CDC in Russia
Russia at a Glance
- Population: 142,847,000
- Per capita income: $18,330
- Life expectancy at birth women/men: 75/63 yrs
- Infant mortality rate: 8.1/1000 live births
The Centers for Disease Control and Prevention (CDC) has collaborated with the Ministry of Health, the Russian public health agency Rospotrebnadzor, the Russian Federal AIDS Center, and regional institutions since 2006 to build the capacity of Russian institutions in HIV/AIDS strategic information. Other activities include building capacity in both regular and multi-drug-resistant tuberculosis (TB) control, HIV-related reproductive health, and tobacco control studies.
The HIV epidemic in Eastern Europe has increased more than any regional epidemic since 2001, and Russia’s epidemic is the largest in the region with more than 900,000 persons estimated to be living with HIV/AIDS. The government of Russia (GOR) is providing more antiretroviral (ARV) treatment and supporting large scale HIV testing at medical and penal institutions. However, the GOR has provided only limited or no HIV prevention activities and care and treatment programs for the populations most-at-risk (MARP). Global Fund prevention projects no longer operate in Russia. CDC is currently building the capacity of GOR institutions, through the President’s Emergency Plan for AIDS Relief (PEPFAR), to improve data collection among MARPs to strengthen the information available for planning HIV control and treatment measures. This initiative is supported by the Russian public health agency, Rospotrebnadzor, and the Russian Federal AIDS Center. The project is seen as a potential model to incorporate into the current national HIV surveillance system. MARPs surveys conducted within CDC-supported projects are already included in the national HIV surveillance plan. Previous projects included supporting enhanced surveillance of mother-to-child-transmission in St. Petersburg.
With the central TB institutes and three regional health authorities, CDC builds capacity through training health care workers in directly observed therapy, MDR TB, operations research, mycobacteriology, and infection control. CDC also strengthens regional and federal TB labratories with current diagnostic technologies and strengthened laboratory systems. CDC established a “Center of Excellence” for infection control in the Vladimir region which now conducts trainings for health care workers from many other regions, including many physicians, nurses, and microbiologists.
Impact in Russia
- 58 government and non-government staff trained in surveillance for populations most at risk
- CDC-supported enhanced HIV surveillance proposed as model for a national system
- Better TB worker training, laboratory capacity, and infection control in TB facilities led to improved response to multi-drug-resistant TB threat
- Trends prevention of mother-to-child transmission (PMTC) and risk factors for HIV transmission to infants found; PMTCT guidelines improved
- Data from a survey on tobacco use was used to develop anti-smoking public health measures
The rapid expansion of the HIV epidemic in the late 1990s led to a rapidly increasing need to improve the prevention of mother-to-child transmission of HIV (PMTCT). From 2003-2012, CDC developed various projects in St. Petersburg funded by USAID including an enhanced PMTCT surveillance project and a study that examined contraception choice, effectiveness, and safety among more than 700 HIV-infected women. The enhanced surveillance findings supported increasing triple ARV regimens. The reproductive health studies documented the need for highly effective contraception among HIV-infected women and the acceptability and significantly increased effective contraception use among HIV-infected women when contraceptive services are integrated into HIV clinical care. Analyses are currently underway to examine rates of effectiveness and safety.
Russia faces a tobacco epidemic due to widespread smoking. The Global Adult Tobacco Survey (GATS) was conducted in 2009 as a household survey of persons 15 years of age and older by the Statistics of Russia under the Federal State Statistics Service (Rosstat) and the Pulmonary Research Institute (PRI), under the coordination of the Ministry of Health and Social Development of the Russian Federation (MoHSD). GATS found that nearly 43.9 million of the nation’s adults are smokers; 60.2% of men and 21.7% of women smoke. The vast majority of adults (90.8%) believe smoking causes serious illness and a large majority (81.0%) support smoking bans in the workplaces. Additionally, a great majority of adults (82.5%) favor banning all advertising of tobacco products. Prime Minister Vladimir Putin recently signed the national tobacco control strategy “Concept of creation of a public policy to combat tobacco consumption from 2010-2015” to protect the country’s people from the impact of tobacco use.
CDC works with the WHO Regional Office for Europe to provide immunization technical and laboratory assistance to the Russian Federation Ministry of Health. Although the European Region eliminated polio in 2002, there have been poliovirus importations that have led to outbreaks, including 14 cases of wild poliovirus reported in Russia in 2010. To prevent further cases of polio in Russia, CDC provides technical assistance by conducting polio importation risk assessments. CDC also supports measles and rubella elimination in Russia by providing epidemiologic analysis of reported data. Russia plays a leadership role for immunization in the sub-region, and CDC supports that role by providing assistance to ensure Russia remains polio-free, achieves measles and rubella elimination, and strengthens its routine immunization program.
Top 10 Causes of DeathSource: WHO World Health Statistics 2006
- Ischaemic heart disease 30 %
- Cerebrovascular disease 22%
- Poisoning 3 %
- Self inflicted injuries 3%
- Trachea, bronchus, lung cancers 2%
- Violence 2%
- Road traffic accidents 2%
- Stomach cancer 2%
- Colon and rectum cancers 2%
- Cirrhosis of the liver 2%
Supported by CDC research, collaborations, or technical assistance (no staff or physical presence)
1 Locally Employed