Western versus post-Soviet medicine: Fighting tuberculosis and HIV in North-West Russia and the Baltic states

Abstract

Western governments and international organizations have since the late 1990s been involved in efforts to combat tuberculosis and HIV in north-west Russia and the Baltic states, and reform the post-Soviet healthcare system. WHO's tuberculosis strategy DOTS encountered fierce resistance in the Russian tuberculosis establishment, but has been implemented in the north-western rim regions in Russia and all Baltic states. While many view Western aid as a welcome contribution, others feel the problems are exaggerated by the West. The Western emphasis on prison reform and sex workers also meets resistance in the post-Soviet context.