Russia suffers from one of the world’s worst epidemics of multidrug-resistant tuberculosis, a more virulent form of tuberculosis that is resistant to the two most powerful first-line anti-tuberculosis drugs.
Partners In Health in Russia, known locally as Партнеры во имя здоровья, has worked closely with the Russia’s Ministry of Health and the Division of Global Health Equity at Brigham and Women’s Hospital in Boston since 1998 to combat this problem in Tomsk Oblast, a state in Siberia that is about the size of Poland.
We’ve improved diagnostics to detect cases earlier, strengthened infection control procedures in hospitals and clinics, and decreased transmission of tuberculosis to HIV-positive patients.
Our approach also includes a key social component. Patients must sometimes remain on treatment for years—a grueling time for them as the medication causes toxic side effects. In the mid-1990s, less than 40 percent of multidrug-resistant patients in Siberia completed treatment. To help patients remain on a long and difficult treatment regimen, we introduced a program called “Sputnik” in 2006. We hire and train nurses to deliver medication and food to patients at home, every day, for the two years of treatment. Between December 2006 and December 2012, 70.5 percent of patients were successfully treated—a major accomplishment for patients who otherwise would likely not have finished treatment.
In addition to Tomsk, PIH operates in two other oblasts, Voronezh and Karelia, where we provide technical assistance to regional tuberculosis services. We advise them on preventing the transmission of tuberculosis within hospitals by rapidly diagnosing tuberculosis and drug-resistant tuberculosis. We also replicated Sputnik for patients living in these areas who are at risk of defaulting from treatment.
Our approach has catalyzed change in the treatment of multidrug-resistant across the entire Russian Federation. Our work has influenced national policy, which now places greater emphasis on quick diagnostics. PIH has also led trainings on the medical management of multidrug-resistant tuberculosis for hundreds of clinicians, nurses, and research staff. This way, we continue to spread our research and the lessons we learn to health authorities throughout Russia and neighboring countries.