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WHO World Health Organization |
A special WHO initiative in Orel Oblast is tackling some of the underlying social economic issues among tuberculosis patients that are contributing to the region’s increases in the disease and making effective treatment difficult.
Tuberculosis is an increasing problem in many Eastern Europe and NIS countries of the WHO European region. Fuelled by the increase in HIV/AIDS and the emergence of drug-resistant strains, tuberculosis is especially prevalent in the poorer parts of society where the highest rates of infection are found. In Orel the incidence of tuberculosis has increased from 41.4 per 100 thousand population in 1990, to 77.1 per 100 thousand in 2001. In tackling this challenge, the local authorities in Orel have implemented a partnership programme with the World Health Organisation, applying the WHO recommended TB control strategy, “Directly Observed Treatment, Short-course – DOTS”.
A major problem in treating tuberculosis is the failure to complete the drug course. If the drug therapy is not maintained until the treatment is complete a resistance to future drug therapy can develop, making recurrences harder to treat. To combat this, part of the DOTS strategy is for health workers to “directly observe” the patient taking the medication, ensuring that it is taken regularly and to the completion of the course.
In Orel the DOTS strategy has been strengthened by a special support programme, carried out in partnership with the local Red Cross and Red Crescent Society, the Russian Government and funding from USAID. The programme integrates a food distribution programme with the tuberculosis treatment. Many of the patients are unable to sustain a healthy diet, which itself could have been a contributing factor in the original infection. The scheme addresses the problem by delivering much needed food and dietary supplements at the point of the drug therapy for tuberculosis, encouraging the patients to fulfil their DOTS programme and helping their recovery by addressing one of their basic needs of good nutrition.
Dr Wieslaw Jakubowiak, WHO TB Programme Coordinator in Russia, says this experiment was created as a way to deal with a high default rate. “In some of the oblasts, the default rate was above thirty percent. This is quite high. So together with our donor, USAID, we tried to find a way to deal with the difficult group of people who abandon treatment before it is completed.”
It is necessary to stress the fact that nurses of Red Cross and Red Crescent visiting nurses services are working in close collaboration with doctors of Orel oblast TB services, who often spent a lot of their private time and efforts to deal with most difficult cases of non-compliance among the patients. Additionally, the immediate plans of expanding joint WHO/Red Cross programme include establishing counseling for to-be-released prisoners. There are two part-time positions being established for the psychologist and legal specialist to work with inmates, who are ill with TB. The work is expected to begin one month before the parole of such a prisoner. The aim of this work is to prepare the inmates for the civilian life and try to commit them for the continuation of treatment.
The more effective intervention, the greater contribution it makes to the health of the community and the local economy; shorter treatment is less expensive, less of a drain on resources and returns the patient sooner to productive life.In this programme the daily and weekly food parcels are distributed to the patients either at the clinics or during home visits.
This initiative has been chosen as one of the subjects of a special publication on Poverty & Health, being compiled by the WHO European Office for Investment for Health and Development. Based in Venice, the newly established office has engaged a team of professional writers to report on a selection of initiatives that demonstrate the direct link between poverty and health. “What we are looking for in these studies”, reports Dr Erio Ziglio, head of the new office, “is real action that is taking place now, that shows good and effective practice - where good health is good economics. Tuberculosis is a particular problem, where the highest infection rates are among the poorest parts of the region and initiatives such as the one in Orel provide us with a model of positive action.”
The publication of these case studies will be part of the presentation of the Office for Investment for Health and Development to the WHO European Regional Committee.
Dr Mikko Vienonen
Tel. +7(095) 7872166
E-mail: m.vienonen@who.org.ru
Dr Wieslaw Jakubowiak
Tel. +7 (095) 787 2118
E-mail: w.jakubowiak@who.org.ru
Dr Erio Ziglio
Tel. +39 0412 791366
E-mail: ezo@who.dk
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UNA - Russia |
In September of this year, the United Nations will hold in Johannesburg the World Summit on Sustainable Development. This meeting will be a wonderful opportunity for all nations to overcome their disagreements and work together to develop an operational plan aimed at maintaining a balance between nature, economics, and human needs. One of the most important items on the summit’s agenda will be ways of solving global ecological problems, and the problem of global warming in particular. In recognizing the importance and timeliness of this issue, the UN Association of Russia ( UNA-Russia), and the UN Association of the United States (among american youth) held a young people’s competition to write reports on the topic “How might nations work on a multi-lateral basis to solve the problem of global warming?”.
Taking part in the competition were hundreds of schoolchildren from different regions and cities in Russia: Moscow, St. Petersburg; the Udmurt, Tatarstan, Buryat, Adygei, and Komi republics, the Altai and Kraynoyarsk territories; Arkhangel Region; Irkutsk, Ekaterinburg, and others. While preparing their work, the youngsters demonstrated a fresh understanding of the problem, as well as unusual ways of approaching it. They also made some very interesting recommendations for resolving the issue.
Out of the enormous number of reports, the organizers chose
the best fifteen; these then went on to the second round
of the competition, which took place at the Moscow State Institute of International
Relations (MGIMO) on May 27. As Jury Chairman, Anatoly Torkunov, the Chairman
of UNA-Russia and Rector of MGIMO, gave a brief speech to welcome the participants.
Other members of the jury were Gennady Golubev, Chairman of the UNA-Russia Commission
on Ecology and Sustainable Development, and Head of the Department of Physical
Geography and Geoecology at Moscow State University; UNA-Russia Deputy Chairmen
Yury Reshetov, Alexei Borisov, and Grigory Kovrizhenko (who is also Chairman
of the UNA-Russia Youth Commission); and Boris Kochurov, a UNA-Russia member
and a senior academic staffer at the Russian Academy of Sciences’ Institute
of Geography.
The third round of the competition took place the same day. There were three winners: Aleksandr Martynov (St. Petersburg), Ekaterina Gelman (Moscow), and Margarita Lavrukovich (Izhevsk). In July of this year, at the invitation of the UN Association of the USA, they will travel to the United States, where the awards ceremony for the American winners, and a meeting with the directors of UN Headquarters, will take place in New York. The other contestants received competition laureate diplomas and memorial prizes. The best works of the competition’s participants were sent to the appropriate officials for their review at the World Summit in Johannesburg.
The holding of the competition, and the fact that schoolchildren from all over Russia took part in it, shows the interest of our young people, not just from Moscow and St. Petersburg but from the regions as well, in global problems.
The UN Association of Russia invites young men and women in advance to take part in its annual youth competitions.
