Russian men and women face far shorter life expectancies than people in developed countries - as much as 14 years shorter than their neighbors in Europe.
Russian men and women face far shorter life expectancies than people in developed countries - as much as 14 years shorter than their neighbors in Europe. Since 2003, Russian authorities, local institutions and international partners have worked together to address the social problems and institutional constraints contributing to Russia’s poor health profile, yielding significant results, particularly in fighting tuberculosis and HIV/AIDS.
Challange
Russian men and women today have a combined life expectancy of 66, about 14 years below the life expectancy of those in the European Union. High mortality and morbidity rates are caused primarily by non-communicable diseases (e.g., heart disease, strokes, cancer) and injuries, mostly from road traffic crashes. These are influenced by the aging of the population, urbanization, changing lifestyles, and risky behaviors, including smoking, alcohol abuse, poor nutrition, and sedentary lifestyles.
At the same time, since the early 1990s, factors including poverty, under-funding of health services, and technical inadequacies have also contributed to Russia having one of the highest rates of tuberculosis (TB) in the world. This has been aggravated by the spread of multi-drug resistant TB and HIV/AIDS.
Approach
Since 2003, the International Bank for Reconstruction and Development (IBRD) has financed two federal-level investment projects in the health sector in Russia, in partnership with the International Finance Corporation (IFC). A TB/AIDS Control Project developed policies, standards and guidelines in line with international standards for prevention, diagnosis, treatment and follow–up of patients with TB and HIV, with a particular focus on prisoners. A health reform project tested new approaches to restructuring the organization of health service delivery, and a third project is building capacity to prevent and treat cardiovascular diseases and trauma.
Results
New guidelines for HIV/AIDS prevention, diagnosis and treatment were developed by the Ministry of Health and Social Development from 2005 to 2007, helping put in place a new normative framework for service delivery in Russia. Health service improvements contributed to decreased infant mortality rates and increased life expectancy of the population (above the average in the country) in the Chuvash Republic and Voronezh Oblast—the pilot regions under the health reform project.
TB mortality in the total population decreased by 15.4 percent from 2006 to 2007, and among prisoners – the most affected group – TB deaths dropped by 37.5 percent. There was also a 72.7 percent increase in TB patients receiving the standardized treatment regimen, including directly observed treatment.
The rate of increase in HIV prevalence dropped by 7.7 percent between 2006 and 2008. HIV-positive infants born to HIV-infected women decreased from 13.6 percent to 9.8 percent between 2004 and 2008.