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, Russia, where PIH/Russia has operated a successful MDR-TB program since the late 1990s. 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, which has now completed its operations, was PIH/Russia’s first formal international partnership that included more than basic technical assistance and training. For nearly four years, PIH/Kazakhstan (PIH/KZ) provided technical assistance on scaling up access to effective treatment for patients suffering from MDR-TB and XDR-TB, trained TB doctors and nurses, and introduced program elements of a patient-centered approach in two pilot regions of Kazakhstan, which were further institutionalized by the National Tuberculosis Program (NTP) for practice.
In close partnership with the NTP, PIH/KZ contributed to the development of a new national policy to improve treatment of MDR-TB. PIH/KZ staff worked with the NTP to improve clinical management and diagnosis; promote adherence among patients through increasing socio-psychological support and introducing alternative models of TB care provision in the ambulatory sector; 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. By 2013, more than 400 patients in the prisons of Karaganda and Pavlodar regions living with MDR-TB received support from PIH/KZ. From training prison personnel in better treatment techniques to advocating for changes in national approaches to managing MDR-TB, PIH’s project aimed to prevent transmission of infection and deaths from MDR-TB in the prison sector of Kazakhstan.
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%