1ST CITY CLINICAL HOSPITAL

World Tuberculosis Day , celebrated annually on March 24 in our country, calls on the government, society as a whole and each of its members to promote dialogue and cooperation in finding new solutions in the fight against the epidemic of this disease.

Taking into account the high prevalence of multidrug-resistant and extensively drug-resistant tuberculosis among patients in the Republic of Belarus, as well as the insufficient number of cases of successful treatment of these patients, WHO requires the use of new strategies and approaches to eliminate the tuberculosis epidemic.

With the slogan “United to end tuberculosis,” WHO calls on governments around the world to engage in dialogue and collaboration that brings people and communities together to find new ways to end the tuberculosis epidemic.

The main strategies and areas of activity to combat tuberculosis in the world:

• “Together we will solve the problem of tuberculosis by ending poverty”
• “Together we can diagnose, treat and cure better.”
• “Together we will stop stigma and discrimination”
• “Together we will drive new research and innovation.”

In May 2014 The World Health Assembly, convened annually by WHO at the Palais des Nations in Geneva, adopted a resolution in which it fully endorsed the new Global Strategy for Tuberculosis with its ambitious goals for the period beyond 2015 to “End the TB Epidemic” (End TB Strategy).

The strategy aims to end the global tuberculosis epidemic, with goals of reducing deaths by 95% and reducing new cases by 90% between 2015 and 2035, and ensuring that no family bears the catastrophic costs of tuberculosis. with tuberculosis. Interim targets are planned for 2020, 2025 and 2030.

Modern trends in the field of tuberculosis treatment always find a response in the TB service of the republic. With the organizational and methodological support of the Ministry of Health of the Republic of Belarus, approaches to providing medical care to patients with tuberculosis have been updated. The main measures to combat tuberculosis in Belarus in 2016 were aimed at strengthening the regulatory, organizational, methodological, information base of health care organizations providing anti-tuberculosis care to the population, introducing modern effective and economically feasible technologies for combating tuberculosis into practical activities.

The situation with tuberculosis is under the control of the government of the Republic of Belarus and the Ministry of Health. A new State Program “Tuberculosis” for 2016-2020 has been developed and approved by the Council of Ministers of the Republic of Belarus, which primarily provides for solving problems associated with preventing the emergence and spread of resistant forms of tuberculosis.

Taking into account the achievements of our country in the fight against tuberculosis, WHO, in collaboration with the international organization Doctors Without Borders, decided to hold a regional symposium on tuberculosis treatment “Tuberculosis in 2017: searching for new solutions in the face of new challenges” in the Republic of Belarus, which took place in Minsk on March 1-2, 2017. During the symposium, current issues in the fight against multidrug-resistant tuberculosis, the WHO Stop TB strategy and its significance for the region of Eastern Europe and Central Asia, new methods and approaches to treatment, as well as experience in the use of new anti-tuberculosis drugs were discussed.

Significant events of 2016 were the beginning of widespread clinical use of new anti-tuberculosis drugs: bedaquiline, delamanid, clofazimine, the introduction of a new treatment regimen for patients with extensively drug-resistant pathogens, the introduction of new approaches to the diagnosis of tuberculosis in children; introduction of social support (food packages) at the outpatient stage of treatment through budget funding. In each region of our country, new methods for diagnosing tuberculosis have been introduced, making it possible to obtain test results for the presence of the disease within one day and diagnose the resistance pattern within a week. In order to create comfortable psychological and living conditions, innovative technologies are used in organizing patient treatment. Video-controlled treatment of tuberculosis has been introduced in the republic: taking anti-tuberculosis drugs with video recording on a mobile phone. With the help of a smartphone, which is given to the patient free of charge, and specially created software, patients are able to lead their usual lifestyle. In addition, preparatory work is being carried out to change the model of financing anti-tuberculosis activities and the possibility of redistributing financial resources in such a way as to ensure the most comfortable conditions for the patient, both at the inpatient stage of treatment and on an outpatient basis.

In the Republic of Belarus, positive dynamics of the tuberculosis epidemic situation has been recorded for about 10 years. The incidence rate in 2016 was 27.6 per 100 thousand population, which is 13.2% lower compared to 2015; the mortality rate is 3.5 per 100 thousand population, which is 12.5% ​​lower compared to 2015. The mortality rate from tuberculosis in the working age population was 4.1 per 100 thousand people (in 2015 – 5.4 ). Thanks to ongoing anti-epidemic measures, early diagnosis and the introduction of effective treatment methods, it was possible to achieve isolated cases of tuberculosis in children and completely eliminate mortality from tuberculosis among the child population.

In 2016, the development and approval of regulatory documents aimed at optimizing the provision of TB care and preventing the spread of multidrug-resistant tuberculosis (MDR-TB) continued, 2 international scientific and practical conferences, 4 republican seminars (meetings) were held on various aspects of the fight against tuberculosis and 28 regional training seminars.

We should not forget that the basis for the prevention of tuberculosis among the population are measures aimed at increasing the body’s defenses: adherence to the correct work and rest schedule, rational, nutritious and timely nutrition, cessation of smoking, the use of psychoactive substances and alcohol-containing beverages, rational physical activity and maintaining a healthy lifestyle.

The use of new strategies in the prevention, spread, diagnosis and treatment of tuberculosis will improve treatment results, improve the quality of life of patients, achieve a positive socio-economic effect, which, in turn, will contribute to the successful implementation of the indicators of Subprogram 4 “Tuberculosis” of the State Program “People's Health” and demographic security in the Republic of Belarus" for 2016-2020.

Close cooperation of the Ministry of Health of the Republic of Belarus with WHO and the Global Fund within the framework of the implementation of the current grant, as well as other international organizations working in the field of tuberculosis control, contributes to the implementation of activities that have a positive impact on the quality of anti-tuberculosis care and improvement of the epidemic situation of tuberculosis in the republic.

The leading institution coordinating the fight against tuberculosis in the republic is the State Institution “Republican Scientific and Practical Center of Pulmonology and Phthisiology”. The center develops new technologies and tests advanced international approaches to the diagnosis and treatment of tuberculosis. A tuberculosis hotline operates daily (toll-free number 88011001313). Information on the fight against tuberculosis, on the provision of free and paid services to the population is presented on the center’s website http: //www.rnpcpf.by.

Prepared from materials provided

Chief freelance TB specialist of the Ministry of Health of the Republic of Belarus,

Director of the State Institution “Republican Scientific and Practical Center of Pulmonology and Phthisiology” G.L. Gurevich