Dr. Gocha Salia, looking at Eldar's X-ray at Senaki Ambulatory point. Georgia 2017 © Daro Sulakauri The morning sky is veiled by steel-gray clouds when Eldar arrives for his appointment at the local hospital in the town of Senaki, in rural western Georgia, deep in the Caucasus. Rail-thin and smartly dressed in a twill blazer and jeans, the 29-year-old has been battling tuberculosis (TB) since 2006. Back then, Eldar’s doctor put him on treatment for multi-drug resistant TB, a long and complicated regimen he was unable to complete. In 2016, ten years after his original diagnosis, Eldar was still sick, and still tested positive for the disease. He was referred to the Doctors Without Borders/Médecins Sans Frontières (MSF) program near Senaki, where he was enrolled in a new treatment using bedaquiline and delamanid, the first new tuberculosis drugs developed in nearly 50 years. After almost two more years of grueling treatment using these new compounds, Eldar recently received the news that he had finally tested negative. Light rain begins to fall as he climbs the crumbling cement steps of the hospital and enters the small consultation area, where he will meet with his MSF doctor and counselor for a follow-up. It’s an appointment he hopes will be one of his last. Once considered all but defeated in Georgia, TB re-emerged as a major threat to public health after the collapse of the Soviet Union. During the years of conflict, displacement, and privation that came afterward, outdated and poorly followed treatment practices led to increased drug resistance. Though the incidence of tuberculosis is lower here than in some other countries in the region, Georgia is grappling with a particularly high burden of drug-resistant TB. For patients with these forms of the disease, the standard antibiotic treatments simply do not work. Read the full story in MSF-USA's Alert, Summer 2017.
