NPR Berlin (07.11.2013)
Russia’s Health Ministry and the US nonprofit organization Partners in Health launched an innovative mobile clinic, “Sputnik,” that “orbited” the city of Tomsk to find TB patients and deliver their medicines. The strategy aimed to combat an increase in the incidence of multidrug-resistant TB in Tomsk. The World Health Organization reported in 2012 that nearly 30 percent of TB cases in Siberia were resistant to two of the most powerful TB medications.
One Sputnik team included a nurse and a driver/bodyguard who drove the nurse around Tomsk to meet with patients who were sometimes dangerous. Sputnik’s primary targets—the homeless, mentally ill, and drug addicts—could be difficult to find and uncooperative; most either could not or would not go to the hospital for treatment. For example, one female TB patient preferred to meet daily with the Sputnik crew and take her TB regimen in the back seat of the Sputnik car than be in the TB hospital with “drunks, dope addicts, ex-cons, crooks.” The Sputnik crew visited another patient, an alcoholic man, twice daily at his home.
The drug regimen for multidrug-resistant TB could require a patient to take as many as 18 pills daily to combat both the TB and side effects of the TB drugs. If patients refused to complete the long course of medicine necessary for the cure, the TB bacteria could rebound and become resistant to TB medications.
Dr. Alexander Barnashov, a Tomsk Health Department head physician, stated that the city had other TB strategies, but the Sputnik program had been effective in reducing the most dangerous forms of TB, and other cities were adopting the Sputnik model. However, a new Russian law that required nonprofits receiving funds from sources outside Russia to register as “foreign agents” could threaten Sputnik. Designation as a foreign agent has been equivalent to the label “spy,” and Russian authorities have raided many charities and demanded their records. Thus far, authorities have not challenged Sputnik.