List of Health Reform Projects
Prevention and control of communicable diseases in North West Russia			EU
Financier	Counterpart	Region	Duration/Budget
European Union (EU), EU-Russia Cooperation Programme (formerly known as Tacis)	Ministry of Justice of the Russian FederationMinistry of Health and Social Development of the Russian Federation	Leningrad oblast, Pskov oblast, Saint-Petersburg	01/06/2003 - 31/05/2005 (24 months) 2 500 000 EUR
Objectives:  The project is supported the FSIN (Federal Service for Execution of Punishments) and the Ministry of Justice in the designing and the implementation of a comprehensive strategy to curb and prevent the spread of communicable diseases in prisons and penitentiary institutions in North West Russia. It involved training of relevant personnel of the penitentiary institutions, promotion of health prevention strategies regarding AIDS and TB as well as other communicable diseases. It also raised awareness of high-risk populations on diseases.
Surveillance of antibiotic resistance in the Baltic region			TFBS
Financier	Counterpart	Region	Duration/Budget
Task Force on Communicable Disease in the Baltic Sea Region (TFBS)		Arkhangelsk oblast, Kaliningrad oblast, Murmansk oblast, Republic of Karelia, Saint-Petersburg	01/11/2002 - 31/12/2004 (26 months) 111 000 EUR
Objectives:  Antibiotic resistance in clinically important bacteria is an emerging and worldwide problem. It severely affects the usefulness of antibiotics in treatment of bacterial infections. One important step in the control of this problem is to apply standardized methodologies and interpretation criteria and to introduce regular surveillance programs of antibiotic resistant bacteria. Surveillance programs based on routine susceptibility data should involve clinical bacteriology laboratories serving defined areas of the country. To initiate a surveillance program the following parts should be attended to: (i) collecting relevant clinical isolates for susceptibility testing, (ii) registering quantitative data, (iii) analysing computerized data, and (iv) modifying and improving methodology and interpretative criteria, if necessary. Regular external quality assurance of methods should be implemented. As a complement to the surveillance system it is necessary to introduce modern DNA-based methods for detection of resistance. These methods could be introduced during an applied training program and need funding in terms of equipment. At the national level, these advanced methods should preferably be centralized to a reference/referral laboratory. Target Group: Primary target group is the participating laboratories, secondary patients in hospitals and communities in the Baltic Sea States Output Indicators: International acknowledged standardized methodology should be used for identification and suscept… Output: Quality assured data on antimicrobial resistance should be available and reported Means of Verification: Standard Operational Procedures (SOPs) should be available for evaluation Criteria for Success: SOPs implemented Participation in a external quality assurance programme Output: Quality assured data on antimicrobial resistance should be available and reported Means of Verification: Data on identification as well as susceptibility testing from the quality assurence programme should be published in a report and available for external assesment Criteria for Success: Satisfactory report within two years Comments: In 2003 Estonia and Lithuania took part in the quality assurance programme of antibiotic resistance organised by the European network for surveillance of antibiotic resistance, EARSS. In 2004 Latvia will also be included in this programme. Purpose Indicators: Establisment of national and local networks for coordinating the strategy for containment of anti... Purpose: To reduce the transmission of resistant microorganisms and to increase the prudent use of antimicrobials Means of Verification: National as well as more local meetings for responsable parties using human resourses from twinning institutions and MOH Success Criteria: Establishment of a national committee and networks for coordinating the strategy to contain antimicrobial resistance and improve the prudent use of antimicrobials Important Assumptions: Comments: In collaboration with project AB24 and by means of a steering committee with representatives from Estonia, Latvia, Lithuania, Russia and Sweden, a joint seminar has been planned for March 2004 in Riga, Latvia. It will focus on antibiotic resistance and infection control. The outcome will be an educational package on recent knowledge in this area. Standard methodology for susceptibility testing and quality assurance (QA) established Purpose: To reduce the transmission of resistant microorganisms and to increase the prudent use of antimicrobials Means of Verification: Adherence to national or international QA programmes Success Criteria: Participating labs enroled in QA programmes using standerdized methods Comments: During the seminar which will be held in March 2004 in Riga, standard methodology for susceptibility testing, detection of antibiotic resistance, and quality assurance will be agreed upon.