Russia suffers from an epidemic of multidrug-resistant tuberculosis, a more virulent form of the disease that is resistant to two standard drugs used for treatment. As of 2015, 36,000 Russians had the disease—one of the worst prevalence rates in the world.

Partners In Health in Russia, known locally as Партнеры во имя здоровья, has worked closely since 1998 with Russia’s Ministry of Health and the Division of Global Health Equity at Brigham and Women’s Hospital in Boston. Together we combat multidrug-resistant tuberculosis in Tomsk Oblast, a state in Siberia about the size of Poland.

We’ve improved diagnostic tests to detect cases earlier, strengthened infection control procedures in hospitals and clinics, and decreased transmission of tuberculosis to HIV-positive patients. Our work has influenced national policy, which now places greater emphasis on quick diagnostics.

To help patients complete their treatment regimens—a grueling period of up to two years with medication that causes toxic side effects—we introduced a program called “Sputnik.” We hire and train nurses to deliver medication and food to patients at home, every day. The program was a major accomplishment for PIH and for patients who otherwise would not likely have finished treatment. Between December 2006 and December 2012, 70.5 percent of our patients were successfully treated.

PIH also operates in two other states, Voronezh and Karelia, where we provide technical assistance to regional tuberculosis services. We advise them on rapid diagnosis of tuberculosis and drug-resistant tuberculosis to prevent its transmission within hospitals. We also replicated Sputnik for patients who are at risk of defaulting on treatment.

PIH also leads trainings on the medical management of multidrug-resistant tuberculosis for hundreds of clinicians, nurses, and research staff. This way, we continue to spread our research and the lessons we’ve learned throughout Russia and to neighboring countries.