WHO should push for rethinking of TB loan
How to shoot yourself in the foot, Russian-style
With negotiations suspended between Russia and the World Bank for a $100 million loan intended to fight Russia’s runaway TB epidemic, the need is urgent for public health advocates around the world to pressure Russia to go back to the table, says Alex Goldfarb, PhD, director of the Public Health Research Institute’s Russian TB control program.
"When South African President Thabo Mbeke made his infamous statement about HIV not causing AIDS, there was an international outcry," says Goldfarb. "Everyone, from the press to the scientific community to the international health community, all got onto the South African president. So why not here?"
The World Health Organization, which served as go-between when loan negotiations were initiated, has a particularly important role to play in the situation, Goldfarb says. "Since negotiations were suspended, the WHO has been silent. Now, it’s imperative for them to act," he says. "After all, the multidrug-resistant TB epidemic isn’t just confined to Russia; this is a global health emergency which threatens the rest of the world."
All through last spring, opposition to the loan has been building among members of Russia’s pharmaceutical industry. Goldfarb and other Russia-watchers say the nation’s drug manufacturers are fearful that drug manufacturing standards attached to the loan may bar their products from the running when it comes time to purchase drugs for TB projects.
In addition, the Russian press may have fueled industry paranoia with a series of accounts scolding drug makers for their huge product mark-ups. That, Goldfarb notes, has led to the ironically familiar spectacle of the pharmaceutical industry taking yet another drubbing for allegedly predatory pricing.
World Bank rep tossed out of meeting
Whatever the reason, Russian’s version of
Big Pharma seems to have successfully put the screws to the Health Ministry, which capitulated in June with an announcement that the government would refuse the loan. The announcement came on the heels of a scandalous incident: In one especially tense meeting, the Russian Health Minister grew so cross that he ejected the Bank’s project representative, a Russian woman, from the room.
The bank, for its part, seems to have thrown up its hands in disgust. Julian Schweitzer, head of the World Bank’s Moscow office, says he is "not optimistic" about the fate of the loan.
If the loan does fall through altogether, Goldfarb and other Russian experts warn the fallout will be severe and sustained. "I don’t think any responsible agency would fund Russia after watching the World Bank get slapped in the face," he says.
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