Somalia makes progress on TB, but drug resistant strain worries experts

World Vision has partnered with the World Health Organization (WHO), Somaliland government, other agencies to establish the first specialized treatment center in Hargeisa, Somaliland.

Equipped with a hi-tech laboratory, 30 bed capacity ward and trained staff, the center will address the risks posed by multi-drug resistant (MDR) form of Tuberculosis (TB), by providing specialized diagnosis and treatment.

“Patients suffering from resistant TB have been traveling to Ethiopia, Kenya and Djibouti to seek treatment. It is very expensive and a majority of the patients cannot afford the treatment, let alone traveling,” says Dr. Vianney Rusagara, Global Fund TB Program Director at World Vision.

The new treatment facility housed within Hargeisa general hospital is currently treating 40 cases referred from across the country.

“By expanding the TB program, we hope to fast track the 2015 Millennium Development Goal of reversing TB incidence and reducing the TB mortality rate by 50% worldwide,” says Francois Batalingaya, World Vision Somalia Country Director.

World Vision started TB treatment in Somalia in 2004 and over 100,000 people in Somalia have been treated. Despite this success, there is growing concern that the MDR form of TB is under diagnosed and treated in Somalia.

Treatment of ordinary TB can last up to eight months. Patients are required to make daily trips to TB centres to take medication on physical observation. Some patients are unable to maintain the schedule due to conflict displacement, lack of food and long distances to be covered.

“Such patients are most likely to develop resistant TB, which is harder to treat, and has a lower success rate of between 60 and 70 percent.” Dr. Vianney continues to say. “Treatment of MDR TB lasts as long as 24 months.”

While there are about 70 TB treatment centres in Somalia supported by World Vision through a number of implementing partner agencies, the presence and spread of TB in the country is mostly a result of communities’ lack information and access to quality treatment.

Working closely with implementing partners, and governments, World Vision is conducting awareness campaigns to reach more people, especially those in remote areas.

“Many people are still missing out on diagnosis, and are suffering as a result. We want to reach as many of these communities with messages of hope, that TB is preventable and treatable at no cost to the patients,” says Dr. Vianney.

A recent survey (conducted by an independent TB expert on behalf of the TB program) indicates that the treatment ratio has been brought down to 100,000 people per TB centre in 2013, from 500,000 people per TB center in 2004.

Another survey conducted in Somalia in 2012 indicated that MDR cases among newly diagnosed cases stood at 5%, and 41% among previously treated patients. This is a major challenge for TB control in Somalia, also listed among the high burden countries.

This year’s World TB Day (24th March) aims to raise awareness of the 3 million people worldwide who are "missed" by public health systems and don’t get the care they need. Many of these three million people live in the world’s poorest, most vulnerable communities, including Somalia.

The TB program in Somalia is funded by the Global Fund to fight AIDS, Tuberculosis and Malaria, while technical support and additional funds are provided by World Vision United Kingdom (UK). The World Food Program provides additional food support to patients, while the European Commission Humanitarian Organization ECHO provides logistics.

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