During the 1990’s, after the collapse of the Soviet Union, Russia began to experience a tuberculosis epidemic within their prison system. During much of the Cold War period the Soviet Union and the United States shared the position of having more people incarcerated than any other country on earth. In fact, after the fall of the Soviet Union it was found that the Jackson Prison was the largest prison on the planet until the 1980’s when the state divided the prison into smaller prison units due to rioting. In Russia however things only became worse after the collapse of the Soviet government. People began to be sentenced to prison for minor infractions and the prison population expanded to an all new high. Because of prison overcrowding, and reduced funds being spent on the Russian medical system, tuberculosis had taken hold within the prisons. It was found that one in ten prisoners had active tuberculosis and this number was only going to increase as these prisoners infected other prisoners and possibly even their families after their release. It can also be said that being sentenced to prison during this time period included the sentence of tuberculosis.
In response to the epidemic The Public Health Institute (PHRI) and Partners in Health (PHI), which was founded and run by Dr. Paul Farmer, established medical facilities within Russia to manage the threat of tuberculosis for both prisoners and the general public. “Accomplishing this aim required the establishment of collaborative working relationships with a variety of partners in Russia, building a laboratory infrastructure virtually from scratch, training laboratory and medical personnel, implementation of TB control procedures, provision of appropriate first and second line drugs, advocacy to convince TB and governmental leaders to proceed with the program, and a myriad of additional tasks, all taking place in a highly charged political atmosphere.”
The political atmosphere of Russia during this time period made it difficult for westerners to affect change. Dr. Paul Farmer was forced to meet with many political members of the Russian government and argue the need to treat the people suffering from this disease including the nation’s prisoners. A colleague of Dr. Farmer who witnessed Farmer’s heated exchanges recollected an argument at “a congenial dinner with a famous personage in public health. By day Paul had been arguing with him. The fight had to do with milk. Paul wanted Russian prisoners with TB to get a glass of milk each day, and the public-health expert didn’t think this was necessary.” These heated exchanges were common for Dr. Farmer while he attempted to gain a support for the medical centers and tuberculosis treatments.
By 1997 PHRI had successfully established effective tuberculosis controls in Russia for both the civilian and prison population. The PHRI then turned over management of the program to Dr. Paul Farmer and the PHI. Because of the efforts of world health organizations such as PHRI and PHI and medical anthropologist and physician Paul Farmer tuberculosis is now controlled and treated within the Russian prison system and the sentence of tuberculosis has also been eliminated from the Russian criminal justice system.
 Paul Farmer, “Russia’s Tuberculosis Catastrophe,” Project Syndicate, January 18, 2001, accessed August 9,2012, http://www.project-syndicate.org/commentary/russia-s-tuberculosis-catastrophe.
 The Public Health Research Institute Center, “The PHRI/Soros Russian TB Program: Treating MDRTB in Siberian Prisons,” The Public Health Research Center, Accessed August 9, 2012, http://www.phri.org/programs/program_russiantb.asp.
 Tracy Kidder, “Paul Farmer Is Revolutionizing Medicine,” The Daily Beast, May 5, 2010, accessed August 9, 2012, http://www.thedailybeast.com/articles/2010/05/06/paul-farmer-is-revolutionizing-medicine.html.