Did you know Friday is World Tuberculosis Day? You do now.
Ukrainian? In Ukraine? A Ukraine-watcher, whatever that means? Here’s a list of ten things you should know about TB in Ukraine:
- The TB incidence rate in Ukraine in 2016 was 67.6 per 100,000 persons – which, for perspective, is anywhere from ten to twenty times the rate in countries like the US, the UK or Canada (to say nothing of the absurdly high rates among First Nations and Inuit in Canada, but I digress).
- Fewer Ukrainians were diagnosed with TB in 2016 than in 2015 – a 4.3% decrease in the number of new diagnoses. Good.
- Ukraine has, alongside Russia, a spot on the World Health Organization’s (WHO) list of 20 countries with the highest estimated burdens of multidrug-resistant tuberculosis (MDR-TB). There’s more than 8,000 new cases of MDR-TB registered in Ukraine every year, and it’s increasing. That’s bad.
- Anyone can get TB in Ukraine, including children – especially if you don’t vaccinate them. OMFG BCG vaccine pls FFS.
- TB’s still a disease concentrated in at-risk groups in Ukraine. According to stats from Ukraine’s Public Health Center (thankfully renamed from the unwieldy “Ukrainian Center for Social Disease Control of the Ministry of Healthcare of Ukraine”), around 70% of new TB cases in 2014 were in so-called “socially vulnerable groups” like unemployed people of working age and drug/alcohol abusers. (NB. these are the most recent breakdowns they seem to have but I don’t see any reason why these would’ve changed at all over 2015/16).
- One the major groups of people at risk of TB, particularly MDR-TB, are people with HIV/AIDS. As I wrote about earlier this week, more than half (52%) of deaths from AIDS-related causes in Ukraine last year were from TB – much higher than the one-third of deaths globally from TB in people with AIDS.
- HIV/TB co-infection is increasing in Ukraine – a “noticeable increase” according to the Public Health Center, increasing year-on-year from 2013. All this “[reflects] the increasing burden of HIV infection in the country.”
- There aren’t any numbers on TB, HIV or anything coming out of the non-Ukrainian-government-controlled parts of Donetsk and Luhansk oblasts (“DNR”/”LNR”), but everyone assumes the TB situation there is pretty bad. One senior international official I spoke to last month told me “we hear about used needles, terrible conditions there” with the at-risk population in the east – largely in and around Donetsk, which has long been an HIV hotspot in Ukraine. “I’d say of course HIV is growing there, TB is growing there, because the conditions in which they are spending time in is terrible,” this official told me.
- As Oksana Grytsenko reported in the Kyiv Post a few days ago, Ukraine struggles to provide effective TB treatment. Read her piece. No point in me rehashing it here, other than to add this quote from the Public Health Center: “Especially dangerous is the untimely addresses for medical assistance, late TB diagnostics, and HIV/TB co-infection, which causes a high level of mortality due to TB and results from the lack of a comprehensive approach to the combination of preventive and treatment programs at the national and regional levels into a single system of counteraction”
- There’s cause for some cautious optimism, I think. To plug again what I wrote about HIV earlier this week, state funding for TB treatment is being increased in 2017 and activists I spoke to seemed confident that the Ministry of Health and the government as a whole is (re)recognizing HIV/TB as a priority. Still, we’ll see.