Sep. 16, 1998 The Public Health Research Institute, Doctors Without Borders (Medecins sans Frontiers) and the Medical Emergency Relief Network International (MERLIN) have issued a joint statement about the need for international attention and support to combat the epidemic of drug-resistant tuberculosis (MDR-TB) in Russia, which is threatening to become a global problem.
Referring to the disease as "Ebola with Wings," the organizations released their plea after members of the PHRI/Soros TB Advisory Committee toured prisons in Tomsk and Kemerovo the week Sept. 7. PHRI has begun pilot programs in prisons in Tomsk, Ivanovo and Marii El as part of a $12.3 million project funded by philanthropist George Soros to combat TB in Russia. Before their tour, PHRI and the Russian Ministry of Health hosted the International Workshop on TB in Russia on Monday, Sept. 7, 1998 to address the serious public health problem.
Following is the statement from three organizations. For additional information about PHRI, the PHRI/Soros project, TB in Russia and globally or the disease in general, please visit: http://www.noonanrusso.com/www/phri.
For more information or to arrange an interview with the director of the PHRI/Soros project, please call Noonan/Russo Communications at 212-696-4455 and ask for Ernie Knewitz, x 204, Marion E. Glick, x 221 or Tony Russo at x202.
Doctors Without Borders (Medecins sans Frontiers), the Medical Emergency Relief Network International (MERLIN) and The Public Health Research Institute
Multi Drug Resistant-TB: Russian Economic Collapse will Lead to Global Spread of "Ebola with Wings"
Foreign Funds are Needed to Prevent Epidemic
Our three nongovernmental organizations are calling for an urgent worldwide campaign to raise the $100 million needed to prevent the imminent epidemic of multidrug resistant tuberculosis (MDR-TB) in Russia. In our view, this local humanitarian disaster is already a direct global public health threat.
Drug-senstive TB is curable through proper drug therapy. MDR-TB is potentially much more dangerous, especially because TB spreads through the air and can move from patient to patient in its deadly drug-resistant form. MDR-TB has been dubbed "Ebola with wings."
Current levels of MDR-TB in Russia are alarming. The looming economic crisis will exacerbate the problem. It is only a matter of time before MDR-TB of Russian origin becomes a daily reality in other countries worldwide.
The current Russian economic crisis will further deplete already strained resources of public medicine. The resulting shortage of anti-TB drugs will inevitably lead to the massive practice of substandard antibiotic treatment of patients with TB, which is the principal cause of MDR-TB. Standard treatment of regular TB consists of a daily regimen of four different antibiotics for six months. When this treatment is incomplete or interrupted, a patient can easily develop MDR-TB and then spread this potentially lethal form of TB to other people.
We are particularly concerned about the dire situation in Russian prisons, where systematic underfunding combined with epidemic-prone conditions already has resulted in the generation of nearly 20,000 MDR-TB cases. The number of cases is expected to rise because, under the current conditions, about 100,000 inmates with regular TB are subjected to inappropriate, MDR-causing treatment protocols.
Among the civilian population, TB patients undergoing treatment often are required to pay for their own drugs, even in state run hospitals. In the worsening economic situation, this burden on patients will translate into inadequate treatment and, consequently, thousands of new MDR-TB cases because most people will discontinue prescribed treatment as soon as symptoms subside.
Our activities in several pilot projects in Russia convinced us that an effective anti-TB program can be implemented nationwide, but only through cooperation among foreign health agencies and Russian health authorities. Alone, Russia will not have the needed resources to cope with this problem.
We are calling on the world community to provide funds needed to bring the Russian epidemics of TB and MDR-TB under control. The minimum estimate for a nationwide emergency program is $100 million. This cost is small in comparison to the loss of life and potential global economic damage that can be anticipated in the near future if the problem of MDR-TB in Russia is not addressed today.
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