Russians' health declines

BMJ 1996; 312 doi: (Published 25 May 1996) Cite this as: BMJ 1996;312:1319

The health of Russians is declining dramatically, according to the latest figures released by the Russian state committee for sanitary and epidemiological control. Doctors are complaining that health is low on the government's list of spending priorities.

The number of people with polio has risen from an average of 17 a year over the past few years to 154 in 1995—this is partly explained by the breakdown in the vaccination programme in Chechnya, which has been torn apart by civil war. The incidence of hepatitis B increased by a third between 1994 and 1995. The authors of the report point out that, although a hepatitis vaccine is manufactured in Russia, there are problems in paying for its production.

Perhaps of greatest concern is the spread of tuberculosis, which has risen by 40% in the past four years. It now affects 57.4 per 100 000 people—Russia has one of the highest rates in Europe. Whereas the rise of tuberculosis in much of the world is linked to a rise in AIDS, this does not seem to be the case in Russia, where even unofficial AIDS figures are relatively low. “In Russia tuberculosis is mostly an economic and social problem,” says Valentina Aksonova, deputy director of Russia's research centre for tuberculosis. She cites the drop in living standards associated with unemployment and rampant inflation as the main predisposing causes for the increase in the number of people contracting tuberculosis. Intestinal worms are now believed to affect every fifth Russian, although the problem, the report points out, could be cleared up rapidly with sufficient funding.

Valentin Pokrovsky, the president of the Russian Academy of Medical Sciences, says, “At the moment we have the paradoxical situation whereby the state committee for emergency situations (which includes epidemics) receives a bigger share of the budget than the ministry of health and the sanitary and epidemiological control committee put together. This makes it clear that clearing up after an epidemic is considered more important than preventing it in the first place. It is time that the powers that be understand that the nation's health is not only the individual's responsibility but also a political and economic issue.”—MIRANDA INGRAM, Moscow correspondent, European

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