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preparations, (h) Research Institute of Phthisiopulmonology, (i) State Research Institute of Biological Instrument-Making, and (j) Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry. At present, CDC has a long-term collaborative arrangement with the Research Institute of Influenza.

Topics that have been undertaken include studies on (a) smallpox, although a genome project on smallpox was approved but not implemented, (b) influenza surveillance, (c) rabies, (d) antimicrobial-resistant Streptococcus pneumoniae, (e) beta-lactamase resistance in gram-negative bacteria, (f) improvement of diagnostics for HIV and hepatitis in donor blood, (g) hepatitis C reference panels, (h) investigations of clinical isolates of M. tuberculosis, (i) tuberculosis clinical trials, (j) rapid diagnosis of susceptibility testing for M. tuberculosis, (k) laboratory determination of resistance to MDR-TB drugs, (l) molecular characterization of rubella virus strains in Russia, (m) rubella epidemiology and surveillance, (n) molecular diagnostics of mixed tick-borne infections (Ixodes persulcatus ticks), including tick-borne encephalitis and Lyme disease (borreliosis), Bartonella, and gastroenteritis viruses, and (o) Salmonella surveillance. The total cost to the U.S. government for 19 collaborations in these areas involving 13 Russian institutes has been about $12,200,000. Most of these projects have been successfully completed.

CDC also maintains technical relationships with different counterparts in Russia built around certain categorical disease issues. These involve joint participation in scientific meetings, seminars, and workshops. An example is collaborations on polio eradication. CDC is engaged with Russian partners in several studies on HIV, including mother-to-child transmission, attitudes toward HIV testing, seroprevalence studies, and development of pediatric AIDS guidelines, generally through the Global AIDS Program. Joint efforts also exist on tobacco control.

CDC took the lead in Russia in implementing joint efforts in tobacco control. An Adult Tobacco Survey became the foundation for the efforts of the Ministry of Health and Social Development to develop robust antismoking legislations.

There are occasional information exchanges between public health officials in Russia and CDC dealing with emergent issues, such as outbreaks of food-borne diseases or circulations of influenza strains. This informal dialogue has been in place for many years on a scientist-to-scientist basis, and considerable mutual respect has been engendered through these informal communications. In at least one case, contacts and communications were a direct result of personal friendships made during the early engagement with Vector scientists following the collapse of the Soviet Union.

Plans are in place for joint meetings between U.S. and Russian officials to discuss collaborations in health that will focus on tobacco control, food safety, HIV/AIDS, and TB, with CDC as a primary U.S. partner. However, CDC is primarily a technical agency with expertise in disease detection, surveillance, epidemiology, and laboratory capacity, in addition to public health program



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