Rajshahi TB & Leprosy Control Project (RTLCP) is one of the four Damien Foundation projects, implementing the TB & Leprosy Control Program since 1995. The expansion was realized in mid-1998. This project covers the three districts: Rajshahi, Chapai Nawabganj and Naogaon with a population of about 7 million. Currently the project is operating 31 daily combined (TB & Leprosy) clinics in 3 districts. All the clinics are located in the government infrastructures such as: Health & Family Welfare Center, Upazilla Health Complex, District Sadar Hospital, Chest Diseases Clinic and Sub-centers. Different levels of Govt. personnel are closely involved with the project activities. In addition, RTLCP has established a DOTS corner in Rajshahi Medical College Hospital in the year 2002. During 2006 the project has established 75 sputum collection centers in the remotest parts of each upazilla. 75 volunteers are working in those collection centers. Prisons of 3 districts are under coverage of DOTS. Effective community participation is one of the unique features by setting dense networks of about 2000 trained Fixed DOT Provider (FDP), most of them are village doctors and cured TB patients. A “Regional Tuberculosis Reference Laboratory (RTRL)” has been started at Chest Diseases Hospital (CDH) of Rajshahi since May 2008. It plays a significant role in the field of MDR TB in Rajshahi and Rangpur division. Damien Foundation provides technical support to the laboratory and 2nd line drugs for the MDR patients of the entire Rajshahi and Rangpur divisions. Gene-Xpert and Culture & Drug susceptibility Test (DST) for Tuberculosis are done by this laboratory and diagnosed MDR cases using 9 month regimen keeping them admitted in CDH for the intensive phase. This is the first ever initiative of MoH&FW and WHO out of Dhaka. 50 beds out of 150 are allocated for MDR patients in Rajshahi CDH. A total of 99 staffs are engaged in this project.