Green Light Committee has approved the expansion of cohort of MDR TB patients treated in Vladimir region up to 350.

Экспертным советом от 12 августа 2009 г. были отобраны следующие шесть противотуберкулезных учреждений, участников проекта "Совершенствование организации раннего выявления и контролируемого лечения больных туберкулезом", получателей гранта в виде одного автомобиля УАЗ-220694-310-04 в 2009 году:

1. Государственное учреждение здравоохранения "Забайкальский краевой противотуберкулезный диспансер №2",
2. ГУЗ "Приморская детская краевая клиническая туберкулезная больница",
3. ГУЗ "Великолукский противотуберкулезный диспансер",
4. ГУЗ "Областной противотуберкулезный диспансер им. М.Б.Стоюнина",
5. ГУЗ «Республиканский противотуберкулезный диспансер», Республика Северная Осетия-Алания,
6. ГУЗ "Противотуберкулезный диспансер" министерства здравоохранения Хабаровского края (ГУЗ ПТД).

20.07.09
On July 21-27, 2009, a tender will be held to award a grant in the form of an UAZ-220694-310-04 vehicle in 2009.

To implement the improved early TB detection and observed treatment project, the Russian Health Care Foundation will held a tender to select a Russian TB care facility to award a grant in the form of an UAZ-220694-310-04 vehicle in 2009.

Applications are to be submitted to D.A. Goliaev, GF Project Director and should contain the following information:
- Detailed justification of the need in such a vehicle for the health facility,
- Capacity of the health facility to maintain and operate it in a proper manner,
- Ability of the health facility to pay for its insurance and fuels and lubricants on its own.

The deadline for application submission is July 28, 2009; applications are to be e-mailed to:
eliseenkova@rhcf.ru or sent by fax: (495)258-38-84 att: E.A. Liseenkova, Chief Specialist/Coordinator.

Original copies of applications are to be sent via courier or mailed to the following address:
Program: Strategic Response to TB -- Treatment and Care for Vulnerable Populations in the Russian Federation, Russian Health Care Foundation, 4th Syromyatnichesky Pereulok, 3/5-5, 105120, Moscow.

11.06.09 On June 10, 2009, the Meditsinskaya Gazeta (a newspaper for medical professionals) published an article about the 3rd Russian National Conference on Drug Resistant TB in HIV Patients. The Conference took place in the Moscow Oblast on May 12-13, 2009. International resource persons also made their inputs in the discussion of scientific and clinical aspects of the disease.
On June 10, 2009, the Meditsinskaya Gazeta published an article under the heading How to overcome the awesome mix? The article tells readers about the Conference referred to above.

It may be downloaded from the attachment (see below).

On May 28, 2009, Nikolay Yurgel, Chief of Roszdravnadzor, had a meeting with representatives from the WHO and the Global Fund to Fight AIDS, TB and Malaria to discuss the progress of the Program: Strategic Response to TB -- Treatment and Care for Vulnerable Populations in the Russian Federation.

The meeting was attended by D. Pashkevich, Coordinator, WHO TB Control Program in Russia, N. Sautenkova, Team Leader, Pharmaceutical Program for the CIS, European Bureau, WHO, E. de Wood, Executive Director, International Pharmaceutical Supply Association, J. Loeber, Manager, Global Drug Facility (GDF), Paloma Marroquin Legra, GDF, Nicolas Canto, Portfolio Manager, Eastern Europe and Central Asia, Global Fund to Fight AIDS, TB and Malaria, Vicente Segovia, Sale Manager, IDA Foundation, A. Polishchuk, Specialist, Pharmaceutical Program for the CIS, European Bureau, WHO, A. Disu, Medical Specialist, WHO TB Control Program in Russia, and M. Bionyshev, Deputy Project Director, Strategic Response to TB -- Treatment and Care for Vulnerable Populations in the Russian Federation RHCF.

The Russian Federation is an active participant of international programs aimed at providing access to high-quality health care. There are 28 on-going projects, which include components to improve TB drug supply in Russia.

