Nepal is a beautiful country sandwiched between India and China. It is famous as the home of the Himalayan mountain range including Mount Everest, the world’s highest peak. However, it is also one of the world’s least developed countries and faces a lot of challenges providing healthcare to its people, including human resources, remote and inhospitable terrain, transport infrastructure and very limited finances.There were 44,000 cases of TB in Nepal in 2014, with an estimated incidence of 158 cases for every hundred thousand people. There were five thousand deaths from TB in Nepal in 2014.

Multi-drug resistant tuberculosis rates are 2.2% in new cases and 15% among re-treatment cases. Importantly only 349 of the estimated 1,160 cases of multi drug resistant tuberculosis (30%) occurring in 2014 were started on effective treatment for their drug-resistant disease.

Over the last decade, many countries have begun to see a decline in TB incidence of 1-2% per year, following intensified control activities. However, in Nepal the incidence has remained stagnant for the last decade, despite high treatment success rates of 90% for those enrolled on treatment. The national strategic plan for 2016-2021 identifies active case finding through contact tracing as a priority aim of the National TB Program, but the resources available for this are not clear within an already financially strained programme. Nepal will embark on a prevalence survey in 2016 to update estimates of disease burden.

IMPACT TB will implement intensified TB case finding in four districts of Nepal (shown on the map) Chitawan, Makawanpur, Mahotari and Dhanusha.