A Sputnik nurse on her way to visit an MDR-TB patient.


Partners In Health (PIH), through its Representative Office in Russia (PIH-R), is expanding services to five new regions in Russia. The expansion is funded by a new $1.5 million USAID grant and will allow the organization to deliver care to a greater number of people living with tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB).

The expansion will target people who have difficulty adhering to the intensive treatment regimen needed to cure the disease, and patients who are at high-risk of defaulting treatment, including those affected by homelessness, poverty, alcohol and substance abuse, HIV, and previous incarceration. Beginning September 30, 2010, this five-year grant will enroll approximately 700 high-risk patients and will screen up to 10,500 of their contacts for the disease (people who may have been exposed to TB or MDR-TB).

One new initiative, the Patient Centered Accompaniment project (PCA), expands on the successes of Sputnik, a program that has grown out of PIH-R’s decade of work in the Tomsk, Siberia. Sputnik focuses on home-based care for MDR-TB patients who would otherwise slip through the cracks. It is a unique and effective service that differs from the health care models traditionally found in Russia. PIH-R hires and specially trains nurses who regularly visit patients in their homes to deliver the TB and MDR-TB drug regimes—which can take up to two years to complete. Beyond medicine, these nurses also offer various forms of social support, ranging from bringing patients meals to providing emotional support. This innovative model of care gives patients the individual attention they need to get better.

With over 90 percent of these hard to reach patients adhering to the program for the entirety of their treatment, the Sputnik model of care has been incredibly successful.

The PCA brings a similar intensive patient accompaniment approach to five new Russian oblasts (regions equivalent to states): Novosibirsk, Altai Krai, Saratov, the Republic of Marii-El, and Voronezh.

“With high levels of hospitalization of TB patients, Russia’s TB program faces a major challenge of delivering treatment in the ambulatory sector,” said PIH-R Medical Director Alex Golubkov. “The PCA project will show that difficult-to-reach TB patients can be successfully managed in outpatient settings and the lessons learned can be applied to all Russia territories,” he added

The new USAID grant allows PIH-R to continue its collaboration with local Russian medical institutions, working together to both locate people suffering the effects of TB and to administer appropriate care. While PIH will organize the new TB projects in each of these five oblasts and coordinate models of care and treatment, each oblast’s TB dispensaries—government run regional medical facilities that focus on TB care—will fund laboratory services, physician follow-up care, and employ TB dispensary support staff.

“PIH is grateful that USAID supports patient-centered approach in TB control and that such program would be expanded into 5 new regions of Russia,” said Dr. Golubkov.

This article is made possible by the generous support of the American people through the United States Agency for International Development (USAID) and Partners In Health. The contents of this article are the responsibility of Partners In Health and do not necessarily reflect the views of USAID or the United States Government.