The number of registered T. B. patients is some 250,000
Tuberculosis remains a real threat even in the 21st century. One third of the world’s population are exposed to the tuberculosis’ causative agent – Mycobacterium tuberculosis. Not many develop the disease, but each one of those who do infect from 10 to 15 people a year. No one knows the exact number of T. B.- infected people in Russia. However, according to the ‘Moscow news’, even the official statistics could embarrass the official medical establishment: the refusal to accept foreign help with vaccines and claims of ‘total control’ over the spread of the infection doesn’t seem to correspond to the reality. The number of T.B. patients in Russia is much higher than it should have been in a developed country. Nevertheless, phthisiatricians seem to be rather optimistically disposed.
Peter Yablonsky, chief specialist on thoracic surgery and phthisiology at the Health Ministry of Russia, Professor
The past year gives us reasons for optimism!"- is the slogan of the today's press conference and I find it very fitting. First of all, because the country for the first time worked according to the new system of treatment of patients with tuberculosis in the Russian Federation, which was adopted in late 2010. On the other hand, the Association of phthisiologists of Russia has been founded, and this year in October its first congress will be held, where we are going to summarize the results of our first social movement to consolidate all those scientific and practical efforts to combat tuberculosis in the Russian Federation. This year were developed several target research topics, which culminated in the preparation of a new concept (00:55?) ... of diagnosis of tuberculosis in the Russian Federation. A fundamentally different instruction on the treatment of patients with tuberculosis of the Russian Federation has been prepared. Preconditions have been created for the implementation of the concept of medical and social services for patients who cannot be helped at the moment - unfortunately, there are such people - which are designed to fulfill the role of a social insulator in order to stop their contacts with our healthy population and to protect from healthy patients. We are very close to the development of a medico-technical project for the construction of a fundamentally new type of dispensary. All of this, I think, gives grounds for serious optimism not only in drawing conclusions – it allows us to look with optimism to the future. It seems to me that we lack social optimism in order to accomplish these tasks. So I look with hope at today’s audience and I would like to appeal to the article, which will be released today in the "Moscow News," which is called "Closed form of disease." In it one of your colleagues wrote that the chief TB doctors from the Ministry of Health are concealing the data on tuberculosis in the Russian Federation, that this figure is not known to anyone in the country and that today’s phthisiatricians is just a bunch of stupid people who are paid for God knows what.
Today in the Russian Federation there are 240,237 patients registered with active tuberculosis. Last year there were 253,555 people. I would say that publications, which periodically appear in the press, do not bring anything except for social pessimism. And this surprises me, because today we do have a lot of reasons to be optimistic: we are consolidated, the ministry from year to year increases funding for the purchase of drugs, for modernization, for instance, for diagnostic equipment, construction of new clinics, modernization of institutions - we are really in a unique position in the world. When we go to a conference of the International Union Against Tuberculosis and Lung Disease, our delegation is one of the most convincing. On May 2 we are expecting Nils Billo to visit us, the executive director of the International Union Against Tuberculosis, which came up with an initiative to hold the next congress of this esteemed institution in the Russian Federation. Is it not the best proof that today we are really on the right track? It is extremely important to emphasize that we maintain a dialogue with numerous public organizations that help us
in this work. With the representative office of the World Health Organization in St. Petersburg, in my opinion on December 21 we had a very productive meeting in which we compared notes to ensure that we spoke the same language. And I think that this time we also reached certain success.
That is why I hope that there will be only more questions, but please believes us: today we are open to the public and we have every reason to be optimistic.
Luigi Migliorini, specialist, WHO Representative in the Russian Federation
The World Health Organization is working very closely with the member states of the WHO. We have developed an active plan to combat tuberculosis with multidrug resistance in Europe. And your country is also involved in the implementation of this project. Of course, the plan will only remain a plan if it is just written on paper. The biggest challenge that we are facing today is the daily task to begin implementing this plan into practice, so that it starts helping our patients. Of course, this problem in Russia is very important. Russia is a very big country, but I want to say that in recent years many achievements have been reached in the field of TB, and they were discussed by my colleagues and representatives of the Ministry of Health, before I have taken the floor. Of course, despite the size of the country, above all, we pay special attention to special groups of population, particularly the poor, marginalized groups of society and people who are among other things addicted to alcohol. In addition, all these people are facing the non-medical aspects of the disease,
that is why our task is also to improve their socio-economic living conditions.
