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Russia's epidemic of multi-drug resistant tuberculosis (MDR-TB) is one of the worst in the world. The challenge to physicians is daunting, as patients suffer from poor nutrition, high rates of alcoholism and inadequate housing and transportation-all of which undermine treatment of this deadly disease.
In November 2004, BWH physicians joined a Partners In Health effort to save lives and cure TB worldwide, with a special relief effort in Russia, where 11.2 percent of new TB infections each year are unresponsive to treatment.
The BWH Division of Social Medicine and Health Inequalities' Michael Rich, MD, MPH, Jennifer Furin, MD, PhD, Sonya Shin, MD, MPH, Edward Nardell, MD, Salmaan Keshavjee, MD, PhD, and Joia Mukherjee, MD, MPH, traveled to Russia to initiate an extensive training program for educating Russian doctors and nurses on treating MDR-TB. During the first two-week seminar, 20 Russian physicians, PIH and BWH faculty, and an interpreter gathered in Tomsk, Siberia-a region suffering from a severe problem with MDR-TB.
"The trainees at this initial session were intensely interested and thirsty for knowledge," Shin said. "One of the most important messages we imparted was that excellent care could be provided."
This seminar launched the Advanced Tuberculosis Care in Russia program, a project funded by the Eli Lilly Foundation to help Russian doctors manage MDR-TB incidence and fatalities. Several months after the seminar, PIH and BWH faculty and local Tomsk physicians evaluated local hospitals, ambulatory facilities and research labs to train doctors to treat patients. PIH and BWH doctors are presently in Novosibirsk, Siberia, for the fifth training on MDR-TB management.
Moving forward, PIH and BWH are working on an extensive training model based at Russia's top five TB research institutes, which would feasibly train an additional 250-300 Russian physicians to perform TB care with the latest available medical technologies by mid-2007.
"Our goals are to teach Russian TB doctors how to properly treat MDR-TB, which was not even treated eight years ago when PIH began its work in Russia," Nardell said. "Not only do we hope to influence major public health policy in Russia, but we must help implement those changes." Worldwide, TB kills 2 million people a year. For more information on TB, visit www.stoptb.org For information on PIH efforts, visit www.pih.org