Institute for War and Peace Reporting | Giving Voice, Driving Change

Central Asia: Apr '08

IWPR special report draws international donor community’s attention to spread of resilient tuberculosis in Kyrgyzstan.
By an IWPR
An IWPR special report looking at the growing difficulties involved in combating tuberculosis in Kyrgyzstan has been welcomed by both local doctors and international NGOs.



The report, Resilient TB Strains Thrive in Kyrgyzstan, provided an in-depth analysis of why increasing numbers of patients are developing resistant forms of tuberculosis and what kind of challenge this poses to the country and region as a whole.



Despite some success in bringing down the number of new TB cases over the last seven years, Kyrgyzstan is now struggling with more instances of drug-resistant, and even multi-drug resistant, MDR, forms of the disease.



The report was able to provide a comprehensive account of the reasons why hardier strains of tuberculosis are on the rise in the country.



The main reasons for the increase are abbreviated therapies and insufficient medication. These factors are compounded by a lack of trained medical personnel.



The cost of a full standard course of treatment for drug-resistant strains of TB is presently 4,600 US dollars, compared with some 50 dollars for ordinary TB.



Due to the shortage of drugs, medical practitioners are providing treatment to patients with only some of the required combinations of drugs. Many patients are also self-medicating with less effective drugs bought from the chemist.



This is merely serving to produce more drug-resistant TB, as the ad hoc combinations allow resistant strains to survive and multiply. A German laboratory recently identified a Kyrgyz case of “XDR” – a TB strain resistant to all drugs.



Maxim Berdnikov of the International Committee of the Red Cross, ICRC, in Kyrgyzstan said that IWPR’s thorough analysis raised awareness of the problem.



Such a report, he said, increases discussion and promotes cooperation among international organisations fighting TB, such as Global Fund to Fight AIDS, Tuberculosis and Malaria and World Health Organisation, WHO.



“I think that the article was interesting to those who are monitoring the problem, especially for international partners helping to combat TB. All my colleagues from the Global Fund read it, as well as those at WHO in Geneva and Copenhagen,” he said.



Berdnikov said more reporting on the subject is needed to get the Kyrgyz authorities more involved in tackling the problem.



“The government is responsible for providing adequate treatment. International partners can only advise – they cannot dictate how to deal with the problem,” he said.



Atyrkul Toktogonova, a doctor who treats the country's MDR TB population at the National TB Centre in Bishkek, is relieved that high-quality second-line drugs – enough to treat more than 1,700 MDR TB patients for five years – have just arrived in the country.



She said that the IWPR report was highly appreciated among medical circles.



“This report brought up a really huge problem. I hope similar reports will be released on a regular basis because everyone must know the dire challenge that our medical system is facing at the moment,” said Toktogona.