Russia has long struggled with some of the highest burdens in the world for tuberculosis (TB) and its more severe, drug-resistant variants.
Following the dissolution of the Soviet Union in 1991 and the termination of many Soviet-era social services, there was a dramatic increase in TB rates across the newly established Russian Federation. As the new millennium approached, rates of both TB and the more severe multidrug-resistant TB (MDR-TB) had doubled compared to rates at the end of Soviet governance. Rates in Tomsk Oblast, within the vast region of Siberia, were even higher than the average across the rest of the Russian Federation.
In 1998, Partners In Health began working in Tomsk and established a long-term program to decrease incidence and mortality rates for MDR-TB. PIH’s services eventually expanded to five additional Russian regions. The main focus was to address the structural and social challenges associated with TB and bring treatment and access to health services for people suffering from TB and its drug-resistant forms.
After a transitional period of several years, PIH has revived its work in Russia through participation in the Zero TB Initiative, a global effort to eliminate TB in key regions as part of the World Health Organization’s goals to drastically reduce TB incidence and mortality worldwide by 2035. PIH’s participation in Russia now is centered in the city and oblast of Vladimir, east of Moscow.
71% treatment success rate for patients with drug-susceptible TB
267 at-risk people showed no signs of TB after preventive therapy.
TB Detection and Treatment
PIH’s work with the Zero TB Initiative aims to rapidly reduce TB incidence and mortality in Vladimir by preventing the development of active disease in people with latent infection, early detection and effective treatment, and patient-centered approaches to TB care. Partners In Healthcare, as PIH is known in Russia, uses video-observed treatment and mobile health care teams to reach patients in their homes and communities.
PIH and its partners have been making great strides in the region in addressing MDR-TB and its more severe variant, extensively drug-resistant TB (XDR-TB). PIH supports training for specialists and access to preventative therapy, using WHO-recommended treatment regimens.
PIH-supported teams provide preventive therapy for people who are at risk for MDR and XDR-TBat TB clinics, care with mobile teams who visit patients and communities, and direct observation of patient therapy by health care workers via video support.
PIH’s work in Vladimir focuses on population groups who are the most vulnerable to TB: people exposed to others with active TB; people living with HIV or suffering from other immunity disorders; people who are homeless; and people with high occupational risk of tuberculosis, such as health care and prison workers.
A Lasting Model
Throughout the years, PIH’s work to provide and support TB care in some of the most remote and destitute regions of Russia has proven to be a model for what is achievable when patients are adequately supported on their journey to healthy lives.
Delegations from almost all former Soviet Union countries have visited Tomsk to learn best practices and exchange information. Tomsk has become the training site for many TB practitioners through numerous partnerships, including with the World Health Organization Regional Office for Europe. PIH projects in Russia have been referenced in numerous WHO publications. Based on the successful experience of the Tomsk program, PIH continues to build partnerships with local governments, influence policy, train medical professionals, and provide our patients with the best patient-centered care possible in Russia.