Almost 20 per cent of tuberculosis (TB) cases in Georgia are estimated to be multidrug-resistant forms of the disease, according to the World Health Organization. Médecins Sans Frontières collaborates with the national TB programme, and facilitates access to healthcare for marginalised people.

Tuberculosis programmes

Treatment for TB was developed in the 1950s, and is a long and complex process. It involves daily medication over a period of six to eight months, which many patients struggle to adhere to. However, for patients to be cured, it is crucial that the full course of treatment is followed without interruption. If medication is interrupted, there is a risk of drug-resistant TB (DR-TB) developing, which necessitates even longer, more arduous treatment.

The DR-TB programme in Zugdidi, western Georgia, opened in November 2006.  In 2010, the programme adopted a flexible, home-based and multidisciplinary approach to the management of DR-TB cases. Adherence teams of medical and psychological staff tried to take into account all the medical, social and economic factors that affect patients’ adherence in an effort to detect problems earlier and manage them more effectively. With a stronger support structure around them, patients found the programme easier to follow and, despite the debilitating side effects, about 70 per cent of patients adhered well to the treatment.

Substantial funding, mainly from the Global Fund to Fight AIDS, Tuberculosis and Malaria, has strengthened Georgia’s fight against DR-TB. The Georgian Ministry of Health opened a new TB hospital in Tbilisi in August 2008, and in September 2010 it took over Médecins Sans Frontières’ activities in Zugdidi. Over almost four years of operation, 256 patients had been enrolled in the programme.

Médecins Sans Frontières continues to support the national TB programme in Abkhazia, a separatist region in northwest Georgia, providing direct support for DR-TB. Staff provide health education and counselling in order to improve patients’ adherence to treatment. In 2010, 36 new patients were enrolled in the programme.

Health access

An Médecins Sans Frontières programme aimed at assisting people who have difficulties accessing healthcare in Abkhazia has been considerably reduced as national capacity has improved. The programme started in 1993 with a peak of 6,000 patients, and in 2010 only 108 people, mainly home-bound and bedridden, were registered.

Médecins Sans Frontières has worked in Georgia since 1993.