Refusal of international assistance threatens the Russian Federation with an outbreak of tuberculosis

Employees of Russian medical non-profit organizations (NPOs) say that a number of regional clinics are faced with a shortage or complete absence of anti-tuberculosis drugs, which, in turn, is fraught with a surge in mortality among this category of patients. They directly link this situation with the refusal of the Ministry of Health and Social Development of the Russian Federation to receive financial assistance from the Global Fund to Fight AIDS, Tuberculosis and Malaria. To combat diseases, the fund was ready to transfer $127 million to the Russian Federation, but in response, Russia itself declared its desire to become a donor to this international organization.

The situation with tuberculosis treatment in Russian hospitals began to deteriorate in February, NGO representatives say. Denis Godlevsky, a member of the International Coalition for Preparedness for HIV/AIDS Treatment in Eastern and Central Europe, draws attention to the fact that patients in St. Petersburg hospitals began to die from the almost complete lack of medicines. “The fact is that money and medicine from the federal center have stopped reaching even St. Petersburg, not to mention other regions,” he says. According to Mr. Godlevsky, the St. Petersburg prison hospital named after Gaza, where about 30 people died from HIV and tuberculosis in the first half of 2011, received no financial assistance at all in 2012. According to a Kommersant source in medical circles, “now the situation in many other regions is close to critical: in Ulyanovsk, for example, there are practically no drugs at all, and there is not enough money for purchases.” By autumn, he says, experts predict a “very serious outbreak of tuberculosis” in the regions.

According to representatives of NGOs, the shortage of drugs is directly related to Russia’s refusal to receive financial assistance from the Global Fund to Fight AIDS, Tuberculosis and Malaria, one of the largest international distributors of charitable assistance. As part of the five-year Global Fund program in 2010, Russia was allocated about $127 million to fight tuberculosis. It was assumed that as part of the project, about 20 thousand people suffering from severe forms of tuberculosis would receive medicines.

However, later, one of the authors of the application for a grant from the Global Fund, the head of the Research Institute of Epidemiology, Valentin Pokrovsky, received a letter from the Deputy Head of the Ministry of Health, Veronica Skvortsova, which stated that the Russian Federation no longer needed foreign assistance. “Russia is acquiring the status of a donor country of the Global Fund. Taking this into account, we consider the participation of the Russian side in the application inappropriate,” the letter says.

Nevertheless, the Global Fund approved the application for financial assistance, adding that if the NGO and the ministry do not reach a consensus by March 20, 2012, they will be forced to withdraw the grant. The other day, the director of the Global Fund's country programs office, Mark Eldon-Edington, notified that "the grant will not be allocated and this decision cannot be appealed."

Representatives of the Ministry of Health have a different view of the situation. On Friday, Deputy Director of the Department for the Organization of Medical Prevention, Medical Care and Health Development Lyudmila Mikhailova told reporters that the Global Fund program to combat tuberculosis is ineffective and in the regions where it operates, mortality rates from this disease are only increasing. At the same time, according to a statement from the Ministry of Health released on Friday, starting in 2009, “the incidence of tuberculosis began to decline.” Over three years, the department says, the incidence rate decreased by 14.2% compared to 2008. “The mortality rate from tuberculosis has decreased by 38.5% compared to 2005,” the Ministry of Health said in a statement.

“But these figures are very crafty: in fact, there are no statistics on tuberculosis in the public domain, there are figures for the media, and there are for the authorities, which no one, of course, shows,” says Mr. Godlevsky. According to him, the assistance of the Global Fund has long been a serious help for Russian medicine and allowed many patients to survive.

Grigory Tumanov

Tuberculosis developed under conditions of donation