A queue of uniformed students waits to show a ZTB physician their TB skin test results Kunchok Dorjee gives a student a physical exam using a stethoscope

The Challenge

Tibetan refugee children living in India suffer from tuberculosis (TB) at an astounding rate 5 times higher than that of Indian children. The ZTB team is addressing this critical health-equity challenge with innovative approaches in diagnostics, therapeutics, and patient education to create the most effective strategies for eliminating TB among refugee children in India, Nepal, and beyond.

A substantial proportion of Tibetan children in India attend boarding schools for educational, spiritual, and cultural instruction. The schools, largely supported by charitable donations, provide a nurturing environment, good nutrition, and a rigorous curriculum. However, children live in dormitories and hostels with up to 40 children per room or dormitory, often in over-crowded conditions. During harsh Himalayan winters, ventilation is not optimal, thus increasing the transmission of TB.

Introduction to ZTB and its partnerships in northern India, featuring founders Dr. Kunchok Dorjee and Dr. Richard Chaisson (April 2017).
Collaboration Across Sectors

This approach was designed through a collaboration between Johns Hopkins schools of Medicine, Nursing, Public Health, Business, Education, and Arts & Sciences. Our researchers are partnering with the Tibetan Delek Hospital and the Tibetan community in India. The project has the full support of His Holiness the Dalai Lama; political leaders from the Central Tibetan Administration; the Ministries of Health and Education; the Tibetan Children’s Villages; and the larger Tibetan community.

This multidisciplinary collaboration represents the unification of global experts to address a major health inequity faced by a vulnerable refugee population. Results from this project will inform policy and action at the national and global level, which is significant because current screening and treatment related to latent TB are largely insufficient despite the proven benefits of TB preventive therapy.