Donetsk news 21.02.07
 
Ukraine is among the countries-leaders in tuberculosis case detection rate. In addition, more and more often Ukraine sees cases of drug resistant tuberculosis, which cannot be cured using usual methods of treatment. In order to change the situation a pilot project has been launched in the Donetsk Region. The project is fully financed by the SCM Foundation for Development of Ukraine and technically guided by the World Health Organization.
 
«Ukraine is experiencing tuberculosis epidemic. According to the official statistics the epidemic threshold has been significantly exceeded and as of today there are 85 sick people with tuberculosis per 100 thousand," stated a medical council on struggle against tuberculosis, a representative of WHO in Ukraine Dr. Kestutis Miskinis, "Indeed, the situation is getting more threatening: just 10 or 15 years ago tuberculosis was a disease of  marginal levels of people (people suffering from alcoholism, prisoners, etc., and now everyone is at threat. Quite socially successful people and even children can become infected with tuberculosis.
 
WHO has outlined the target for each country - to detect 70% of "contagious" tuberculosis cases and have 85% of the detected patients cured. Ukraine has still a long way to go to get to the standards. "According to our data approximately 50-60% of all sick people are detected in Ukraine and about 65-70% of patients get cured," said Kestutis Miskinis, "Tuberculosis in its active phase is a very contagious disease. You can become infected in public transportation, in crowded places, etc. But the problem is that multi-drug resistant tuberculosis (MDR-TB) is actively spreading in Ukraine. Usual anti-TB drugs (the doctors call them the first line drugs) do not only help treat a patient but can further aggravate the disease. In this situation it is necessary to use the second line drugs, which are less effective and have more side effects but this is the only way to conquer the disease.
 
According to Kestutis Miskinis, MDR tuberculosis is spreading as the result of incorrect treatment. The patients do not take all the prescribed drugs and don’t finish the full course of treatment. As the result, the TB bacteria quickly become resistant to these drugs and the drugs no longer work.  There are about 10% of such TB patients in Ukraine. 
 
In addition, to cure drug resistant tuberculosis it’s necessary to diagnose it correctly. In Ukraine it’s a big problem ? there are no modern laboratories and necessary diagnosis methods.
 
Unfortunately, at present the situation in Ukraine is so that drug resistant tuberculosis in many cases becomes a death sentence for a person.
 
At the end of last year Foundation for Development of Ukraine of SCM Company decided to solve the problem. The Foundation is going to fully finance a pilot project on struggle against MDR TB in Donetskaya Oblast. The goal of the project is to implement DOTS+ program in the region, which has proved to be efficient in many countries of the world. "Right now Ukraine has made the first steps to implementation of the DOTS+ strategy of treatment recognized worldwide, which allows to efficiently struggle against the problem of MDR TB," stated Kestutis Miskinis. 
 
The program is aimed at detecting TB in a timely manner including MDR-TB and at correct curing of the disease. This means that a patient shall take all the drugs under the doctor’s control not to miss his regular dose of drugs and to avoid "adjusting" the course of treatment by the patient in a way of getting MDR-TB.
 
Foundation for Development of Ukraine is allocating more than 2 million euros for purchasing the necessary diagnose equipment and staff training. WHO is responsible for the technical part of the project. The implementation of the program is supervised by Donetsk Oblast Administration. 
 
Within the framework of the project a group of tuberculosis specialists was trained in the largest tuberculosis hospital of Latvia. The doctors were explained the advantages of the DOTS+ program and were trained how to diagnose, treat and manage patients. The trip was financed by the Development for Foundation of Ukraine.
 
In order to treat patients with MDR-TB within the framework of the DOTS+ project it is necessary to properly equip the laboratories of anti TB institutions in Donetskaya Oblast and to create treatment control system (including home visiting services). The patients will receive free drugs effective for combating this form of TB.
 
"We have supported the project because it is in line with the philosophy of our Foundation: we are struggling not against the consequences but against the causes. Within the framework of the DOTS+ project there will be created an effective system of detecting and managing patients with MDR TB. This is of high importance for us that upon completion of the project the created system will not be ruined and not disappear and that it will keep working without our support and the program will be taken care of by the state," noted Anatoliy Zabolotnyy, Director of the Foundation for Development of Ukraine of SCM. "This is the first example of financing system programs on combating TB in Ukraine by private companies. We are sure that at present serious social programs in Ukraine can be settled only with effective cooperation of state and business. At the same time we realize that it’s not possible to fully settle the problem without attracting close attention of the public to the problem."
 
DN reference
 
Foundation for Development of Ukraine is a non-profitable organization founded by SCM Group on July 15, 2005.The budget of the Foundation is financed by SCM Company. The areas of activity of the Foundation include: contemporary education, health of the nation and cultural heritage.
The projects of the Foundation for Development of Ukraine are being implemented in seven Oblasts of Ukraine (Kyivskaya, Lvovskaya, Zakarpatskaya, Kharkovskaya, Luganskaya, Dnepropetrovskaya and Donetskaya Oblasts) and in the Autonomous Republic of Crimea. Foundation for Development of Ukraine of SCM is planning to invest up to 10 million dollars annually into social projects.
 
Comments
 
"We have seen the working WHO construction model"
 
Boris Noreiko, a professor, a participant of the training program for tuberculosis specialists:
When we came to Latvia we knew about the DOTS+ program and we were ready to apply it in practice. Latvia implemented the program earlier than Ukraine. They started the program in 1995 and we - in 2001.
We were surprised that Latvia had managed to fully implement the WHO program on combating TB. We saw the working WHO construction model. Now all we need is to use this experience in Ukraine.
Of course, the Latvians have better equipment compared with the Ukrainians. However, in Ukraine the problem is only in financing and not in the lack of specialists or lack of knowledge.
 
Tuberculosis specialists trained in Riga will be training local specialists"
Svetlana Svetlichnaya, the Head Doctor of the Oblast Tuberculosis Health Center:
 
MDR-TB is a very complicated and serious issue. In order to get certain results in struggle against the disease we need some time and certain staff training and necessary financing.
Foundation for Development of Ukraine is the donor of the project on combating MDR-TB. Right now we are improving the material base of the Oblast Tuberculosis Health Center and training the staff.
Tuberculosis specialists trained in Riga will be training local employees. There is a plan to open soon a department in Gorlovka Tuberculosis Health Center to treat patients with MDR-TB.
 
 
Author: Andrey Tyutyunikov