Under the Program: Strategic Response to TB -- Treatment and Care for Vulnerable Populations in the Russian Federation, Roszdravnadzor contributes to improving the system of health care provision to patients with socially significant diseases. There are projects to provide social support and rehabilitation care, psychological and awareness services for patients, and to promote volunteer movement. Civil society organisations are actively involved in addressing problems of patients with socially significant diseases. The structure of health facilities is improved, particularly, to deliver better care to patients with co-infections; the skills of medical personnel are upgraded; best practice manuals and guidelines are developed.

A major objective of the Program is to supply high-quality, effective and safe pharmaceuticals. Participants of the meeting evaluated the mid-term progress of the Program and discussed existing problems. They also dwelled on such issues as registration of needed TB drugs in the Russian Federation. An emphasis was made on expanding the entry of pharmaceuticals manufactured in Russian into international pharmaceutical markets. In the nearest future, it is expected to assess the feasibility of such a project. The Chief of Roszdravnadzor expressed readiness to cooperate with other stakeholders to address all issues both at the federal and regional level.

Participants also discussed international cooperation to develop the system of drug supply and quality management. Pr. Yurgel presented the concept of drug quality assurance which is under implementation in Russia. The concept includes the establishment of a network of multi-functional laboratory facilities integrated into the European laboratory network. He informed the audience about active cooperation between Roszdravnadzor and European countries, USA, and countries of South East Asia in the area of drug quality control. With a view to developing fruitful cooperation, the meeting discussed a possibility to sign an agreement between Roszdravnadzor and the Global Fund.

The Conference brought together over 180 specialists from all over the world, TB doctors from TB facilities, infectionists from the Federal and Regional AIDS Centres, specialists from the prison service and lead TB and HIV research institutes. International organisations (WHO, CDC, GBC) and mass media (the Meditsinskaya Gazeta) also showed great interest to the problem.
The agenda and some of the presentations may be found in this site (through the Library Section: Conferences).

Information about the Conference was published in websites of various international organisations.

Detailed information about the Conference is available from the following website: http://www.tbpolicy.ru/news/?id=227

Participants of the meeting agreed that today, the coverage of migrants with prevention and treatment programs leaves much to be desired and should be necessarily improved. Lack of reliable data on the actual number of labour migrants in Moscow makes it difficult to assess the needs in prevention programs. Potential sources of such information are the Federal and Moscow City Migration Services, the Ministry of Interior of the Russian Federation and research institutions.

The Aga Khan Foundation presented a draft questionnaire for non-commercial organisations helping migrants from Central Asia in Russia.

Data to be obtained will be used (i) to prepare a handbook for migrants, containing information about available health, education and legal services; and (ii) to develop a database of non-commercial organisations to be used by other non-commercial organisations working with migrants to learn about their activities and establish cooperation with them.

Participants expressed their concern about the intention of the Aga Khan Foundation to build up capacity of informal groups in the community of labour migrants because unless objectives of such capacity building is clearly defined, migrants will become even more isolated which would, in its turn, hinder their adaptation in Russian society and provoke social conflicts.

As regards efforts to reach the labour migrant community, the meeting concluded that labour migrants can be reached not only through internal relations of their organisations, but also through developing new approaches in the course of work. Lessons learnt by the Ash Project (HIV prevention among migrants) show that a client-centred approach and support from respected leaders of their communities can help secure confidence of the target group to services of non-commercial organisations.

According to a representative from the Alfa Insurance Company, both migrants and their employers remain reluctant to participate in commercially-based voluntary health insurance programs. Employers do not want to pay for private insurance policies for their employees who are not citizens of Russia. Discussing this issue, participants came to the conclusion that the most reasonable way to address it would be to implement microfinance programs, support civil society initiatives related to so called mutual-aid cash desks, broaden the scope of health services provided free of charge, and raise awareness of available legally provided health care for legally employed migrants.

