as soon as possible. The DR-TB health team visits the patient on a monthly basis.
Dr. Sam Sophan visiting patients with drug resistant TB (DR-TB) in northwest Cambodia on March 3, 2025. These patients were left without the support of the DR-TB program that was funded by USAID. CHC has been following the patients and trying to fill the gap.
Above left: Dr. Sam Sophan, clinical coordinator of the CHC/ National TB Program (NTP) collaborative drug resistant TB (DR TB) Program, visiting a patient with medication side effects to evaluate her and provide advice on medication consumption on March 4, 2025. Above right: Dr. Sophan visits an ill young father with extensive DR-TB disease affecting both of his lungs. He has been unable to continue his job as a day laborer on construction sites since falling ill, and his wife has gone in his place to work manual labor to support the family. The patient and his two children are living in the primitive shack behind them on a relative’s land. Medical check showed he is progressing with his treatment. Support was provided by CHC for food and school fees for his 10 year old daughter (standing between the patient and Dr. Sophan) for this extremely poor family.
Lahdy
When Lahdy, above, first presented to the CHC team in 2016 in Banteay Meanchey Hospital in northwest Cambodia (Top left and middle photos) she was a 28 year old seamstress and young mother with a 4 year old son, in severe respiratory distress. Her severe multidrug resistant (DR)-TB pneumonia was obliterating one of her lungs (Top right photo). She was also suffering from severe malnutrition and was not improving on the typical regimen for multidrug resistant (MDR) TB.
She was found to have a form of MDR-TB that is resistant to even the usual drugs used for MDR-TB. CHC was able to obtain one of the new TB drugs, called bedaquiline in 2018, on a compassionate use basis from the MSF-Belgium team when the CHC/GHC visited Myanmar. This new MDR-TB drug which is effective for this type of extensively resistant DR-TB called XDR-TB, was hand carried to Cambodia.
Bedaquiline made the difference between life and death to Lahdy, and she became the first patient in Cambodia to receive this drug, which when added to her medical regimen resulted in her cure.
CHC went on to introduce bedaquiline to the country with the National TB Program for extensively drug resistant (XDR) TB. CHC worked with the National TB Program to integrate it into the Cambodian national recommendations for pre-XDR and XDR TB and conducted trainings for the national staff in its use.
Below, is a picture of Dr. Sam Sophan, CHC Clinical Coordinator of the national Cambodian DR-TB program and Dr. Rocio Hurtado, longtime GHC Clinical Advisor who visited Lahdy on March 4, 2025.
Lahdy, who is cured of her XDR-TB, now runs her own cosmetics business. She gave birth 4 years ago in 2021 to a daughter and her son is now 12 years old. In the photo below Lahdy is in a red jacket with her husband to her left and her 4 year old daughter behind her and Dr. Rocio who is immediately to her right and Dr. Sophan is next to Dr. Rocio. Lahdy’s son was in school when the team visited.
