In 2010, Partners In Health launched a new partnership to combat multidrug-resistant tuberculosis (MDR-TB) in Kazakhstan, a central Asian country that borders regions in Siberia where PIH/Russia has operated a successful MDR-TB program since 1998. Because of PIH’s track record of curing MDR-TB and curbing its spread in the Russian Federation, the Kazakhstani Ministry of Health invited PIH to help fight one of the highest rates of MDR-TB in the world.

The program in Kazakhstan is PIH/Russia’s first formal international partnership that includes more than basic technical assistance and training. The initiative is largely funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria. PIH/Kazakhstan (PIH/KZ) trains and assists state-hired nurses to visit and accompany patients throughout the difficult two-year drug regimen, providing access to comprehensive health and psychosocial services.

In close partnership with the National Tuberculosis Program, PIH/KZ has contributed to the development of a new national policy to improve treatment of MDR-TB. PIH/KZ staff work with the national government to improve clinical management and diagnosis, promote adherence among patients, improve infection control, and decrease transmission of tuberculosis to HIV-positive patients. In addition, staff developed a new reporting and evaluation tool to better track adherence to treatment, improve drug management, and take action on gaps in care.

Providing care throughout Kazakhstan's prison system

Before 2010, Kazakhstan’s Soviet-era prison system was unequipped to meet the needs of patients suffering from MDR-TB, with almost no one receiving appropriate treatment due to the lack of medicines and expertise. Today, 350 prisoners in the Karaganda and Pavlodar regions living with MDR-TB receive support from PIH/KZ. From training prison personnel in better treatment techniques to advocating for changes in outdated laws, PIH’s project aims to prevent infection and death in the six regions with prisons housing TB patients.

By the numbers:

Total population: 16,675,000
Life expectancy at birth: 67.87 years
Infant mortality: 18.4 per 1,000 live births
Adult prevalence of HIV: 0.1%
Prevalence of TB: 86.6 per 100,000
Population living below national poverty line: 8.2%