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Appendix C.8 United States Agency for International Development The United States Agency for International Development (USAID) has sup- ported many programs in Russia, beginning in 1992. They have included pro- grams in the fields of health, environment, agriculture, and human welfare, as well as in many other areas of relevance to economic and social development. Among the programs that have been supported at levels of tens of millions of dollars during the past decade have been HIV/AIDS, tuberculosis, reproductive health, maternal and child health, and child welfare programs. Partnerships with the Russian Ministry of Health and Social Development, nongovernmental orga- nizations, and international agencies have provided frameworks for administering the activities and disseminating the results of programs. Given the vast scope of USAID’s involvement in Russia, with cumulative expenditures of more than $2.5 billion, this appendix provides but small snap- shots of health-related activities supported in 2003 and in 2010 that provide important examples of the types of work that have been emphasized. The program in 2003 included the following activities: • Promoted healthy lifestyles and HIV prevention among the youth. • Disseminated HIV/AIDS educational materials through a wide array of media outlets. • Offered technical assistance in support of multidrug-resistant tuberculo- sis control. • Supported marketing campaigns for condom use. • Supported training workshops and conferences, and upgraded laboratory equipment to improve diagnostic capabilities for sexually transmitted diseases. • Increased accessibility to quality medical care. 179
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180 APPENDIX C.8 • Improved maternal and childhood health programs. Activities in 2010 included the following: • Developed model tuberculosis treatment and drug-resistance prevention programs. • Supported AIDS training and education centers for medical professionals. • Fostered drug abuse prevention and rehabilitation services. • Developed standardized approaches to HIV prevention among injection drug users. • Disseminated HIV prevention education materials to high-risk populations. • Organized efforts to reduce neonatal mortality. • Provided teen health and family planning counseling. • Encouraged best practices in maternal and childhood health. In mid-2012, plans were under way to significantly reduce the level of USAID’s programs in Russia. Only two health-related areas were scheduled for continuation, namely control of tuberculosis and improvement of mother-child health. Activities related to HIV/AIDS had been removed, at least for the immedi- ate future, from further funding consideration. The Centers for Disease Control and Prevention was to provide the following services to address tuberculosis problems: • Evaluate methods for diagnosing TB, including the use of rapid tests that are registered and commercially available in Russia. • Conduct training courses for TB professionals and paramedical personnel. • Assist in the development of national standards and guidelines for effec- tive TB control, including training curricula. • Support participation of Russian specialists in international conferences and workshops. With regard to mother and child health issues, USAID partners were to focus on (a) putting into effect federal guidelines and best international practices and (b) improving the skills, resources, and services at the primary, secondary, and tertiary levels of care. A neonatal resuscitation training course was to be devel- oped in partnership with a Russian center. As to funding levels, in the late 1990s, USAID programs were funded at levels in the hundreds of millions of dollars annually. During the early 2000s, annual funding levels exceeded $50 million, including more than $10 million to support health-related activities. Then in September 2012, USAID announced its intention to terminate its
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APPENDIX C.8 181 Russia-based activities in response to the request of the Russian government. It was not immediately clear whether programs administered from Washington would continue in Russia, although the U.S. government vowed to stay engaged with Russian organizations with common interests. SOURCE: Information provided by USAID, Moscow, October 2011 and updated November 2012.
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