Partner of the Month: Highlighting the work of the Nepal Anti-Tuberculosis Association (NATA) on MDR-TB

The Stop TB Partnership and our nearly 1200 partners are a collective force that is transforming the fight against TB in more than 100 countries. They include international and technical organizations, government programmes, research and funding agencies, foundations, NGOs, civil society and community groups and the private sector.

01 September - To highlight the work and expertise of our partners in various aspects of TB care and control we have started an initiative called "Partner of the Month". Each month we will be sending you a brief account on the excellent work being done in the field and also getting to know our partners better.

This month we focused on developing countries NGOs who are working on interventions on MDR-TB care and control in their operational areas. We inform you of the Nepal Anti-Tuberculosis Association through this question and answer:

NATA has a longstanding history of involvement in TB control activities in Nepal particularly in DR-TB management as one of the Sub Recipients (SR) of the Global Fund. It has been providing diagnostic, treatment, care and support services for DR-TB patients and contributing through research, surveillance and providing technical assistance in DR-TB management.

NATA runs a Laboratory of International Standard known as German Nepal Tuberculosis Project (GENETUP) with the facilities of AFB smear, solid culture, first line and second line drug susceptibility testing (DST), and genotype line probe assay. GENETUP is working under quality control of the Gauting Supra National Reference Laboratory in Germany and is functioning as a National Reference Laboratory for culture and DST.

Similarly, out of 13 DR treatment centers in Nepal, NATA runs three treatment centers offering DR TB management services in 3 different regions of the country. Likewise, it runs 25 bedded chest hospital providing inpatient services to TB patients including DR-TB patients at central level and a 20 bedded DR referral clinic at Mid Western Region.

NATA also runs four 15 bedded hostels with a full package of lodging and food for DR-TB patients. DR-TB patients living away from home are being accommodated in the hostels where they are provided with concentrated treatment, care and support.

Further, NATA is providing socio-economic support to DR-TB patients. In order to support them in life skills development and income generating activities, NATA has provided various skills development and vocational trainings to DR-TB patients. Additionally, it has provided economic support to poor and needy patients along with education support to their children.

Importantly, NATA is also contributing through research and studies in DR TB. It has carried out various studies and has participated in clinical trials in DR-TB at national as well as international levels. It has also been conducting DR surveillances. Similarly, it has been continuously providing technical assistance to National TB Program and other stakeholders in DR-TB management.

NATA is one of the pioneers in implementing Drug Resistance TB program in Nepal. As one of the major partners of NTP, NATA has significant contribution in piloting and implementing DR management programs. At present, it is leading in implementation of DR TB management programs in Nepal. NATA GENETUP has prominent role in diagnosis of DR TB and over the last 5 years, GENETUP conducted 15067 Culture examinations and 680 DST. Similarly, it provided 622 second line DST services during the period.

During the last 5 year period, 277 MDR-TB patients and 42 XDR-TB patients have been registered for treatment. There are now 132 DR patients who are under treatment. Similarly, there are 38 DR-TB patients who are currently receiving services from the hostels.

Regarding socio-economic support, NATA has provided income generation training to 243 DR-TB patients which includes tailoring, candle making, beauty parlor training and computer training. Likewise 69 children of DR-TB patients have received education support.

NATA has conducted various studies and surveillances and participated in various clinical trials.

Yes, NATA, since its inception, is working closely with national programs. In fact, it had a key role in initiating the National TB control project in Nepal. Today, it stands as one of the key partners of the National TB Program, Nepal. The chest hospital is running under the direct support from the Ministry of Health and Population (MoHP). Further, it has been working in close coordination with Regional Health Directorate and Regional TB Center at regional level, District Public/Health Offices at district level and respective health institutions at community levels.

TB is a global public health problem and TB control requires collaborative efforts. DR-TB is more devastating and needs actions from both public and non public sectors. As such, organizations like us have a significant role in addressing the challenge. These organizations should support national TB programs and can contribute through various aspects. Strong determination and commitment of such organizations and joint efforts of government and non-government sectors along with civil societies play vital role to combat DR TB. It is our responsibility to make our nation free of TB. So, our collaborative work is a must to fight DR TB.

"...When I was at home I used to think that I am the only one who is suffering from this kind of disease but after staying at hostel I found many people like me which made me feel easy and comfort... I talk with other friends at hostel and here I found good cooperative environment than home..."

- DR-TB patient (Age: 21yrs)