Томск

Tomsk is one of the oldest cities in Siberia and is home to about half of a million people.

This city and region is also home to one of the world's worst epidemics of multi-drug resistant Tuberculosis. Because EVA addresses not only HIV, but also other socially significant diseases such as  TB, this region and the work being done there is crucial. Tomsk suffers high rates of intravenous drug use which fuel the spread of diseases like HIV and TB. Patients who are co-infected with HIV and TB face a difficult road to restored health. TB treatment can take years to complete and often involves a period of clinical isolation and a daily cocktail of TB medication. Those with multi-drug resistant TB (MDR-TB), or in some cases drug-resistant TB (XDR-TB), face the uncertainty that any treatment will effectively cure them. When you add HIV to the mix, treatment regimes and side effects become more complicated and difficult to deal with.

Partners in Health has worked in the Tomsk region since 1998 addressing TB and MDR-TB. One of the greatest challenges is adherence to treatment. When patients have gaps in treatment, strains of the disease develop resistance to certain medications, fueling the growth of MDR and XDR TB. Partners in Health works to improve adherence especially among vulnerable populations such as the homeless, those in poverty, and those with substance abuse problems. Their work is proof that elimination of a disease and putting the breaks on an epidemic starts not with integrated members of society, but with those who are often ignored and rejected from our everyday lives. If we can learn how to educate and cure these people, then certainly we can reach our friends, our co-workers, the man in the grocery store or the woman working at the bank.

Take a look at their work here: http://www.pih.org/country/russia/about

This year EVA received a grant from StopTB which is being implemented by my friend and colleague, Natasha. As a Tomsk native and former employee of Partners in Health, her experience and knowledge about TB and evidence-based methods in addressing this disease are unparalleled. As EVA seeks to reach women suffering from HIV/TB co-infection we are investing in outreach to vulnerable groups in society. And, as a network organization, our work spreads beyond the Leningrad region and across most of Russia.

A recent report done in Tomsk showed a rapid increase of HIV infection rates during the 2013 year. In 2012, 338 cases of HIV were newly diagnosed. Within the first three months of 2013, 372 new cases were diagnosed. 82% of these individuals were intravenous drug users. These numbers are a red flag for those working in the sphere of HIV. While the rest of the world has stabilized or decreased their rate of HIV growth, Russia's status as the country with the fastest growing rate of HIV in the world isn't about to go away anytime soon.

The facts are grim. And while we would all love to see TB and HIV go the way of guinea worm (thanks to the Carter Foundation!), eradication seems like a distant dream. All the more reason to invest. Even if adherence among the general population and, especially, vulnerable groups, it difficult - it is possible.

A EVA member and friend is proof of this. A former drug user who was co-infected with HIV & TB, this gentleman somehow defied the odds and survived addiction, TB and HIV. While he will forever take HIV treatment, he lives a healthy life as an advocate and testament to the power of investment. This is why we do what we do.