FORSE IN RUSSIA CI SONO PROBLEMI PIU' URGENTI DELLA GEORGIA.....

Sfogliando l'Economist mi hanno incuriosito alcune cifre riguardo la demografia russa e lo stato (del tutto pietoso) del suo sistema sanitario. Alcuni, come il demografo Murray Feshbach, propendono per proiezioni abbastanza estreme. Altri sono piu' cauti. Nondimeno, i dati relativi agli scorsi 15 anni sembrano parlare abbastanza chiaro e le cifre sulla crescente diffusione di HIV/AIDS, epatite e tubercolosi fanno in effetti una certa impressione (per l'OMS, tra il 45% ed il 55% delle prostitute di San Pietroburgo ha l'HIV. Dunque, watch out se siete nei paraggi!!)
Potrebbe essere interessante contrastare il caso russo con quello della Thailandia (che dalla prima meta' degli anni novanta in poi ha fatto della lotta all'AIDS un primario obiettivo, con estese campagne di prevenzione/informazione) e quello del Sud-Africa, ove sempre l'OMS ritiene che il 30% almeno delle donne gravide rechi il virus dell'HIV. Il Sud-Africa e' spesso citato come un paese che ha vissuto a lungo in uno stato di public denial del fenomeno (vedi la tardiva, malcerta confessione da parte di Mandela circa la morte del figlio a causa del virus), in tal modo ritardando ogni possibile misura correttiva. Per molti, la Russia assomiglia oggi piu' al Sud Africa che alla Thailandia. Naturalmente, molte di queste cifre si prestano a manipolazioni allegre, sptutto allorquando la Russia (ri)diventa bersaglio politico. Per esempio, nel 2007 pur continuando il trend di crescita negativa della popolazione, il decremento netto in Russia e' stato molto al di sotto della media dei precedenti 15 anni, situandosi attorno alle 280,000 unita' (fonte: Max Planck Institute for Demographic Research, che e' in linea con i dati rilasciati dall'istituto russo di statistica e diffusi dal New York Times nell'aprile scorso. Inoltre: life expectancy maschile sotto i 60 anni e fertility rate a circa 1.35, ben sotto il replacement rate). Tuttavia, per l'Economist (la mia speculation e' che spesso le cifre vengono usate per fomentare l'ardore politico/retorico e nulla piu') sono invece state 800,000. Cio' non toglie che forse ci sarebbero temi piu' urgenti da affrontare per il well-being dei cittadini russi che non le enclavi caucasiche. In ogni caso, ecco un abstract sul tema:


Wilson Center Senior Scholar Murray Feshbach paints a dismal picture of health and population trends in Russia, even by his conservative estimates. By 2050, he predicts, Russia will lose at least a third of its current population. Disease, environmental hazards, and a decline in healthy newborns underlie this staggering statistic.

In Russia, deaths far outnumber births. Meanwhile, only a third of Russian babies are born healthy and last year's child health census showed that some 50 to 60 percent of all Russian children suffer from a chronic illness. Current mortality rates reflect the very high share of deaths between ages 20 and 49, potentially the most productive population segment. Such a population decline has a devastating impact on the labor force, military recruitment, and family formation.

By 2050, said Feshbach, Russia's current population of 144 million could fall to 101 million or as low as 77 million if factoring in the AIDS epidemic. Russia and Ukraine have the fastest growing rates of new HIV/AIDS cases in the world, reported Feshbach in his 2003 study, Russia's Health and Demographic Crises: Policy Implications and Consequences, published by the Chemical and Biological Arms Control Institute. If current trends continue, by 2020, 5-14 million Russians will be living with HIV and 250,000-650,000 will die from AIDS annually.

Other sexually transmitted diseases (STDs) are propagating, as well, particularly syphilis. Initially spread through drug use and prostitution, STDs now are proliferating by heterosexual transmission. Another disease on the rise is tuberculosis (TB). In 2001, 781 Americans died from TB while Russia, with half America's population, had nearly 30,000 TB deaths. The same year, 18,000 Americans died from AIDS. Yet by 2010, at least four times that number will die from AIDS in Russia. Unfortunately, Russian government statistics remain optimistic, rather than realistic, diverting attention and funding from research and treatment.

Feshbach, an economist and demographer, has visited Moscow 53 times throughout his career. He worked in the Foreign Demographic Analysis Division of the U.S. Census Bureau for 25 years and later taught courses at Georgetown University on demography, health, and the environment in the Soviet Union for more than 20 years. Feshbach was a Wilson Center fellow during 1978-1979, after which he co-authored a 1980 report depicting the Soviet health crisis, exposing rising infant mortality and the negative impact of understated official statistics.

Economist Vladimir Treml of Duke University, in his 1999 book Censorship, Access, and Influence, wrote, "Several of my colleagues and I visiting Moscow in the early 1980s heard Soviet demographers and economists saying 'Feshbach saved thousands of infant lives in the Soviet Union,' implying that the Davis/Feshbach study was made available to high Soviet authorities, who directed certain (apparently beneficial) changes in public health policies."

Today, Feshbach continues his lifelong work to study the trends and impact of Russia's health and demographic crises. He is an investigator for a USAID project to track and analyze HIV/AIDS, TB, and other diseases in Russia and their impact on Russia's social transition.

Feshbach said, "I think the reason the Russians haven't paid attention [to this crisis], is that not enough people have died yet to capture their appropriate concern."