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About Program
The re-emergence of the TB epidemic in Russia began in the early 1990’s. By 2002, the number of new TB cases nearly tripled, compared with 1991, reaching an incidence rate of 86.1 per 100,000 population. The TB notification rate in children has steadily increased since 1989 and by 2002 it has doubled to 15.9 per 100,000 population. In the same period, the TB mortality rate increased more than 2.5 times, reaching 21.8 per 100,000 population in 2002. This is among the highest mortality rates of the European region countries (source: Ministry of Health, RF). High TB mortality is associated with late detection and delayed appearance of the patient in a medical facility, resulting in advanced forms of disease prior to diagnosis. Average multi-drug resistance rates are estimated at 10% among new cases and ad 40% among previously treated cases in the Russian Federation.
TB notification rate in the RF, 2002 (per 100 000 population)
The TB epidemic in Russia is linked to key factors: poverty and prisons. The economic crisis of the 1990’s led to a dramatic decline in living standards and healthcare service. Overall decrease of health budget drastically affected national TB control services. Currently more than 50% of new TB cases belong to socially vulnerable groups, including unemployed, retired, disabled, homeless people and alcoholics. Adherence to 6 month daily treatment is problematic for many of these patients because of socioeconomic problems and access to health care.
The spread of HIV infection poses a serious threat to the overall epidemiology of TB. Initially, from 1987 to 1996, Russia had few new HIV cases (100-150 cases per year). However, since 1996, there has been a rapid increase in the number of newly HIV positive cases. 229,049 persons with HIV infection were registered in the country by the end of 2002 and 6,967 of them suffered from active TB, compared to 515 in 1999.
Financial resources of the Program “Promoting a Strategic Response to TB Treatment and Care for Vulnerable Populations in the Russian Federation” are directed to make good the critical deficiency of financing TB activities in the Russian Federation. 5-years’ strategic plan “Provision of guarantee diagnostic and treating measures and development of TB care system for population of the RF (2003-2007)” serves the base for this Program.
“Promoting a Strategic Response to TB Treatment and Care for Vulnerable Populations in the Russian Federation” Program target is reduction of TB mobility and mortality, decrease national TB disease burden in the Russian Federation be means of up-grading level and medical treatment quality for population, accenting at marginalized and social-vulnerable groups. Program is an addition to those activities, being realized within the frameworks of the World Bank loan, and aimed at consolidation of all recourses for implementation of the National strategic 5-years plan to combat TB in the Russian Federation.
Program realization envisages consolidation and development of TB services, advancement of up-to-date approaches in the practice of Russian health care, and also is focused on fulfillment of 5 main targets:
1.Enhancement of efficiency of TB early detection and treatment in civilian sector;
2.Enhancement of efficiency of detection, diagnosis quality and treatment of MDR-TB patients;
3.Enhancement of efficiency of TB early detection and treatment in Penitentiary Sector;
4.Increase potential and partnership development to fight TB;
5. Development of TB prophylaxis system and rendering assistance to PLWHA at the federal and regional levels.
Program activity supposes:
- education of specialists at federal and regional levels of different administrations under the questions of organizing, logistics, detection, treatment, monitoring of TB with HIV co-infection, providing drugs’ procurement and social support;
- Development of infrastructure in health settings of civilian and penitentiary sectors at federal and regional levels, active in TB detection, treatment, diagnostic and monitoring;
- Improvement of drugs procurement, purchase/procure system strengthening, quality control system improvement for TB drugs;
- Realization of social support to TB patients under treatment, and particularly to poor and marginalized population groups;
- Setting up excellence centers on DR-TB treatment in civilian and penitentiary sectors;
- Provision of infectious control measures when diagnosis and treatment of DR-TB at federal and regional levels;
- Drugs procurement for treatment of MDR-TB patients;
- Development and improvement of different department integration, involved into the process of HIV/AIDS testing, prevention, treatment, care and support, HIV testing and consulting of TB patients;
- elaboration, publishing and distribution of methodic literature and instructions;
- Development and strengthening of cooperation between State and NG Organizations involved to combat TB;
- Development and strengthening of information/education and outreach activity on TB and HIV/AIDS prevention;
- Holding regular scientific workshops, conferences and break-out sessions.
Program supposes close cooperation between federal research institutes and regional health settings of TB profile and Health Ministries, Ministries of Justice, Home Ministries and NGOs.
PRESENTATIONS
[The Global Fund. What is it?]
Doctor Urban Weber
[Project International Value and International Organizations’ Role]
W.Jakubowiak
[Program “Promoting a Strategic Response TB Treatment and Care for Vulnerable Population in the Russian Federation”.Targets.Goals.Structure. Activities arrangement]
D.Goliaev
[Social Support Program for TB patients’ under Global Fund Grant]
E.Bogorodskaya – Candidate of Medical Science; I.Danilova - Candidate of Medical Science
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