Russian Prisons Become a Threat to Humankind: 1997-1999.

In 1997-2000, the population of Russia’ SIZOs and IUs stabilized, with annual fluctuations within 5-6% (See Table 1 and Chart 1).

1996, with its 300 thousand prisoners in SIZOs, has gone in the history of the last decade as the “record” year. However, the “stabilization” failed to bring about any improvement in the penitentiary system. The resources that the government commanded were too short to support physical survival of the million prisoners, to say nothing about compliance with at least national regulations. Everything was in short supply, including food, medical services, sanitary and hygienic materials. This resulted in further development of the tuberculosis (TB) epidemic at prisons (See Chart 2). The number of TB cases was only brought to a plateau of 9-10% in 1999. However, Western foundations and organizations helping Russia counter TB in prisons came across another foreboding issue. Lack of funds and continual transfers from one institution to another, which breaks the continuity of the treatment, have led to advent of TB forms that are resistant to first series medications (the MLU-TB-1). This form is now diagnosed in 25-30% of TB patients in the UIS.

Chart 1. Number of prisoners in SIZOs and Correctional Institutions in the Last Ten Years, as % of the 1993 Number

The "new tuberculosis" is a virtually incurable illness, the once effective anti-tuberculosis medications are useless against it. The UN World Health Organization has declared the MDR-TB-1 the most dangerous infectious disease of the 21st century, and Russia has been declared one of the main sources of this disease and its spread in the world. This issue a very grave one indeed, a single carrier in an airplane will spread the drug-resistant form of consumption to all passengers, and the airplane may land in any country of the world. Unlike a radioactive emission or a load of explosives, the pathogen - Koch's bacillus - is impossible to detect. Every year, 250-300 thousand people are released from prisons. Out of this number, 30 thousand are infected with TB. One out of four is a carrier of the incurable form. He can transmit the deadly infection to dozens of people within a year.

Official information about the TB situation at Russia's penal institutions first emerged in 1991: the incidence of TB at penitentiaries was 17 times, and the death rate was 8 times the corresponding rates outside the penal system. These shocking figures failed to cause any particular concern in either the nation's political leadership or its society at large. This was likely due to the long-established perception of tuberculosis as a disease that is, albeit dangerous, quite curable, while prisons were seen as something that is fenced off the society in a reliable way. At first, federal anti-tuberculosis programs did not cover prisons or colonies at all.

In 1999, the TB incidence rate at the UIS hit a record 9.7%, exceeding the outside rate by a factor of 58, while the death rate was 28 times that outside prisons. The grave TB situation was a consequence of the inhuman conditions in which Russian prisoners had been kept, while being the most vivid and clear reflection of the inhuman nature of the society. However, it was still believed that the "white plaque" (as TB had been called in the past), although difficult, can be quite dealt with. All that was needed was the right drugs and effective methods of treatment. One such method had been developed in the early 90s to become known as the DOTS program. A six-month course of treatment under this program costs less than USD50, and even in the poorest countries the cure rate has been about 85%.

The illusions about prison tuberculosis were dispelled in 1997-1998, when international organizations conducted extensive microbiological studies in our prisons and colonies. They found that 20-25% of inmates are infected with virtually incurable multiple-drug-resistant form of tuberculosis, the MDR-TB-1. Inexpensive and once effective preparations are totally useless against this form of TB. The scale of the epidemic of both common and new TBs is largely due to the conditions of imprisonment: shortage of food, drugs, overcrowded cells (particularly at SIZOs), interrupted treatment, etc.

Chart 2. Number of TB and HIV cases per 1,000 prisoners at institutions of GUIN of the Ministry of Justice of the Russian Federation in 1995-2003.

The number of TB cases among prisoners in 1993 was 35 thousand persons (45 per 1,000 prisoners), while the first reports about rare cases of HIV infection at Russia' penitentiaries emerged in 1993.

According to experts (1999), if the epidemic of the old and the new tuberculosis at penitentiaries is not stopped, by 2010 two million Russian nationals will become carriers of the deadly infection.

Copyright © 1998 Moscow Center for Prison Reform. All rights reserved.
Design and support © 1998 Moscow Center for Prison Reform. All rights reserved.