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In the Soviet post-war years, Belarus became one of the most prosperous parts of the USSR, but with independence came economic decline.
The landlocked country, sat between Poland and the Russian Federation, has a population of 9.5 million.
Its capital, Minsk, is known for its monumental Stalinist architecture.
Yury, 38, was the first patient to complete treatment in MSF’s TB programme in Belarus, run in close cooperation with the Ministry of Health.
Yury learned he was sick in 2013. “I felt weak. I was losing weight. Then I got a fever. I went to the polyclinic, thinking it was a common cold.” After learning what it was, Yury was too scared to mention it by name – not so much afraid for his life or health, more the reaction of others. “I thought everything had ended, that everybody would turn away from me.”
When MSF set up its treatment programme in 2015, Yury had been fighting the disease for two years and been diagnosed with extensively drug-resistant TB. “My doctors told me, ‘This is the only chance’. It was getting worse and worse.”
Yury agreed to be admitted for treatment with MSF at once. “I started to improve immediately: I didn’t feel better, I had no appetite, but the tests, the X-rays – everybody was surprised! Already in October I had clear tests. Everything was clear.”
“You certainly get tired in two years. But what can you do? If it wasn’t for this treatment, we wouldn’t be speaking here right now.”
Médecins Sans Frontières supports the Belarusian Ministry of Health to treat patients with multidrug-resistant tuberculosis (MDR-TB).
Belarus is listed as a high-burden country for MDR-TB in the World Health Organization’s 2018 Global Tuberculosis Report.
In 2018, we supported the Ministry of Health in three TB facilities: in Minsk; in City TB hospital in Volkovichi, Minsk region; and in Orsha, where we had a team providing drug-resistant TB (DR-TB) treatment for 22 inmates of a penal colony. Six of these patients were co-infected with hepatitis C and were given new drugs that have a 95 per cent cure rate.
The focus of our programme in Minsk is on supporting adherence to treatment for patients with alcohol-use problems and marginalised groups. Using a patientcentred approach, our multidisciplinary team provided psychosocial assistance to support adherence to the entire course of treatment, conducting 2,225 consultations in 2018.
By the end of the year, 59 patients with DR-TB were on treatment with new regimens containing bedaquiline and/or delamanid as part of an endTB observational study.1 With 41 new patients enrolled in 2018, the project reached the national target of 122 patients recruited since August 2015.
In 2018, we also started recruiting Belarusian patients for the TB PRACTECAL trial, which explores short, innovative MDR-TB treatment regimens; 20 people had been recruited by the end of the year.