Outlook for loan bleak as ministry ends talks
Ominous silence from Moscow
Negotiations between Russia and the World Bank for a proposed $150 million loan to Russia to fight TB and AIDS have been shelved, maybe for good, bank spokesmen say. The Russian Ministry of Corrections — whose crowded prisons mark ground zero of the country’s raging TB epidemic — says it desperately needs the loan and wants very much to restart negotiations, says Jean Jacques de St. Antoine, the bank’s team leader for Russia. But the financial institution can do nothing until it receives a formal proposal from the Russian national government, and so far, no proposal has materialized, de St. Antoine adds.
Long-running troubles with the loan culminated on July 20, when the country’s Ministry of Health formally cut ties with the Bank, declaring that there was "no longer a need" for the loan and asking that the bank cease processing it.
Prisons still begging for help
In October, a small ray of hope seemed to reappear as de St. Antoine and other bank representatives traveled to Moscow to meet with representatives from the Ministry of Corrections. Ministry heads "made a strong plea," saying they needed money as well as technical expertise, reports de St. Antoine, and the minister sent a letter to the Russian prime minister, asking for formal approval to restart the loan. Other ministries who might have a say one way or the other — namely, finance and economy — gave their go-ahead to the re-start, de St.Antoine adds. The bank, for its part, "is prepared to regroup and to extend its support if a clear mandate comes from the government," he says.
But will the mandate come? "Your guess is as good as mine," he says flatly.
Negotiations over the much-needed TB and AIDS loan began to run aground early last year when the nation’s nascent pharmaceutical industry started campaigning against it, fearing the industry would be cut out of the bidding to make the drugs needed for the loan project. That fear reflected the industry’s sense that it wouldn’t meet with tough standards governing the manufacture of drugs used in World Bank projects.
At the time, some Russia-watchers declared that those fears were unwarranted and that at least some Russian drug-makers would prove up to the challenge. Even so, Russian pharmaceutical houses kept up the pressure on the Ministry of Health to drop the loan. Added to that was resistance from adherents of old-style Russian TB control, still heavily reliant on hospitalization and surgery, and wary of Western-style DOTS treatment strategies.
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