An estimated 860,000 people were living with HIV in Russia at the end of 2003, fully 80 percent of them were between15-29 years of age and more than one-third of them were women. HIV prevalence is increasing steadily. Infection levels among pregnant women have risen from less than .01 percent in 1998 to .11 percent in 2003. At the heart of the country’s epidemic are the extraordinarily large numbers of young people who inject drugs and have active sex lives. In early 2004, more than 80 percent of all officially reported HIV cases were drug injectors.
SOURCE: AIDS Epidemic Update, UNAIDS, and WHO (December 2004).
are too often found on Russian farms (Onishchenko, 2002; Pokroksky, 2002:5; WHO, 2003).
Although the public health situation in Russia is clearly similar to that in other industrialized nations, Russia faces several unique challenges in safeguarding public health and protecting its agriculture. The physical environment of Russia, in which diseases emerge and spread, geographically stretches across 12 time zones and 4 ecological zones, producing infectious agents that vary widely in type, frequency of occurrence, and persistence. Russia has densely populated industrial regions with well-established public health infrastructures, manufacturing centers in sparsely populated areas with limited support services, and vast agricultural regions. This diversity complicates the government’s ability to provide adequate protection from outbreaks of diseases across different regional settings.
Second, as Russia evolves from being a centrally managed but relatively prosperous nation to having a free market economy, social and economic upheavals continue to cause problems. Disruptions in living patterns and in the availability of health services have increased the susceptibility of large segments of the population to disease. Additionally, the sharp erosion of the technological base for the manufacture of drugs, vaccines, and medical devices has opened the door for a large influx of foreign products that now inhibit the recovery of a Russian pharmaceutical industry capable of producing cheaper and better products.
In recent years, the budget of the former Ministry of Health (now incorporated into the Ministry of Health and Social Development) has been slowly growing (see Figure 1.1), but it is still small relative to the needs of the population.