Public health factors may prove an issue in Russian invasion of Ukraine

In the last month, Ukraine has undoubtedly seen its fair share of violence and horror. Russia’s invasion has disrupted the lives of millions of people immeasurably, but there is an additional burden that has appeared: the disruption of treating burgeoning infectious diseases, especially tuberculosis, in the country. Although the international arena has been mostly supportive towards Ukraine in their resistance to the invasion, it is essential that countries help them fight off this new and pervasive threat to the country’s well-being. 

Tuberculosis is a highly infectious bacterial disease caused by the bacteria Mycobacterium tuberculosis, which particularly affects the lungs. Although it is a bacterial infection and has a vaccine, there are still many cases of it around the world annually, primarily for two reasons. First, according to the CDC, the vaccine is often only given to people who live or work in high-risk environments, and while it is incredibly effective for children, it has variable effectiveness in adults. Second, the rise of drug-resistant tuberculosis variants around the world has resulted in a resurgence of cases, which has made it especially difficult to fight the disease. 

Ukraine has historically been especially affected by tuberculosis, a disease that remains the 13th leading cause of death worldwide according to the World Health Organization; in the scope of infectious diseases, it is second only to COVID-19 and above HIV/AIDS. As of 2021, Ukraine had the fourth highest incidence of tuberculosis out of the WHO European Region countries.

After the collapse of the Soviet Union in 1991, the economy in Ukraine was devastated and with it, the healthcare system. According to an NPR article from March 19, this led to an increase in crime, resulting in an increase of prisoners. Prisons are an excellent breeding ground for diseases as communicable as tuberculosis, leading to an explosion of cases. In the years since the ’90s, the Ukrainian government has been making progress on decreasing the prevalence of tuberculosis, but this has been hindered by the rise of antibiotic-resistant versions of the disease. According to the World Health Organization, Ukraine has one of the highest rates of the antibiotic-resistant version of the disease, making up 29 percent of the cases found in the country. Although recent programs to prevent its transmission and help those suffering from the disease have made a lot of progress, everything came to a halt when Russia invaded the country in late February.

Now, people who had previously been diagnosed with tuberculosis have mostly fled the country, taking the disease with them. The antibiotic regimen for treating tuberculosis can be quite prolonged, lasting anywhere from two to six months. If these regimens are not finished correctly, they may lead to a rise in antibiotic resistance, which could have horrifying consequences. This means that a lot of people in Ukraine suffering from the disease have now left the country in various stages of treatment and have been mostly packed into close, crowded quarters with others as they seek refuge from the violence. These kinds of conditions are once again prime for the disease to spread and affect people, especially those who are most vulnerable; this may add to the burden that Ukrainians are feeling now. 

Prior to World War I, most of the deaths in war were often seen as a result of infectious diseases. After the war and the advent of antibiotics, this has no longer been the case. Even though tuberculosis is still nowhere near as deadly as it used to be, the current conditions in Ukraine are optimal in allowing the disease to proliferate and cause pain and suffering. What Ukrainians need right now more than ever are medical supplies. Although it is of the utmost essence that Ukrainian refugees get to physical safety before anything else, it is also important that we do not let tuberculosis have the upper hand in this battle. 

Ukraine’s stunning previous progress toward slowly eradicating tuberculosis is an effort to be commended, with the World Health Organization pinpointing a decrease from 127 cases per 100,000 in 2004-2005 to 42.2 cases per 100,000 now. It is important to try to ensure that this progress is not undone in the coming weeks. Although some medical professionals are attempting to keep up with identification and treatment of the disease, it is difficult given the mass movement of millions of people out of the country in recent years. The rest of the world must help. To do this, the international community must send medical aid and supplies, and additionally send support for diagnostic testing and prevention of transmission of the disease. The Russian invasion has stripped many Ukrainians of their homes, families and livelihoods, and we must do everything possible to ensure that their good health is not taken from them as well. 

 

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