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Cablegate: Russia Making Progress On Berlin Tb Declaration

VZCZCXRO1337
RR RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHMO #0575/01 0601417
ZNR UUUUU ZZH
R 291417Z FEB 08
FM AMEMBASSY MOSCOW
TO RUEHC/SECSTATE WASHDC 6889
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHYG/AMCONSUL YEKATERINBURG 3062
RUEHVK/AMCONSUL VLADIVOSTOK 2720
RUEHZN/EST COLLECTIVE
RUEHPH/CDC ATLANTA GA

UNCLAS SECTION 01 OF 02 MOSCOW 000575

SIPDIS

SENSITIVE
SIPDIS

DEPARTMENT FOR OES/IHB (LAURITZEN) AND EUR/PGI (TESSLER)
USAID FOR GH, E&E
HHS FOR OGHA

E.O. 12958: N/A
TAGS: TBIO SCUL SOCI WHO RS
SUBJECT: RUSSIA MAKING PROGRESS ON BERLIN TB DECLARATION

REF: A. 08 State 6989

B. 07 Moscow 4543
C. 06 Moscow 12876
D. 07 Moscow 2847
E. 08 Moscow 536

MOSCOW 00000575 001.2 OF 002


THIS CABLE IS SENSITIVE BUT UNCLASSIFIED. NOT FOR INTERNET
DISTRIBUTION.

1. (SBU) SUMMARY: Russia has made effective progress in
implementing the Berlin Declaration on Tuberculosis (TB). The
Russian Government's adoption of the Berlin Declaration confirmed
Russia's political commitment to TB control. The GOR continues to
focus its attention on TB control and treatment, and the development
of regional pilot programs supported by the USG, World Health
Organization, international NGOs, and the Global Fund to Fight AIDS,
TB and Malaria. TB rates in Russia have stabilized within the
general population, albeit at a high level, and are dramatically
declining within prisons, though they are still almost five times
higher than the civilian rates (Ref B). While cases of drug
resistant TB and TB/HIV co-infections are growing, the GOR,
international donor community, NGOs, and the U.S. and Russian
pharmaceutical sector are devoting substantial resources to
combating these new and deadly infections. Russia is also emerging
as an international health donor and repaying its Global Fund grants
(Ref C). END SUMMARY.

2. (U) Per Ref A request, this cable summarizes Russia's progress in
implementing the Berlin Declaration on TB. As discussed in Ref B,
the World Health Organization (WHO) ranks Russia twelfth on the list
of the world's 22 high burden TB countries. According to statistics
published by the Ministry of Health and Social Development (MOHSD),
Russia registered 117,646 new cases of TB in 2006 (a rate of 82.4
cases per 100,000 people), a decline of 1.3 percent compared to
2005. TB mortality has declined in recent years from 21.9 deaths
recorded per 100,000 population in 2002 to 19.5 deaths per 100,000
in 2006. The TB situation in Russian prisons has dramatically
improved over the last seven years. A threefold decline of both the
prevalence of TB cases in prisons and TB mortality has been
registered since 1999. This progress was achieved thanks to the
joint efforts of the penitentiary and civilian health care systems
and international organizations working closely together to resolve
questions of TB drug supply, laboratory and testing capacity, and
training of health care personnel.

3. (U) Multi-drug resistant TB (MDR-TB) cases have gradually
increased over the past seven years (Ref B), and the issue remains
high on the agenda of both the GOR and international organizations.
Through the combined efforts of the GOR and international donors,
laboratory testing and diagnostics capacity for drug resistant TB in
regional and central labs has significantly improved over the last
two years. U.S. and Russian pharmaceutical companies have also
played a constructive role. U.S. drug company Eli Lilly's MDR-TB
partnership has worked with SIA International, one of Russia's
leading pharmaceutical manufacturers, to transfer know-how and
technology to Russia so that second line TB drugs can be produced
domestically (Ref D).

4. (U) TB/HIV co-infection is a growing problem. TB is the leading
cause of death among people with HIV/AIDS, accounting for 59 percent
of all deaths among this group in 2006 (Ref E). The MOHSD has
established a center for treating HIV/TB co-infections, which is
tasked with monitoring the epidemiological situation and developing
guidelines for treatment of patients with TB/HIV co-infections.

5. (SBU) In contrast to most other high burden TB countries, Russia
spends massively on TB control and treatment. The GOR slightly
modified its five year budget estimate for the TB program in
February 2008, increasing the budget by $8 million, to over one
billion dollars for the period 2007 to 2011. The Russian federal
and regional governments together spent $280 million on TB control
and treatment in 2006 and 2007, and will spend similar amounts in
2008. Most regions currently have a stockpile of first line TB
drugs available in both the civilian and penitentiary systems, and
federal level funding for provision of second-line drugs is growing
significantly. Second line drugs are not available in most regions
in Russia, even though officially 18 regions are approved by the WHO
Green Light Committee to provide second line drugs. Only three
regions have received these drugs through the international
procurement system set up by the WHO Stop TB partnership. The WHO
and international donors continue to work with the MOHSD to resolve
the issue of availability of second line TB drugs.

6. (U) Through 2006, the WHO revised TB control strategy of Directly

MOSCOW 00000575 002.2 OF 002


Observed Therapy Short Course (DOTS) had been officially adopted in
nearly all Russian regions with the support of USG, WHO, World Bank
and Global Fund grants. New TB treatment standards and new TB
reporting requirements have already been implemented in 68 Russian
regions which cover 83 percent of Russia's population.

BURNS

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