Russia Bracing for Spread of Dangerous TB Strains

Preliminary state surveys have recorded an uptick in Russia's TB rate, from 83.2 cases per 100,000 people in 2007 to 85.2 cases per 100,000 last year. Health officials and other experts are warning that worse could follow, given the most severe economic decline in a decade and Russia's weak health care system. The 1998 financial downturn preceded a rise in TB from 74 cases per 100,000 population to 90.4 two years later.

Last year, Russia's Ministry of Health never ordered critical TB drugs, according to local officials and specialists. Federal officials never delivered key TB drugs to the far-eastern Amur province, said Valentina Kravchenko, the province's deputy health minister. Ministry officials told Kravchenko and others involved with TB treatment that the government shuttered the procurement agency during a restructuring and had failed to reassign the task.

"About 70 percent of those who needed treatment were not provided with proper medication," Kravchenko said. "As a result, many of them got drug-resistant forms or had complications. And of course, more people caught tuberculosis, and the number of cases grew in our region."

TB treatment is free, but nearly one-fifth of TB hospitals experience shortages of the necessary medicines, according to a 2007 report by Gennady Onishchenko, Russia's head epidemiologist. More than 40 percent have inadequate medical equipment, he noted.

"The problem is the long delivery process for products from the WHO [World Health Organization]," the ministry stated in response to an inquiry. However, Dmitry Pashkevich, coordinator for WHO's TB control program, said Russia's government should actually be purchasing antibiotics directly from domestic manufacturers using a 2003 World Bank loan, "We are not involved in procurement," he said.

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