MDR-TB Treatment & Prevention

Operation ASHA focuses on slums and serves 2 million slum dwellers in five states in India. It has achieved excellent results: with increase in detection rate of 78% in two years and virtual elimination of default.
It is also participating in a government led trial of treating MDR. I am attaching a brief introduction to our work below. More information is available on our website www.opasha.org . I will be happy to answer follow-up questions about our model.

Introduction to Operation ASHA
Operation ASHA has devised a new patient-friendly system. The treatment is taken to the doorsteps of the disadvantaged. Treatment centers are established within the community, e.g. in small shops, huts and temples. Centers are located a mile from each other and operated by community providers for 12-16 hours a day. Thus, patients can procure the medicine conveniently, without spending money on transport, waste time or lose wages.
Easy accessibility is supported by a robust educational campaign, which is carried out by highly trained counselors, who are also responsible for tracking and eliminating missed doses.
All employees are recruited from within the community. So Operation ASHA’s message is accepted readily. Counselors screen every person and ensure ...

Operation ASHA focuses on slums and serves 2 million slum dwellers in five states in India. It has achieved excellent results: with increase in detection rate of 78% in two years and virtual elimination of default.
It is also participating in a government led trial of treating MDR. I am attaching a brief introduction to our work below. More information is available on our website www.opasha.org . I will be happy to answer follow-up questions about our model.

Introduction to Operation ASHA
Operation ASHA has devised a new patient-friendly system. The treatment is taken to the doorsteps of the disadvantaged. Treatment centers are established within the community, e.g. in small shops, huts and temples. Centers are located a mile from each other and operated by community providers for 12-16 hours a day. Thus, patients can procure the medicine conveniently, without spending money on transport, waste time or lose wages.
Easy accessibility is supported by a robust educational campaign, which is carried out by highly trained counselors, who are also responsible for tracking and eliminating missed doses.
All employees are recruited from within the community. So Operation ASHA’s message is accepted readily. Counselors screen every person and ensure that every suspect undergoes a sputum test. All employees are paid performance linked incentive salaries, which motivates them to do well.
Operation ASHA works very closely with the National TB Program and uses drugs, hospitals and diagnostic facilities provided by the NTP. Government officials are encouraged to visit the centers. Their feedback is helpful in maintaining high quality. NTP also provides a grant so each center becomes self-sustaining within two years.
Our model has achieved excellent results. In South Delhi where Operation ASHA is a major force, detection rate has increased by 78%. Default is down to nearly 3%, many times less than usual in slums that have subsantial migratory population. Thus, Operation ASHA has turned the tap off, preventing MDR. Experts have found our work to be truly remarkable and fascinating and excellent.
High quality does not mean high costs. Operation ASHA practices stringent quality control. The cost of treating a patient for the entire therapy is only $15 = $2 a month approximately. The “social return on investment” is 22500%. Our investment is matched 25 times by our partners.
 
Operation ASHA is developing bio-metric devices in collaboration with Research Department of Microsoft to track each dose taken by each patient so missed doses and default can be eliminated.
Operation ASHA’s model has been appreciated world-wide. Prajnopaya Foundation, headed by Nobel Laureate His Holiness the Dalai Lama is running a joint program in which Operation ASHA executes the work.
 
Having eliminated default, established a cost-effective and replicable model, Operation ASHA is expanding rapidly. It plans to establish 1000 DOTS centers by 2012, which will serve a population of 70 million.

Here is a link to another short video documenting Indus Hospital's community-based treatment for MDR-TB patients in Karachi.

http://www.youtube.com/watch?v=K-EQ6BdijFM