Despite a recent economic and military resurgence in Russia, the country is "facing a public health crisis that verges on the catastrophic," including high rates of HIV/AIDS and tuberculosis, Murray Feshbach, a senior scholar at the Woodrow Wilson International Center for Scholars and a research professor emeritus at Georgetown University's School of Foreign Service, writes in a Washington Post opinion piece.

According to the World Health Organization, about one million people in Russia have been diagnosed with HIV/AIDS and, using mid-year figures, it is estimated that 25% more new HIV/AIDS cases will be recorded this year than in 2007. Peter Piot, executive director of UNAIDS, told a press conference earlier this year that he is "very pessimistic about what is going on in Russia and Eastern Europe ... where there is the least progress." Feshbach reports that young people are most at risk of contracting HIV in Russia and that although injection drug use accounts for 65% of Russia's HIV/AIDS cases, the country officially has rejected methadone as a substitution therapy.

In addition, Russia records about 50 new smear-positive TB cases per 100,000 people each year, Feshbach reports. While 650 people out of a total population of about 300 million died of TB in the U.S. in 2007, about 24,000 of Russia's total 142 million people died of the disease in the same year, according to Feshbach. "Can it possibly be coincidental that, according to Gennady Onishchenko, the country's chief public health physician, only 9% of Russian TB hospitals meet current hygienic standards, 21% lack either hot or cold running water, 11% lack a sewer system and 20% have a shortage of TB drugs?" Feshbach asks, adding, "Hardly."

Feshbach writes that Piot last summer said that "bringing Russia's HIV/AIDS epidemic under control was 'a matter of political leadership and of changing the policy.' He might just as well have been talking about the much larger public health crisis that threatens this vast country. But the policies seem unlikely to change as the bear lumbers along, driven by disastrously misplaced priorities and the blindingly unrealistic expectations of a resentment-driven political leadership. Moscow remains bent on ignoring the devastating truth: The nation is not just sick but dying" (Feshbach, Washington Post, 10/5).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

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