A new pro­gram started by Medecins Sans Fron­tieres is help­ing to make the treat­ment of tuber­cu­lo­sis eas­ier on it’s patients. In South Africa, those sick with TB were effec­tively quar­an­tined in hos­pi­tals to pre­vent the spread of the virus, but once peo­ple real­ized that they would be locked up for a long time many did not come for­ward for treat­ment. The MSF pro­gram treats the peo­ple in their homes, but they must promise not to leave the homes.

From the New York Times, reporter Celia Dug­ger explains the new treat­ment further.

Under South Africa’s cur­rent pol­icy, Ms. Vani would nor­mally have been whisked away to a hos­pi­tal after tuber­cu­lo­sis was diag­nosed and iso­lated from the pub­lic for a gru­el­ing reg­i­men of toxic, hard-to-tolerate pills and injec­tions, last­ing months.

In the neigh­bor­ing Eastern Cape Province, patients have effec­tively been impris­oned in a hos­pi­tal encir­cled by fences topped with razor wire, and dozens of them have escaped in des­per­ate bids to reunite with their fam­i­lies. Both the East­ern Cape and West­ern Cape Provinces have sought court orders to com­pel the return of runaways.

But in this case, Ms. Vani is being treated in a local clinic and lives at home under a pilot pro­gram run by Doc­tors With­out Bor­ders and sup­ported by both the city of Cape Town and West­ern Cape Province. The idea is to show that such patients can be suc­cess­fully treated in an impov­er­ished com­mu­nity like Khayelit­sha even while they are still infectious.

For Ms. Vani to con­tinue in the pro­gram, Ms. Beko had to ensure that the young woman could live at home dur­ing her treat­ment with min­i­mal risk of infect­ing oth­ers. Tuber­cu­lo­sis spreads through the air when patients cough and sneeze, and the germs could get trapped in the tiny room where Ms. Vani lives alone.

“They may send you to the hos­pi­tal, as there are no win­dows in the house,” Ms. Beko said with a doubt­ful shake of her head.

Ms. Vani, eager to avoid a long-term hos­pi­tal­iza­tion, promised that she would remain alone in the house and only see friends out­side in the open air. “I already told my boyfriend it would not be good for him to sleep over,” she said through a paper mask that cov­ered her mouth.

Drug-resistant tuber­cu­lo­sis is a mount­ing global health threat. The World Health Orga­ni­za­tion reported the high­est rates of it ever last year. Some 500,000 of the 9 mil­lion new cases of tuber­cu­lo­sis in 2007, the most recent esti­mates, failed to respond to the stan­dard, inex­pen­sive first-line drugs. About 150,000 peo­ple died of drug-resistant TB.

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