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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.”
Belarus is listed as a high-burden country for MDR-TB in the World Health Organization’s 2017 Global Tuberculosis Report. MSF is currently supporting the Ministry of Health in four TB facilities: the Republican Scientific and Practical Centre of Pulmonology and Tuberculosis, 1st and 2nd City TB dispensaries in Minsk, and City TB hospital in Volkovichi, Minsk region. In late 2017, a team started to treat prisoners with MDR-TB in Orsha’s Colony 12. Following a review conducted by MSF in 2016 that identified alcohol use disorder as the main risk factor for poor adherence to treatment, teams are exploring new measures to address this problem in the project.
By the end of 2017, MSF was treating 59 patients with extensively drug-resistant TB with new regimens containing bedaquiline and/or delamanid. The project continues to participate in the endTB observational study, which covers more than 15 countries and aims to find shorter, less toxic and more effective treatments for MDR-TB, with fewer debilitating side effects. MSF is conducting the study in partnership with Partners in Health and Interactive Research and Development. Since August 2015, 81 patients in Belarus had been recruited for the study, including 31 in 2017. At the end of December, after a year of preparing the site in Minsk to meet the strict requirements, a pioneering clinical trial, TB PRACTECAL, received approval to start admitting patients.