Importantly, overall the DPRK MoPH reported in a summary they supplied to us that they now have “positive opinions on the treatment effects of TB by moxa therapy”.

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Discussion of these FIRST DPRK research study findings

 

The most exciting of these findings undoubtedly relate to the last graph (of positive treatment outcomes) bearing in mind that these cases were MDR-TB, its limitation being the small numbers studied. It’s worth considering that the current success rate for treating MDR-TB as reported in the most recent WHO Global TB Report is a lowly 56% (widely accepted as being too low to contain this disease) and in this study the Korean control group was reported as having a 60% success rate – i.e. similar to the global rate. The moxa group, however, reported an 85% success rate (a hike of 42%). We believe that it’s reasonable for us to suggest that (if this is confirmable by other studies) this difference is potentially game-changing.

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To illustrate why we make this claim, we have extrapolated the proportional improvement in treatment outcome recorded in this study against the global success rate of 56% and can thus suggest that, if these data are corroborated by further studies, then the global success rate for treating MDR-TB could be lifted to 77% (for a meagre material cost of less than 30 dollars of moxa).

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(It should be further noted that the current success rate for treating drug-susceptible TB is 82%, so this possible uplift by using moxa could potentially bring MDR success rates within shouting distance of more easily treated TB.)

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What this needs, of course, is further testing on an urgent basis which so far we’ve so far been unable to either initiate or facilitate anywhere, although we have a top team lined up in Uganda willing to take on the challenge if funds can be raised.

 

With regards to symptom improvements it can also be seen that the improvements when using moxa weren’t just statistically significant: when they occurred they came through significantly faster as well. We are certainly cautious of reading too much into this, but (given that treatment for MDR-TB is generally lengthy – 9-24 months and with pernicious side-effects) any improvements in patients’ experiences could make adherence easier as well which could in turn also feed into improved outcomes and reduced mortality.

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Meanwhile, the most basic data of all – that the moxa patients’ weight improved during therapy, while the control group lost weight – not only supports the rest of the data, it suggests that moxa was helping patients to constitutionally recover as well.

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*

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In the meantime geopolitics sadly inflicted its own pernicious impact on the North Korean TB epidemic and its vulnerable population. The Global Fund (which had until then been supplying drugs and diagnostics for the treatment of both TB and malaria in the country) cut off all its support early in 2018 (at the same time as the results of this first study were shared). No convincing explanations were available as to why this decision was made - and to make things worse this coincided with support from the WHO being sadly lacking as well. This left TB patients in the country at enormous risk, threw the national program into disarray, threatening an epidemiologically inevitable hike in existing numbers of MDR-TB cases.

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Moxafrica committed to doing all it could to offer help in what was an emerging and continuing humanitarian crisis.

 

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The Results of the Second DPRK Study

 

 

The second study looked at the possible preventative efficacy of low-dose daily moxa in reducing the incidence of active tuberculosis occurring in a vulnerable group.

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This time they looked at disease activation rates of latent TB cases who were known to be in close contact with ‘smear-positive’ infectious pulmonary TB cases, and they have since then shared their results with us.

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They studied a total of 294 close contacts of infectious cases, 152 of whom used a daily prophylactic dose of small cone moxa at St36 for a 3 month period, the other 142 using the standard WHO-approved isoniazid  (INH) medication (10㎎/㎏ per day) for a period of 6 months.

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The results in terms of incidence of TB disease were compared in each case studied at the end of a 12 month period.

 

(Why did they only use a 3 month treatment regimen for the moxa patients, compared with a 6 month one for the INH group? Unfortunately, we don’t know because we weren’t party to the final study design, but we believe that it may have been down to a misunderstanding because we’re sure it should have been for at least 6 months, and wonder whether the results in the moxa group might have been better had this been the case).

 

The results revealed no difference in numbers of new disease between the two groups (with 2 new active cases emerging in each group making for a 1.31% and 1.41% incidence rate in each group respectively). In other words, moxa appeared to be neither worse nor better in preventing activation of disease from latency than isoniazid – and isoniazid is the current approved treatment for latent infectious TB.

 

This may not seem of any significance, but it is actually a very significant finding indeed for reasons we will explain further below.

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But before doing so, it is noteworthy that they also found a 'trend' of raised WBC and lymphocyte count in the moxa group. This suggests (yet again) that moxa provokes a host immune response that is beneficial in TB infection – but we now have evidence that it may do so at an earlier sub-clinical stage of the disease as well as after reactivation.

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