MSF has finalised the expansion of the treatment programme for tuberculosis (TB) in Khorezm oblast, Uzbekistan. Since December 2002 the entire population of Khorezm oblast (population 1,300,000) has access to free TB treatment. The programme is being implemented in collaboration with the Ministry of Health.

Since then 2,800 patients have been registered and over 1,000 are currently receiving treatment. MSF is also involved in tuberculosis treatment programmes in Karakalpakstan in Uzbekistan and Dashoguz in Turkmenistan. In total tuberculosis treatment is now available to 3.3 million people throughout the region.

For successful treatment of tuberculosis completion of the treatment is essential. If patients do not complete their treatment they may not be fully cured and develop multi drug resistant tuberculosis (MDR-TB) soon afterwards.

MDR-TB is very difficult to cure and involves a long and expensive treatment that is currently unavailable in Uzbekistan. To facilitate completion of the treatment, and to ensure adequate monitoring by health care workers, 186 small local centres have been opened throughout Khorezm oblast.

Patients are treated using the DOTS (Directly Observed Treatment Short course) programme. DOTS is recognised as the most effective treatment currently available for infectious cases of tuberculosis. MSF has ensured that the medical workers of tuberculosis dispensaries are trained in implementation of DOTS.

To check whether the programme is working effectively data on the programme are collected and evaluated. MSF is supplying drugs, equipment and material for the diagnosis and treatment to prevent any interruption in the treatment schedule. In the longer term, the Ministry of Health will ensure the sustainability of drug supplies. Laboratory facilities in the 12 tuberculosis hospitals have been updated and laboratory technicians have been trained to facilitate analysis of sputum, necessary in identifying infectious patients.