South Africa is trying a home-based care program to contain the spread of drug-resistant tuberculosis.

With no new drugs on the horizon, the only way to contain the spread of the highly contagious disease is to help people stick to the gruelling two-year treatment plan required for a full recovery, said Dr. Eric Goemaere, who heads Médecins Sans Frontières in South Africa.

Tuberculosis in Canada

In Canada, tuberculosis used to be associated mainly with the homeless and aboriginal communities, but the majority of new cases are now among immigrants.

The Canadian epicentre of tuberculosis is Toronto, since about 40 per cent of immigrants settle in southern Ontario. Many escaped poverty, war and famine but arrive with inactive TB.

"Only a few people actually have the active disease," said Dr. Jay Yang, who treats hundreds of patients a year at a TB clinic at St. Michael's Hospital in downtown Toronto.

"There are multiple factors, such as the stress of immigration, the stress of a new workplace, a new job, et cetera, et cetera, which can break down their immunity and therefore they reactivate the dormant TB to the active disease."

On Tuesday, the World Health Organization said that about 500,000 people worldwide have been diagnosed with multi drug-resistant strains of tuberculosis, which cannot be treated with two or more front-line drugs.

And 55 countries and territories worldwide, including Canada, have reported at least one case of "extensively drug-resistant" tuberculosis or XDR-TB, which is virtually untreatable with today's medicines, according to WHO.

"We are recycling old drugs" that were invented in the 1950s, Goemaere said in an interview for World TB Day on Tuesday. "They were abandoned because they were too toxic."

Goemaere has launched a home-based care program in Khayelitsha, a poor, black township near Cape Town.

Busi Beko was isolated from her family when she was diagnosed with a strain of tuberculosis that is resistant to conventional TB medications. Beko endured two years of injections so toxic that they could have left her permanently deaf.

"It seems as if you are a threatening bomb" to the family, Beko said, "because you are going to spread this disease."

By arming family members with face masks, MSF hopes to slow the spread of drug-resistant TB in the township, where the cases are four times higher than the levels classed as an emergency by the World Health Organization.

"We are promoting the use of these masks for everybody out there that is coughing," said Virginia Azevedo of Cape Town's health department.

"Just like you see it in Japan, where people walk down the streets wearing masks, the same needs to happen here. Immediately."

In Khayelitsha, where more than half the 500,000 residents are unemployed, one in three women is HIV positive, and their weakened immune systems leave them extremely vulnerable to contracting TB.

Azevedo said they have no idea how many people are dying of drug-resistant TB, and many die before they are diagnosed.