Siberian jail is champion in fight against TB

By James Kilner

TOMSK, Russia (Reuters) - Alexander Pushkarev, head doctor at the 1,000-bed hospital in a Soviet-era prison nestling at the edge of Siberia, flashed a row of metal teeth with his smile.

"Welcome to Tomsk Correction Facility No. 1," he said. "This is the best treatment for TB in Russia."

In the mid-1990s, virulent tuberculosis was killing prisoners here every week, but with the help of a group of American doctors, the jail near one of the world's biggest swamps has set an example to others worldwide dealing with drug-resistant TB.

Following an initiative from the U.S. Public Health Research Institute which was funded by George Soros, the Tomsk project now run by Boston-based doctors' group Partners in Health (PIH) has overturned conventional medical thinking that drug-resistant TB strains are extremely difficult and expensive to treat.

"Without the Tomsk project, drug-resistant TB treatment would be years behind where it is now," said Jussi Saukkonen, a doctor from Boston who was in Tomsk to inspect the project.

"It's been an important benchmark in dealing with this problem."

Under the project, which has now extended beyond the prison to the general population in the region, deaths from TB in Tomsk have nearly halved in eight years to around 12 per 100,000 people -- a third of the average in Siberia.

Its main thrust is simple: just to ensure existing treatment is adhered to properly, rather than introducing new high-tech solutions or expensive drugs.