A country with the highest prevalence of MDR-TB ever recorded worldwide.

Belarus is listed as a high-burden country for multidrug resistant tuberculosis (MDR-TB) by the World Health Organization. The high prevalence of MDR-TB among TB patients in Belarus has raised major concerns. In a survey conducted in 2010 in Minsk, the capital city, nearly one out of every two (47.8%) TB patients investigated was found to have MDR-TB; this was the highest prevalence of MDR-TB ever recorded among TB patients worldwide.

MSF providing treatment with new TB drugs in Belarus.

MSF started working in the country at the end of 2015, after an invitation from the Ministry of Health to assist with its TB treatment programme. MSF is now supporting the Ministry of Health in four TB facilities: the Republican Scientific and Practical Centre of Pulmonology and Tuberculosis (RSPC PT), 1st and 2nd City TB dispensaries in Minsk and the City TB hospital in Volkovichi, Minsk region. In late 2017, a team started to treat prisoners with MDR-TB in Orsha’s Prison Colony 12. MSF is providing treatment using bedaquiline and delamanid, the first new TB drugs to be developed in nearly 50 years that give hope to patients who suffered repeated failures of treatment and whose strain of the infection is resistant to available medicines. Psychological counselling and socioeconomic support provided by MSF helps to improve patients’ adherence to treatment.

TB and alcohol use disorder.

Alcohol abuse and alcohol use disorders are known to play a role in the development of TB as well as in the outcomes of TB treatment. In 2016, the WHO rated Belarus the second country in the world for alcohol consumption with 16 litres of alcohol consumed per capita. Alcoholism also makes Belarus one of the world’s leaders in suicide. Following a review conducted by MSF in 2016 in Minsk, that identified alcohol use disorder as the main risk factor for poor adherence to TB treatment, MSF teams are exploring new measures to address this problem in the project. MSF believes the integration of treatment of alcohol-use disorders with clinical services for TB can improve the outcomes of TB treatment and reduce disease transmission.