MINSK, Belarus – Formerly part of the Soviet Republic, Belarus established its borders in the aftermath of World War II. During the 1941–1944 Nazi occupation, 2.2 million people were slaughtered and Belarus’ Jewish population was nearly exterminated.
What was once a prospering part of the Soviet Union has since shifted drastically. In the summer of 2011, after a crisis with Russia, and a settling of balance, the country’s economic reserves have been drained.
As such, Belarus has appealed to Russia and the International Monetary Fund for assistance, both of which have failed to respond. President Alexander Lukashenko, who has been dubbed “Europe’s last dictator,” is subsidizing the economy via Russian gas-lines. While less than 1% of the Belarus population is living in extreme poverty, a significant number of people fall into the “low-income” category. 17.8% of the population, about 1.7 million people, live on the minimum subsistence budget. This poverty has made the people of Belarus more susceptible to diseases, specifically Tuberculosis.
Tuberculosis (TB), second only to HIV/AIDS, is one of the greatest killers worldwide due to a single infectious agent. In 2012, 8.6 million people fell ill with TB, of those, 1.3 million died. 95% of these cases occur in low and middle income countries, and in 2012, an estimated 530,000 children became ill with TB.
Though both curable and preventable, Tuberculosis is caused by the Mycobacterium tuberculosis bacterium. Mostly spread via coughing, sneezing, and spitting, about 1/3 of the world’s population is said to carry latent TB since one need only consume a few of the microbes to become infected. However, without proper treatment, up to two-thirds of those ill with Tuberculosis die.
Belarus is one of 27 countries with a high burden of Multidrug-resistant (MDR)-Tuberculosis. MDR-TB, as the name entails, is extremely difficult to treat because of its resistance to traditional TB-treating medicines, such as Isoniazid and Rifampicin, and is far deadlier.
In 2008, Belarus began implementing reforms to upgrade TB care. “Significant improvement in the quality of treatment and new diagnosis methods were the major achievements of the reform,” says Valentin Rusovich, World Health Organization’s TB coordinator in Belarus.
The Millennium Development Goal aims to reverse the spread of TB by 2015. With the help of the Directly Observed Therapy, Short-Course (DOTS) and Stop TB Strategy recommended by the World Health Organization, an estimated 22 million lives have been saved.
Reforms, according to the World Health Organization, in Belarus have begun to upgrade Tuberculosis care, and have already started to have positive impacts with fewer TB deaths and incidences.
These improvements focused on detection, education, and improved protocols. Infection control guidelines were met by, as one such example shows, separating standard TB patients from the MDR-TB patients, thereby preventing the spread of the deadlier strain. As a result, TB deaths and new cases have dropped 30%, and the duration of hospital stays has been declining.
However, MDR-TB is still being easily transmitted throughout the population, largely due to poor infection control in hospitals. If any monitoring was done, such high levels of drug resistance in the Tuberculosis bacteria could be avoided. Today, 35% of new TB cases and 45% of all TB patients have MDR-TB. 12% have an even deadlier strain, Extensively Drug Resistant Tuberculosis (XDR-TB), a form resistant to an even range of treatments.
Belarus is, at this moment, severely underfunded for its national TB program, and further acquirement of funds is hampered as a result of Belarus’ denied funding from the Global Fund to Fight AIDS and Malaria organization. With increased funding, molecular diagnostic tests, which unlike a simple microscopy test, can test for drug resistance and help monitor treatment outcomes.
It is only through external funding that Belarus will be able to scale up the MDR-TB response, and until so, the serious and dangerous spread of the bug will continue.
– Chloe Nevitt
Sources: United Nations Development Programme, World Health Organization: Tuberculosis, World Health Organization: Belarus, BBC, Action