“Without the help of the Global Fund, there is no chance that we could have started treatment of multi-drug resistant tuberculosis (MDR-TB),” says Tariel Endeladze, head of the state TB hospital in the spa town of Abastumani. He’s played an important role in ensuring Georgia’s MDR-TB treatment program is now available to anyone in the country who needs it.

Back in 1985 when Dr Endeladze was appointed the hospital’s head, there was no regular supply of drugs for the difficult to treat form of TB.

“Sometimes it was one drug, sometimes another. There was no standard time for treatment; people could spend years here. One patient was here for 26 years,” he recalls. “There was certainly [cases of] MDR, but we had no diagnosis for MDR then,” he adds.

As in many former Soviet countries, Georgia suffered a surge in TB cases during the 1990s as a result of economic crises and, in its case, of internal armed conflict with the mass movement of people and large numbers of refugees.

Georgia ranks around 15th on the World Health Organization’s list of countries worldwide that are most burdened by MDR-TB, which can develop when TB patients are not given appropriate treatment or when they fail to complete the full course of drugs. The disease is directly transmissible.

With financing from the Global Fund, Georgia began its first pilot project for MDR-TB treatment in Abastumani in March, 2008. What started with seven patients has grown quickly and the hospital currently has 86 patients in its two MDR-TB wards. It’s one of three in-patient MDR-TB sites in the country and a total of a thousand people are now being treated nationwide.

Abastumani lies in the mountains west of the capital Tbilisi, close to the Black Sea and the Turkish frontier. The Russian Tzars once had a summer residence here, and it used to be full of sanatoriums because the mountain air was considered ideal for TB patients.

The Abastumani TB hospital is in a 1920s building with brightly painted corridors and high ceilings and windows, which makes for good air circulation. The MDR-TB wards are housed on the second and third floors of the building. The Global Fund covers the cost of the MDR treatment, and it also paid for building repairs after hurricane damage in spring 2008.

Although he has been in charge of the TB hospital for nearly 25 years, Endeladze, who is approaching retirement, continues to be full of enthusiasm for his work. “This is my life. Whoever is involved in TB control, it becomes a deep part of your life,” he says.

“I worked in TB in the hard times, I would not want to be doing anything else now that we are in far better times.”