Russia's Tuberculosis Catastrophe

TOMSK, SIBERIA: Europe ignores Russia’s public health problems at its peril. So do the other industrialized countries who cheered the Soviet Union’s fall but have failed to respond to the collapse of Russia’s health and social-service infrastructure. For out of a confused swirl of economic ideology and sometimes insensitive advice has emerged a new form of drug-resistant tuberculosis that is proving hard to contain. Much has been made of Russia’s plummeting life expectancies – its "mortality crisis." Although that grim trend appears to be being slowly reversed, another problem is spiraling out of control: tuberculosis. In several regions of Russia, young men fall ill and die from tuberculosis at rates well in excess of ten times those documented a mere decade ago; in some non-Russian areas of the former USSR, the story is even worse.

A confluence of events is to blame, including the collapse of Russia’s social safety net at the very moment when petty crime, and thus imprisonment, was reaching new heights. Russia and the United States have long been world leaders in rates of imprisonment. In the context of wars and economic disruption, Russia has pulled ahead. Tuberculosis is now epidemic within Russia’s prisons and jails. One in ten prisoners is sick with the disease. Victims of tuberculosis, especially drug-resistant tuberculosis, are likely to have served time in prison or to have a close relative who has gone through the Russian justice system. Like other airborne plagues, drug-resistant tuberculosis cannot be stopped by either prison walls or national boundaries. In the state of Massachusetts, where I practice medicine, close to 70% of all tuberculosis cases are diagnosed in people born abroad. The proportion is much the same throughout Western Europe.

The epidemics of recent years are fundamentally “transnational” in character, as befits the global era. As infecting organisms easily cross frontiers, solidarity and generosity usually get tied up in customs. So far, Russian health specialists have received much haughty advice but little practical assistance from their colleagues abroad.

To continue reading, please log in or enter your email address.

Registration is quick and easy and requires only your email address. If you already have an account with us, please log in. Or subscribe now for unlimited access.

required

Log in

http://prosyn.org/yFx29fj;
  1. Television sets showing a news report on Xi Jinping's speech Anthony Wallace/Getty Images

    Empowering China’s New Miracle Workers

    China’s success in the next five years will depend largely on how well the government manages the tensions underlying its complex agenda. In particular, China’s leaders will need to balance a muscular Communist Party, setting standards and protecting the public interest, with an empowered market, driving the economy into the future.

  2. United States Supreme Court Hisham Ibrahim/Getty Images

    The Sovereignty that Really Matters

    The preference of some countries to isolate themselves within their borders is anachronistic and self-defeating, but it would be a serious mistake for others, fearing contagion, to respond by imposing strict isolation. Even in states that have succumbed to reductionist discourses, much of the population has not.

  3.  The price of Euro and US dollars Daniel Leal Olivas/Getty Images

    Resurrecting Creditor Adjustment

    When the Bretton Woods Agreement was hashed out in 1944, it was agreed that countries with current-account deficits should be able to limit temporarily purchases of goods from countries running surpluses. In the ensuing 73 years, the so-called "scarce-currency clause" has been largely forgotten; but it may be time to bring it back.

  4. Leaders of the Russian Revolution in Red Square Keystone France/Getty Images

    Trump’s Republican Collaborators

    Republican leaders have a choice: they can either continue to collaborate with President Donald Trump, thereby courting disaster, or they can renounce him, finally putting their country’s democracy ahead of loyalty to their party tribe. They are hardly the first politicians to face such a decision.

  5. Angela Merkel, Theresa May and Emmanuel Macron John Thys/Getty Images

    How Money Could Unblock the Brexit Talks

    With talks on the UK's withdrawal from the EU stalled, negotiators should shift to the temporary “transition” Prime Minister Theresa May officially requested last month. Above all, the negotiators should focus immediately on the British budget contributions that will be required to make an orderly transition possible.

  6. Ksenia Sobchak Mladlen Antonov/Getty Images

    Is Vladimir Putin Losing His Grip?

    In recent decades, as President Vladimir Putin has entrenched his authority, Russia has seemed to be moving backward socially and economically. But while the Kremlin knows that it must reverse this trajectory, genuine reform would be incompatible with the kleptocratic character of Putin’s regime.

  7. Right-wing parties hold conference Thomas Lohnes/Getty Images

    Rage Against the Elites

    • With the advantage of hindsight, four recent books bring to bear diverse perspectives on the West’s current populist moment. 
    • Taken together, they help us to understand what that moment is and how it arrived, while reminding us that history is contingent, not inevitable


    Global Bookmark

    Distinguished thinkers review the world’s most important new books on politics, economics, and international affairs.

  8. Treasury Secretary Steven Mnuchin Bill Clark/Getty Images

    Don’t Bank on Bankruptcy for Banks

    As a part of their efforts to roll back the 2010 Dodd-Frank Act, congressional Republicans have approved a measure that would have courts, rather than regulators, oversee megabank bankruptcies. It is now up to the Trump administration to decide if it wants to set the stage for a repeat of the Lehman Brothers collapse in 2008.