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The East: Prisons: Tuberculosis The Scourge Of Jails In Russia, Belarus, Kazakhstan

London, 1 October 1998 (RFE/RL) -- International health authorities are concerned about a new and deadly strain of tuberculosis in overcrowded prisons in Russia, fearing it may spread to epidemic levels in the outside general population.

The danger comes from a mutant form of tuberculosis called multi-drug resistant TB - MDR-TB - which sometimes results when an ordinary TB sufferer receives sub-standard treatment. Usually, it develops when medical treatment is interrupted or reduced, something increasingly common because of drug shortages.

Health experts say Russian jails are thought to have up to 20,000 prisoners infected with the new TB strain. They fear the sufferers will spread the disease to healthy prisoners, thence to the outside. MDR-TB is more likely to kill than common TB and treatment takes much longer and is much more expensive. Vivien Stern, secretary general of Penal Reform International, which campaigns for better prison conditions worldwide, says the new infection is difficult to control.

"One of the most serious problems in prisons in the region is the high incidence of tuberculosis. It's extraordinarily high in Kazakhstan, Russia and some other countries. What's even more disturbing is the emergence of a new strain of tuberculosis called multi-drug resistant tuberculosis, which affects people who have taken some TB medicines, but not for long enough. Therefore the germ develops into something that is extremely hard to combat."

The United States Public Health Research Institute and British and French aid agencies, Merlin and Medicins san Frontieres, recently appealed for funds to fight the new TB strain. In a joint statement, they said that MDR-TB of Russian origin will inevitably become a worldwide threat unless confronted. They said more than 150 million dollars is needed to treat existing cases.

Alex Goldfarb, director of the Russian TB Project, funded by U.S. philanthropist George Soros, said if the money is not spent soon, the cost of the epidemic to the world, as he put it: "will be counted in thousands of millions, and may become unmanageable." Vivien Stern, author of a recent book on prison conditions worldwide, including the former Soviet republics, says that families could be at risk:

"It's a very dangerous health hazard, not just for prisoners, but also for all those who are released from prison, go back to their towns, cities and villages, live with their families, and pass on the infection to their families and other people in the area."

Prison reformers say prisons in the former Soviet Union compound the problem because they are chronically overcrowded and insanitary, and are thus breeding grounds for TB.

What's the best way to tackle the problem? Penal reformers say an urgent first step is to reduce overcrowding in prisons, a priority in countries like Russia, Kazakhstan and Belarus that have among the highest prison populations in the world relative to population.

(Second of four parts)