Burma is a hot zone for Tuberculosis (TB), considered by the World Health Organization to be one of 22 "high burden" countries. In Eastern Burma, internal refugees have had little or no access for TB diagnosis and treatment for decades. They slowly suffer with the disease, unknowingly spreading it to their own children and community. In recent years, the problem has been compounded by increases in the number of multiple-drug resistant (MDR-TB) cases, and more recently by the identification of some cases of the lethal extremely drug resistant TB (XDR-TB) among some migrants.

With PC/GHAP's TB pilot program, 20,000 people living in the conflict zones of Burma for the first time have access to organized, well-resourced TB care. The TB pilot program was implemented by the Karen Department of Health and Welfare (KDHW) in the spring of 2007, after 6 months of training, development, and material support by GHAP and other local partners. Under the management of the KDHW, indigenous health workers provide community wide education, house-to-house screening, and patient-oriented testing and treatment for TB.

The TB pilot program follows the guidelines and goals established by the WHO to provide the highest quality care, while maintaining flexibility and adapting to the challenges inherent to this setting. According to WHO principles, the TB program focuses on education, patient-centered treatment, directly observed pill-taking (the "DOTS" protocol), and aggressive surveillance for and prevention of drug-resistant TB.

Indigenous health workers walk by foot for many hours through difficult and dangerous terrain to perform education and screening in distant villages, as well as to transport sputum test samples and medications. Health workers prepare and examine sputum test samples under the microscope in jungle-based laboratories.

Patients enrolled in the TB program take medication under the direct observation of a health worker, as recommended by the WHO, to ensure the most rapid and complete cure, with close monitoring for side effects or treatment resistant cases.

Though most cases can be treated within Burma, difficult or complex cases are referred to local partners operating along the border.

After analysis of data from the TB pilot program, further expansion is likely, to cover a greater proportion of the population.