Despite Swift Spread of TB, Russians May Reject Big Loan
May 7, 2001
The Russian government is considering turning down a $150 million loan that would help the country contain a serious TB epidemic. Offered by the World Bank, the loan would go to fight TB in its breeding grounds, especially the country's overcrowded prisons. Russia's prison population-963,000-is one of the world's largest. In some prisons, as many as one fifth of all TB cases are multi-drug resistant. One in every 1,000 Russians has TB, triple the rate of a decade ago and 15 times the rate in the United States.Adapted from:
The issue seems to be about what effect foreign pharmaceuticals will have on the Russian drug industry. Boris Spiegal, chair of a parliamentary committee on national security in health, said that "if this loan is accepted, the Russian pharmaceutical industry will be brought to its knees. We have information showing that this is yet another internal fraud being carried out by the World Bank."
As talks continue about the loan, experts expect that the number of TB cases will explode in Russia. Roughly half of all people with AIDS who are exposed to TB contract the disease. One study predicted that the combination of AIDS, TB and intravenous drug use will claim 850,000 working-age adults in Russian by 2005. "The problem is that if you leave people untreated, it's not just that they are untreated. They infect others," said Dr. Jim Yong Kim, the director of the program on infectious disease and social change at Harvard Medical School and one of the directors of an international TB program in Tomsk Province. But Dr. Perelman, a Russian surgeon and TB expert, said that improved TB reporting has increased the seeming prevalence of the disease. He also complained that the strategy for treatment attached to the World Bank loan is one of directly observed therapy, which he said was designed for developing countries without viable health services.
New York Times; 05.06.01; Michael Wines
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.