High Hopes in Russia with New Global TB Strategy

Mikhail-Volik1A version of this post previously appeared on LillyPad.

Today’s guest blog comes from Mikhail Volik, a physician and program officer for the Lilly MDR-TB Partnership in Russia.

In mid-May, historic medical news spread around the world: the World Health Assembly passed a resolution approving the new post-2015 Global Strategy for TB Prevention, Care and Control with ambitious targets and a vision of ending the TB epidemic by 2035. This strategic plan contains unprecedented goals such as decreasing TB mortality by 95 percent from current levels. If the goals are achieved, it would truly be a major breakthrough – something that was unimaginable just 20 years ago, when we thought curing multidrug-resistant TB (MDR-TB) wasn’t possible.

On 28 May, just days after the WHA meeting, the new Global TB Strategy was presented in Moscow by Dr. Ernesto Jaramillo, MDR-TB Team Leader for the World Health Organization's (WHO) Stop TB Department, at the High-Level Working Group of the WHO and the Russian Ministry of Health. This Working Group convenes key stakeholders to discuss hot topics in TB control in the Russian Federation. As Russia was among the first countries to present and commit to the new strategy at a national level, this constitutes a highly important demonstration of Russia’s leadership role in global TB control.

The Ministry of Health and the WHO held the meeting to discuss improving of treatment adherence and patient-centered approaches – both are crucial topics as Russia has one of the world’s highest rates of MDR-TB.  One speaker expressed the problem succinctly by saying, “It is not difficult to start treatment; the key issue is how to complete it successfully.” Together with our partners, the Lilly MDR-TB Partnership addresses this issue by focusing on patients’ needs when designing and piloting our MDR-TB care models, and during this meeting some of our partners, including Partners in Health, the International Federation of Red Cross and Red Crescent Societies, and representatives of the Tomsk and Voronezh regional TB services, presented the results of their projects. 

It was demonstrated that the introduction of a patient-centered approach in Tomsk, along with better infection control and improved MDR-TB treatment, significantly reduced TB morbidity and mortality in the region.  The Lilly MDR-TB Partnership is helping to build and expand this model to other Russian regions, while our partners in the Voronezh region and the Republic of Karelia are demonstrating very strong commitments to improving MDR-TB diagnostics, treatment and care.

Still, there is much more work ahead of us. The world, and Russia in particular, faces rising rates of TB drug resistance, slow development of new treatment regimens, no effective vaccine, and many barriers to TB services for the most vulnerable populations. We must overcome these challenges – and this might only be possible through true cooperation and partnerships. The work of the Working Group makes me believe that it is possible. At a previous meeting in November 2013, we discussed the urgent need for the updated clinical recommendations on MDR-TB treatment. Now they are set, printed and available for all TB professionals around the country. I hope that today’s focus on patient-centered approach will have similar tangible outcomes in the very near future.