Moxafrica has been working in North Korea (DPRK) since 2016 with our local partner, the Korean Red Cross Foundation (KRCF). Largely through happenstance, we found ourselves invited to come to Pyongyang after the DPRK's Minisyry of Public Health had become aware of the findings of the Ugandan RCT.

 

We immediately recognised North Korea as being a suitable location for our work because of its tuberculosis epidemic and also its high rates of drug-resistance. Ironically, its Ministry of Health is so far the only national health authority anywhere in the world that has taken the Ugandan data seriously enough to invest in its own investigative research.

 

One reason for this is because moxibustion is already used as a therapy in 'Koryo' medicine and there is also a strong cultural affinity to the mugwort plant (from which moxa floss is refined). Because of this, despite the fact that the approaches we use are quite different from the traditional moxa techniques in Koryo medicine, introducing this protocol was relatively straightforward. Over four visits, Moxafrica personnel have trained over 140 healthcare workers in the moxibustion protocol (and also many in the M-Test [Mukaino Method]). 

 

With our partners the KRCF, we helped set up two studies that were conducted by the Ministry of Public Health and its Clinical Research Institute. These studies were intended to generally measure the efficacy of moxibustion as an adjunctive therapy for treating TB in the DPRK – but to be especially conscious of the challenge of MDR-TB.

 

As such, the first study looked at the original complete TB protocol as used in Japan (bi-lateral ST36 + Dr. Hara loin points) as an adjunctive therapy for people with multi drug-resistant disease (MDR-TB). This study’s important data are analysed here (Results of research – see section on First DPRK study).

 

The second study looked at daily bi-lateral moxa at St36 only as a prophylactic in individuals in close contact with known infectious TB cases – which has taken Moxafrica’s research into an extra dimension of tuberculosis disease. The results of this study are here (Results of research – section on Second DPRK study). 

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Our long terms goals naturally now depend on how the results of these studies are viewed. With positive results emerging, we need to interest other researchers and stakeholders in them with a view to their being further tested on an urgent basis given what they imply.

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Meanwhile, communications with our contacts in the DPRK remain intermittent.

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We hope that the KRCF and other relevant bodies, in the current deficiency of international support for the nation in respect of supplies of drugs and diagnostics) are rolling out this protocol nationally, including in the development of sustainable moxa production of quality floss. In the meantime geopolitics sadly appears to be making its own impact on the North Korean TB epidemic. The current geopolitical situation, exacerbated by Global Fund (which has supplied drugs and diagnostics for the treatment of both TB and malaria in the country) cutting off much of its support with support from the WHO also now appearing to be deficient too, leaves TB patients in the country at enormous risk. This means that moxa could act as a stop-gap intervention by the MoPH, especially given the MoPH’s own data. 

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