August 8, 2013 -- Editor’s Note: In advance of the many health-related discussions to take place in September at the Clinton Global Initiative, the Social Good Summit, UN week and other such events, the Skoll World Forum asked some of the world’s leading voices in global health to paint a comprehensive picture of key trends, challenges and opportunities to realizing healthcare access and treatment around the world. A new piece will be posted everyday through Friday, and you can view the entire series here.
Dr. George Gotsadze, MD, PhD, has more than 15 years of experience in health policy and systems. Since 1996, he has led Georgian think tank Curatio International Foundation, which focuses on health policy and health systems issues, primarily in the post-Soviet states.
Rahim Kanani: When we talk about public health in countries of the former Soviet Union, what should the world know that might surprise them?
George Gotsadze: The Soviet Union managed to achieve significant health gains for its nations under its health care system. But after the Soviet Union fell in 1991, the independent post-Soviet states failed to sustain and expand these achievements. As a result, the health of these nations deteriorated. Tuberculosis (TB) reemerged. Malaria, which was once fully eliminated, came back in some countries. Immunization rates fell, which triggered vaccine-preventable disease outbreaks that spread across borders. And increased heroin trafficking from Afghanistan fueled substance abuse, which was followed by the HIV/AIDS epidemic. According to UNAIDS, this region now faces the fastest-growing HIV/AIDS epidemic in the world.
While over two decades the post-Soviet governments have managed to deal with reemerged diseases, TB and HIV/AIDS yet have not been brought under control, and they continue to threaten the region. Health care delivery systems, which were relatively well developed during Soviet days, deteriorated because the governments weren’t able to adequately invest in capital and human resources. This underinvesting in skilled medical workers and other human resources adversely affected the quality of services patients received and their treatment outcomes. On top of all this, the universally free entitlement to health care that was guaranteed in the Soviet constitution evaporated when many governments could not financially sustain and deliver needed services.
Now, most people in the region face significant financial barriers to getting health care when they need it. Poor health places an enormous financial burden on households, driving them into poverty. It also adversely affects the nations’ economic prospects. While many nations saw significant health gains over the past few decades, according to the World Bank, progress in health among the former Soviet states—as measured by indicators such as life expectancy—has been among the slowest in the world. PATH has been working in some of these former Soviet countries since the mid-1990s to prevent HIV transmission, strengthen TB control measures, improve breast cancer services, and address other critical health needs.
Read the rest of the interview here.