A MSF psycho-social counsellor is taking one of the advanced TB patients on a walk outside the hospital grounds. Patients spend many months in hospital wards and the rare visits to the outside world are a special treat.

In current WHO statistics, Uzbekistan ranks 11th in terms of estimated number of annual MDR-TB patients per country worldwide. The WHO estimates that 8.700 new cases occur per year in Uzbekistan. For patients, suffering from drug resistant strains of the TB bacteria means an even longer, even more painful treatment than the already tedious TB sensitive regimen. Because of the high costs and complexity of TB diagnostics and treatment, most high burden countries struggle to react properly to this immense challenge. In Karakalpakstan, an autonomous republic within Uzbekistan, MSF in collaboration with the Ministry of Health is treating patients with drug resistant forms of tuberculosis in Nukus and Chimbay. About 1,300 patients have been treated since the start of the program in 2003. In mid-2010, the project has been rolled out to include more districts in Karakalpakstan and offer comprehensive care to TB and MDR-TB patients. MSF has been working in Uzbekistan since 1997.