To tackle MDR-TB and XDR-TB, MSH is supporting the ministries of health and national TB programs in Uganda, Ethiopia, Indonesia, Vietnam, Cambodia, and Nigeria. Within these nations, we are implementing MDR-TB activities through five PEPFAR- and USAID-funded projects: TB CARE I; Help Ethiopia Address Low TB (HEAL TB); TRACK TB; Strengthening TB and AIDS Response, Eastern Region (STAR-E); and Systems for Improved Access to Pharmaceuticals and Services (SIAPS).

MSH builds the capacity of national TB programs and ministries to implement decentralized MDR-TB programs that focus on:

  • An effective programmatic approach,

  • A strong clinical management strategy,

  • A well-functioning laboratory system, and

  • A sound drug management system.

Once these components of a MDR-TB program is in place, we then support the national TB programs and ministries of health to:

  • Train health workers to effectively screen for, diagnosis, and treat MDR-TB;

  • Expand MDR-TB prevention and care initiatives to include more women and children;

  • Establish an MDR-TB patient tracking system;

  • Implement the e-TB Manager to manage all TB program data;[1]

  • Improve health facility systems and expand community-based approaches for MDR-TB control; and

  • Conduct operational research on MDR-TB interventions, patient support, and treatment outcomes to inform future programming.

MSH and KNCV have developed a tool for identifying the cost to patients of MDR-TB, the tool has been used in Kazakhstan, Indonesia and Ethiopia and the results will be reviewed by the MOH’s of those countries and policy recommendations will be developed at those workshops. MSH has developed a tool for costing TB services and a tool for estimating the economic burden of TB – these are being used in Indonesia for developing the TB control financing roadmap and advocacy materials. In addition MSH has developed an MDR-TB cost-effectiveness tool which is currently being updated.

For more information and resources from MSH, please visit: http://www.msh.org