The deterioration of general TB epidemiological situation in Russia took place against a background of inflation, economic reform environment and a time of social change. Price liberalization deteriorated the situation of inflation. Macroeconomic stabilization tightened health budget and diminished medical inputs. Privatization and pro-longed wage arrears enlarged the income gap. Social environment change had caused a number of groups with low social-economic status to be easily affected by infectious diseases. The deterioration of standard of living made the TB situation even worse.
When it comes to tuberculosis, it is a disease that is bound to social conditions. Factors that affected the TB situation in Russia were macroeconomic destruction, worsening of standard of living, increasing number of unemployment and homeless, and these factors were due to political, economic, and social instability. Insufficient financing and the increase of unemployment rate, which caused the decline of X-ray coverage, aging of TB department medical member, and the follow-up treatment of patients from prisons are main tasks for the TB department (ministry of Public Health, RF) to face.
42% of the Russian TB problem is in prisons. The problem of MDR-TB is yet to be settled. Besides, HIV/TB coinfection speeds the deterioration of TB. The acceptance of different kind of statistics of TB epidemiology (for example, the inclusion of prisoners, armed forces, homeless, immigrants, in the list of form № 8) had a great influence on the raise of TB incidence and mortality rate in Russia.
European countries have registered rising tuberculosis (TB) over the last decade, and the situation in the countries of central and eastern Europe and the former Soviet countries is particularly serious. The principal reasons for the increase in TB in the region are:
1.poorly managed and outdated practices, which cause the increase in MDR-TB.
2.economic recession, poverty, malnutrition, alcohol/drug abuse, overcrowded prisons, lack of access to health care.
3.immigration from TB high-burden countries(to western Europe countries).
4.increasing rates of HIV infection, HIV/TB coinfection leads to high mortality rate.
Reasons 1,2,4 discussed above are the case in Russia.