Publication: Monitor Volume: 4 Issue: 177

Malnutrition is spreading rapidly throughout Russia, according to the leading Western authority on health issues in the former USSR. Professor Murray Feshbach of Georgetown University told the American Association for the Advancement of Slavic Studies annual convention in Florida on September 25 that, while starvation is not a danger in Russia, malnutrition does represent a serious threat. A Monitor correspondent attended the session.

At present, the majority of all deaths in Russia are caused by cancer or heart disease. By 2004 or 2005, however, Professor Feshbach expects to see a major shift toward deaths from infectious and parasitic diseases, especially (1) tuberculosis (TB), (2) HIV/AIDS and (3) syphilis.

(1) There are officially reported to be between 70,000 and 80,000 new cases of tuberculosis in Russia each year. The more likely figure in Feshbach’s opinion is 100,000-150,000, because the official figure may not include Russia’s one million prison population or its homeless and refugee populations. Fifty percent of prison inmates are believed to have TB, of whom between 10 and 20 percent suffer from the multidrug resistant (MDR) strain that is not readily amenable to treatment. At present, 25,000 people a year die from TB. That number is rising.

(2) There is a clear and present danger of an explosion on HIV/AIDS in Russia. This reflects increasing use of hard drugs, with an estimated two million users in Russia at present. The U.S. experience suggests that, when MDR TB moves in, the death rate from HIV/AIDS goes up sharply. The Russian Health Ministry projects 800,000 cases of HIV in Russia by 2000. Russia is, in Feshbach’s view, emulating the U.S. experience with a lag of ten years.

(3) Russia is experiencing an explosion of syphilis and chlamydia, both of which are potential precursors of HIV/AIDS. Rates are especially high among young females, with the number of girls aged ten to fourteen infected increasing thirty times between 1990 and 1994. The diseases go largely unreported because the patients often do not recognize the symptoms. The diseases are flourishing in an environment where prostitution has increased sharply. Poor health among young women has a direct impact on the health of the next generation. Much of the blame lies with the shortage of funding for the health system. (For further information, see Murray Feshbach, “Environmental and Health Problems in the former Soviet Union: Does It Matter to the United States?” Center for Strategic and International Studies, Washington, D.C., August 1998.)