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