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Pakistanis aged between 15 to 59 years mainly constitute the annually estimated 15,000 new cases of multi drug resistant (MDR) tuberculosis in the country. Programme Manager, National TB Control Programme, Dr Noor Ahmed Baloch, speaking at the groundbreaking ceremony for a new MDR-TB Out-Patient Department and Bio-Safety Level 3 (BSL-3) Laboratory at Indus Hospital urged need to bring the issue to the forefront of the health dialogue in Pakistan.
MDR-TB, he said, is a dangerous form of TB caused by bacteria that are resistant to the first line anti-TB drugs and its treatment is much more difficult and costly than that for drug-susceptible TB. MDR-TB is a significant and unrecognised problem in Pakistan, with estimates suggesting that 3 per cent of new TB cases and 36 per cent of previously treated TB cases in Pakistan are MDR-TB, said Dr Baloch.
He said there was need for concerted efforts and holistic care to address the infection that is found to hit people in the most productive age group and therefore holds its severe repercussion on national economy and development. A complete course of drug treatment costs approximately Rs 3 lakhs per patient over 2 years, again for patients who take these regularly.
While some of the MDR TB medications cause disconcerting side effects, increasing the likelihood that patients will not adhere to the prescribed treatment. He said it was over the past year and half that the National TB Control Programme and Indus Hospital have been working in partnership to provide free and comprehensive diagnosis, treatment, and social support for patient with MDR-TB.
Indus Hospital managed with the support of local philanthropists is located in Korangi, largely inhabited by factory workers and daily wage earners. Dr Baloch appreciated that the Hospital's pilot programme had provided holistic care for patients with MDR-TB including medication, clinical management and social support to promote adherence to this difficult regimen.
This programme has been met with immense success and will Insha-Allah form the basic model for the government's national programme through the Global Fund Round 9, which aims to treat 12,000 patients over 5 years, said Dr Noor Ahmed Baloch. Dr Abdul Bari Khan, the CEO of Indus Hospital thanked Ghori Trust for donating the MDR-TB facility, in memory of Syed Sarfaraz Ali Ghori and Begum Sadiqa Ghori.
He said The Indus Hospital is working in partnership with the National Tuberculosis Control Programme (NTP) to provide free and comprehensive diagnosis, treatment and social support for patients with MDR-TB. A BSL-3 laboratory has been operational here since 2008, he said.
The Indus Hospital is Pakistan's first site approved by the WHO Green Light Committee, which provides quality-assured drugs to pre-approved MDR-TB treatment centres world-wide. With this approval, the Hospital will be provided with drugs to treat over 400 MDR-TB patients over 2 years. It is expected to receive the first trench of drugs for 200 patients shortly.
Dr Zafar Zaidi, the Director of Medical Services, Indus Hospital and Dr Naseem Salahuddin, an active member of its clinical and MDR-TB programme management team said failure to complete the course of treatment for drug-susceptible TB has led to MDR-TB. The MDR-TB OPD and the high-tech lab represent the next critical step in the Indus Hospital's tireless efforts since 2007, they said.
The ceremony itself was held during a four-day symposium on the diagnosis, clinical management, and control of MDR-TB at the Indus Hospital that concluded on Thursday. Dr Aamir Javed Khan, an active member of the team working for MDR-TB Control and Prevention Programme, Indus Hospital, its Members of the Board of Governors, Board of Directors, faculty and programme staff, trustees of the Rufaydah Foundation, and representatives of the Ghori Trust, the National and Provincial TB Control Programmes attended the ceremony.

Copyright Associated Press of Pakistan, 2009

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