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Infectious Diseases: How to Achieve the UN Sustainable Development Goals by 2030?

13 February 2019

KEY CONCLUSIONS 

Fighting infectious disease is one of the crucial tasks of healthcare

“Thanks to the Health Ministry’s effort we have managed to succeed in reduction of the tuberculosis mortality rate, elimination of rubella, reduction of the HIV-infection mortality rate. However, the situation with infectious diseases is grave,” Guzel Ulumbekova, President of the Board, Association of Medical Societies for Quality of Medical Care and Medical Education; Head, Higher School of Healthcare Organization and Management.

Coordinated effort of state, medical and scientific community is key to success in fighting infectious diseases

“We see our role in cooperation with the state, expert communities, and doctors. I don’t think we should invent anything, we should use the progress, the best practices that have proved to be efficient in various countries,” said Oleg Dubyansky, Vice President of GSK Russia. 

“We can come up with a comprehensive programme for HIV, AIDS, tuberculosis, and hepatitis. We can arrange joint headquarters, which will include all institutions that address these conditions. Those can be reinforced by mathematicians and epidemiologists who will make calculations and design models of how various factors will impact the development of epidemics,” Melita Vujnovic, Representative to the Russian Federation, Head of Country Office in the Russian Federation, World Health Organization.


PROBLEMS

High mortality rate compared to western countries

“Infectious diseases only account for 2% of total mortality, which makes it 35 thousand people. However, it’s almost 4 times more than in new and old EU countries. <…> The biggest problem is mortality in the working age population. 29 thousand out of 35 thousand deaths from infectious diseases occur in the working age population. The mortality rate among 30–44-year-olds is very high, 16 times higher than in the new EU countries,” Guzel Ulumbekova, President of the Board, Association of Medical Societies for Quality of Medical Care and Medical Education; Head, Higher School of Healthcare Organization and Management.


Innovative solutions in healthcare requires increased funding

“Advances in therapy create new challenges. Cured children live, but they require substantial rehabilitation. At the anniversary of our centre we presented a child who had to undergo amputation of both legs. The boy already has prostheses, he walks, however, the rehabilitation costs of this one child add up to 22 million roubles,” Yury Lobzin, Director, Children’s Clinical Research Centre for Infectious Diseases, Federal Biomedical Agency.  

Low adult vaccination coverage rate

“A major challenge, which is worth speaking of and which we are currently closely dealing with, is adult vaccination. All adults need it. <…> Almost all countries are facing this problem: 82% of countries claim that the trust in vaccination is going down, and it affects Russia as well,” Nikolay Briko, Head, Department of Epidemiology and Evidence-Based Medicine, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation.

Shortage of qualified professionals

“Today, there are 4.5 thousand paediatric infectious diseases specialists. Around 2 thousand are employed by outpatient clinics, the others — by in-patient hospitals. It seems like a huge armada, but in fact they meet about 50% of the demand, and in some regions only 12 or 15% in the outpatient sector; at in-patient hospitals it’s a little better. This is one side of things. The other side is the decree of March 2018 that approved the professional standard for infectious diseases. 40% of paediatric infectious diseases specialists urgently require improvement. They need training,” Yury Lobzin, Director, Children’s Clinical Research Centre for Infectious Diseases, Federal Biomedical Agency.


SOLUTIONS

Proper long-term planning

“As manufacturers, we don’t clearly understand when, which vaccine and how much of it is required from the production perspective. <…> We would like to have a simple document that would define which vaccines are required, the quantity thereof, delivery year, what stages of production must be performed in Russia, etc.,” Vladimir Khristenko, President of Nanolek. 

“We must set other goals: to defeat epidemics once and for all. Speaking about elimination thereof or a victory over epidemics is a totally different scale of ambition. We need to reset new goals, not only to reduce by 2% or 5% or fight some phenomena related to morbidity from an infection, but to set new ambitious goals,” Vinay Patrick Saldanha, Director, Regional Support Team for Eastern Europe and Central Asia, UNAIDS, Head of UN team in Russia 

Higher quality professional training

“The most important thing is training professionals. Because we may have good intentions, we may have unlimited funding – or so I hope – but if we don’t have well-trained staff, we won’t be able to accomplish anything,” Sergei Kraevoi, Deputy Minister of Healthcare of the Russian Federation.

Preventive measures priority

“Vaccination is the best way of prevention. Many countries now are adopting what is called life-course vaccination,” Marwan Aqar CEO, MSD in Russia.

“The major measures we arrange in our areas are the full anti-tuberculosis vaccination coverage of population and early diagnosis. In 2018, we solved the problem with a supply of early diagnosis medications for our healthcare providers, which is crucial for tuberculosis prevention,” Vladimir Uyba, Director, Federal Medical and Biological Agency of Russia.

Improving diagnosis

“Further improvements of diagnosis are required. An accurate and timely diagnosis, accurate identification of pathogen susceptibility allows us to prescribe adequate specific treatment, thus achieving the key objective,” Sergei Kraevoi, Deputy Minister of Healthcare of the Russian Federation.

Digitalization of healthcare

“We should provide consistent treatment. It means that healthcare coverage is guaranteed by the constitution. We should provide any patient in any village of Russia at any moment of time with access to care. So that the patient won’t have to think if he is going to have his medicine tomorrow. <…> The system must be digitalized so that the central authority — the Healthcare Ministry — could know which areas fall short of medications,” Melita Vujnovic, Representative to the Russian Federation, Head of Country Office in the Russian Federation, World Health Organization.

Development programmes address regional specifics

“The programme for monitoring and elimination of viral hepatitis must address specific characteristics of the ongoing epidemic process and must obviously address regional specifics. Our country is very big with different opportunities in different regions, therefore, this programme is to be adjusted to each region,” Elena Malinnikova, Head, Department of Virology, Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation.

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