The Open Health Institute made a presentation to inform about lessons learnt by the OHI in HIV control among labour migrants in Russia. The presentation identified factors of migrants’ vulnerability to HIV infection. They are potential marginalisation, discrimination, and exploitation during their travel to and stay in other countries; potential lack of access to information and health care (due to administrative, cultural, linguistic, and legal constraints to the entrance and stay in Russia for people with HIV); provocation of more risky behaviour and susceptibility to impact of surrounding peers.

The OHI implements HIV prevention projects targeting migrants which include: (i) development and dissemination of HIV prevention information products in Russian and native tongues of migrants; (ii) provision of condoms; (iii) HIV testing; (iv) consultations from health and social workers and lawyers; (v) referrals to health facilities; (vi) outreach activities; (vii); individual counselling; (viii) group education. Key project activities take place in areas of increased concentration of migrants (AIDS Centres, market places, dormitories).

M. Bionyshev from the Russian Health Care Foundation made a presentation called TB in communities of labour migrants and difficulties with providing health care to them. The presentation identified goals of the national program related to labour migrants which are to identify TB patients at entry; identify employed TB patients (90% of them have an illegal status); treat them in Russia (sources of pharmaceuticals and payers are not as yet determined) or to send them back home (payers and appropriateness are to be determined). The speaker also listed such barriers to addressing these issues as quality and management of TB detection at entry; poor access to ‘closed’ communities for health workers; administrative hurdles to care provision to illegal patients; social and psychological problems arising from stay in health facilities (conflicts with “entitles” patients).

M. Bionyshev also pointed to lack of reliable data on TB incidence among migrants. In spite of the obvious need in such information and feasibility of its collection, there are certain ethical factors preventing from undertaking a study to do it.

It was decided to set up a working group which would organise and conduct such a study, consisting of representatives from the Russian Health Care Foundation, the Medecins du Monde (MDM) Association, the Aga Khan Foundation, the Russian Red Cross, ALA-TOO, the Tajikistan Regional Civil Society Foundation, and the Global Business Coalition on HIV/AIDS, TB and Malaria. The first step of the working group would be to discuss potential ways to provide TB treatment to migrants.

During the discussion, representatives from the Tajikistan Foundation put forward their proposal to prepare a list of potential stakeholder donors to support migrant programs and develop a joint program targeting migrants.

It was agreed to hold the next meeting of the roundtable in June or July 2009.

http://www.radiorus.ru/audio.html?id=802060&doc_type=tvp&doc_id=211646

The Country Coordinating Mechanism to Fight HIV/AIDS and TB in the Russian Federation (CCM) invites individuals and legal entities to take part in preparing a consolidated proposal for the 9th Round (TB) of distribution of grant proceeds from the Global Fund to Fight AIDS, TB and Malaria (GF).
Descriptions of proposed projects are to be submitted to the Working Group for R9 proposal preparation:
via e-mail: hivrussia@mail.ru;
or fax: (495) 365-46-80 (att: Ludmila Korshunova, CCM Secretary).
The deadline for submission of proposals is by April 15, 2009.
Information about proposal preparation is available from Ludmila Korshunova, CCM Secretary:
via e-mail: hivrussia@mail.ru;
or fax: (495) 689-59-62, (909) 972-20-79.

Olga Borzova, Chairperson of the Health Care Committee, informs that it is planned to spend RUR 4 billion on additional health checks of 3.8 million working people aged from 35 to 55, in 2009.

In addition, RUR 2 million will be allocated for in-depth health checks of 3 million people working in harmful and hazardous conditions.

According to Olga Borzova, results of health checks will be used to issue a Health Passport for each citizen to describe his/her current health status based on key indicators. It will also contain an algorithm of diagnostic services, data on vaccination and allergy. At the same time, the passports will be given to the patients rather than left in health facilities.

Olga Borzova also informed that in view of the crisis, it had been decided to start to screen population for TB since 2009 instead of 2010 as initially planned; and that almost RUR 3.4 billion will be allocated for these purposes.