OBJECTIVE: The World Health Organization has continuously monitored tuberculosis (TB) prevalence across the globe. Even with this vigilance, there remains places around the world where the disease persists. One noteworthy example is in The Russian Federation, particularly the Tomsk Oblast region where a rise in multi-drug resistant TB (MDR-TB) was detected. Non-compliance with medication and treatment regimens were evident and social services had deteriorated. The objective of this poster is to present an array of interventions and demonstrate several successful outcomes that resulted. KEY MESSAGES: 1) COMMUNITIES AND ENVIRONMENT. ENGAGEMENT: This abstract presented the unfailing commitment of a team of health care professionals to improve population health of their region by lowering the MDR-TB and TB prevalence through an unprecedented coalition with Partners in Health. These teams battled formidable barriers to care: harshest climates, overcame compromised mindsets, stretched limited resources, and battled economic disparities; to develop a renowned health care delivery method called Patient Centered Accompaniment. 2) INFLUENCE IN HEALTH. ADVOCACY: The Sputnik Initiative was formed by the Tomsk Oblast Tuberculosis Services and Partners in Health, with the support of the World Health Organization. The premise of the Sputnik Initiative was of health professionals who revolved around the patient, assisting them in most of their every need to ensure they take their medication and are compliant with their treatment regimen. Patient Centered Accompaniment advocates for the patient, practically hand-holding TB victims through their treatment regimen and helping them hurdle obstacles that hindered their completion of treatment; whether delivering daily medications to the victims' homes, shuttling them to appointments, taking them to the hospital, providing groceries or performing follow-up home visits. 3) HEALTH IN CRISIS: 'The Russian Federation has one of the highest rates of tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) in the worldâ€. Partners In Health (PIH) has been working on TB and MDR-TB in Russia since 1998. PIH and Tomsk Oblast Tuberculosis Services launched the â€œSputnikâ€ Initiative, a model of patient-centered accompaniment focused on providing daily comprehensive care to patients at the greatest risk of defaulting from treatment of MDR-TB set forth in the Millennium Development Goals.