TUBERCULOSIS: Treating MDRTB in Siberian Prisons

The PHRI/Soros Russian TB Program ... Treating MDRTB in Siberian Prisons
The tuberculosis epidemic in Russia, particularly in the Russian prisons, had reached alarming proportions by the mid 1990s. Virtually every prisoner in Russia was exposed to tuberculosis, many became sick, and many died, and tens of thousands of infected individuals were being released into the general population.
At the initiation of PHRI's Dr. Alexander Goldfarb, who became the Project Director, the Soros Foundation/Open Society Institute provided several grants, ultimately totaling $13 million, for PHRI to develop demonstration tuberculosis control projects which could become a model for replication throughout Russia.
Accomplishing this aim required the establishment of collaborative working relationships with a variety of partners in Russia, building a laboratory infrastructure virtually from scratch, training laboratory and medical personnel, implementation of TB control procedures, provision of appropriate first and second line drugs, advocacy to convince TB and governmental leaders to proceed with the program, and a myriad of additional tasks, all taking place in a highly charged political atmosphere.
Beginning in 1997, PHRI succeeded in establishing effective TB control systems in several Russian regions, in both civilian and prison populations, and successfully managed the treatment of thousands of patients with drug susceptible tuberculosis. In addition, PHRI established, in the oblast of Tomsk in western Siberia, the first, largest, and still (to our knowledge) the only large scale functioning program in Russia to treat multiple drug-resistant tuberculosis (MDRTB) in both prison and civilian settings.
Once the program was implemented, it required an ongoing medical presence, and PHRI invited the Partners-in-Health (PIH) organization, headed by Drs. Paul Farmer and Jim Kim of Harvard, into the project, first as consultants and then to assume medical management of the project. Ultimately, over the course of 2001-2002, PHRI transferred the entire Tomsk program to PIH.
http://www.phri.org/programs/program_russiantb.asp