Photo story |

Photo story: Out of Step 2014

3 min
Photograph by Wendy Marijnissen
MSF doctor Christoph Höhn performs an eye test on 16-year-old patient Shahnoza in her family home. Shahnoza started MDR-TB treatment in October 2012 but was later diagnosed with XDR-TB. Since January 2013, she is on the right drug regimen, but she will ne

A More Robust Response Needed Now

Drug-resistant TB (DR-TB) is increasingly spreading from person to person in places around the world, with some countries reporting up to 35% of new TB cases as multi-drug resistant (MDR-TB). Extensively drug-resistant TB (XDR-TB) has now been reported in 100 countries, accounting for an estimated 9% of all MDR-TB cases.
Globally, access to proper treatment is drastically low: only one person in five with MDR-TB receives treatment; the rest are left to die, increasing the risk to their families and communities and fuelling the epidemic.
A new report, ‘Out of Step’, by Médecins Sans Frontières (MSF) or Doctors Without Borders, outlines five deadly gaps contributing to the global DR-TB crisis. It calls on governments, drug companies, and donors to urgently step-up care and deliver new and promising treatments.
This photo gallery offers a glimpse of DR-TB’s impact on the lives of patients and medical staff from around the world, and underscores the urgency of MSF’s call to close the gaps that are fuelling the epidemic.

A devastating disease

A 16-year-old XDR-TB patient in Tajikistan has lost sight in one eye as a side effect of treatment, which takes two years of toxic drugs - including around 14,000 pills - for a 22% chance of cure. New data indicates DR-TB in some regions is increasingly spreading from person to person.

Needed: Access to DR-TB diagnostics

Natalia, a MSF doctors show its lung x-ray to a XDR TB patient in Kara Suu hospital.
Photograph by Vincent Tremeau

An MSF doctor at a hospital in Kyrgyzstan, where the TB burden is high, reviews a chest X-ray with a patient. Access to drug sensitivity testing is essential for accurate and timely diagnosis of DR-TB, without which misdiagnosis and mistreatment fuel the epidemic.

Needed: Access to patient-centered, decentralized care

Dumsami receives daily injections in the buttocks, they are painful and part of his lengthy MDR-TB treatment, that he has been ondergoing since 3 months. He is also HIV-positive.
Photograph by Sven Torfinn

In Swaziland, a patient receives his daily injection for MDR-TB from an MSF home care team. Care tailored to patient needs and delivered in or close to home is more bearable for people, delivers medical outcomes equal to hospitalisation, and is more cost-effective.

Needed: Increased diagnostic and treatment services

Sneha Pal (F/18) who has been receiving treatment for the past 6 months from MSF for her XXDRTB, poses for a portrait at her home in Santosh Nagar, Goregaon East, Mumbai.
Photograph by Sami Siva

An XXDR-TB patient treated by MSF in India poses for a portrait at home. Only one person in five with MDR-TB receives treatment worldwide; the number of people left untreated is increasing annually. Access to correct and prompt treatment, with supportive therapies, is crucial to containing the epidemic.

Needed: Access to new and promising drugs

Swaziland, Cana House (MSF residence for patients on treatment) in Makanyane. October 2013.
Photograph by Sven Torfinn

A 30-year-old MDR-TB patient in Swaziland struggles with his treatment. “My bones hurt, I could not walk, I had to vomit…” Patients need better treatments now: new and repurposed drugs for DR-TB must be made accessible and affordable, including for research into new treatment combinations.

As health ministers from around the world gathered in Geneva, Switzerland last week for the 67th World Health Assembly, Phumeza Tisile worked to turn their attention to the “Test Me, Treat Me” DR-TB Manifesto campaign’s call to action.
Photograph by MSF

XDR-TB survivor Phumeza Tisile - cured by an MSF clinic in South Africa - attends the World Health Assembly 2014, in Geneva, to call for a stronger response to DR-TB. If governments and donors are serious about tackling the epidemic, then adequate funding is crucial.

To change the future, start now

5-year-old Umeda has MDR-TB. Here she holds up her star chart. She gets a sticker every time she takes her medicine properly.
Photograph by Wendy Marijnissen

A five-year-old girl in Tajikistan holds her MDR-TB treatment chart with stars for when she takes her medicines correctly. Today, the DR-TB response is failing patients, with deadly gaps that fuel the epidemic. Governments, donors and drug-companies must step up now or face a worsening threat.

MSF at the 45th Union Conference for Lung Health
MSF is present at the biggest conference on tuberculosis with a range of events and presentations.
See the full schedule on our special page.