Indeed we have already done a lot in this direction. Much more is needed to be done. As for the achievements here in Russia, among other one should note the role of donors. First, of course, wherever the WHO is active, each year when we organize special events, we understand that they are possible only because of the support we receive, the support from donors. I would like to thank the government of the United States and the Government of the Russian Federation for them supporting us. Over the past three years, Russia has also become a donor country. And I want to say that Russia's role as a donor country
is becoming more and more important. Russia is allocating large sums of money not only for the fight against TB for international organizations, but also allocates significant resources for the World Health Organization for similar purposes, as well as for our office.
And I want to say that we are able thanks to the fact that Russian Federation has become a donor, to introduce at the same time supra-regional activities, when these funds are used not only in Russia but also in neighboring countries. That is why I associate these concepts – achievements and donation - together. I would also like to say that the WHO is very grateful to the Ministry of Health of the Russian Federation for the support which it provides to us."
Igor Kazanets, head of the medical section of the International Organization for Migration in Russia
Tuberculosis is a real contagious threat. About a third of world population is being infected with the causative agent of tuberculosis, the Koch’s bacillus. The disease does not become active often, but each carrier allegedly infects 10 to 15 people a year. Mankind has come a long way in the fight against tuberculosis and has not slowed down in this direction. Year after year we are observing the emergence of new diagnostic methods, the development of promising directions in the field of treatment and care, the introduction of a number of potent drugs. A lot is being done. We see how much stronger the TB service in the country has become, how the financial base of medical institutions has expanded and how the optimization of production and supply of anti-TB drugs is being solved. However, the path to the total eradication of this disease is still long. We are witnessing adaptation of the causative agent of tuberculosis to changing conditions and drugs that reduce the success of treatment. Tuberculosis in combination with immune deficiency diseases, HIV often leads to death. Tuberculosis is presenting us with new challenges, and we are willing to accept them. In most cases, modern science makes it possible to identify and absolutely cure the disease, which means that TB can be eradicated and that it is up to us, to our generation to
accomplish it. We all know that tuberculosis has social roots. Migrant population, people with unstable status are often more vulnerable to tuberculosis because of their low income and difficult living conditions. The coverage of this group by health education, diagnostic and therapeutic work is sometimes problematic. However, the exclusion of migrants from our field of vision will negatively affect both the health of migrants and of the local population. The International Organization for Migration welcomes the efforts of state institutions, international organizations and NGOs to integrate mobile populations in the planning of TB control, and thanks all those who are not indifferent to the needs of migrants.
Lyudmila Mihaylova, Deputy Director of the Department of Organization of Prevention, Care and Health Development of the Russian Ministry of Public Health
We are currently deploying medical and midwifery facilities. We have deployed additional outpatient clinics, general practitioners' offices. We are doing all of that according to the standards. And they are all defined and given to subjects. When a subject implements its
program, it reports to us exactly on the basis of these institutions. The institutions that I have named, will play the role of an intermediary between the specialized institutions, the so-called dispensaries and the patient, and will supervise the treatment and monitor the intake of drugs by patients. Thus, the patient does not need to go anywhere - he receives his treatment, he receives his prescription. These procedures will be supervised by the primary institution of health care, which is entrusted with these controllable functions, stated in the regulations of the Ministry of Health. As for the interaction with the institutions of the Federal Penitentiary Service (FSIN), here we must have cooperation and to monitor... But we are behind on controlled monitoring. So naturally we are going to meet already next week and develop our position on monitoring these patients. In addition, all patients who are registered at the institutions of the Federal Penitentiary Service are naturally present
in the federal report, which is currently the only reliable source of information. To say that the information is concealed, that we do not know something or do not count properly ... Not at all: we have everything, we have complete information about every patient. Of course, the information is anonymous but nevertheless we are aware of all the patients that are monitored at the FSIN institutions and that are monitored by us, the migrant workers, foreigners and homeless people. We record all the information in special protocols of federal statistical monitoring. It is then analyzed and management decisions are made.
