If Putin Is So Great, Why Are So Many Russians Getting HIV?

Like an unlucky penny, Vladimir Putin keeps showing up in the American media. From allegations of election tampering to hacking emails, Mr. Putin chooses to stay relevant through notoriety. This has, bizarrely, earned him admirers all over the world.

For many reasons, this admiration is deeply misguided. Mr. Putin heads a kleptocracy and imprisons or murders political dissidents. And, as a shocking new essay in Foreign Policy explains, he fiddles while an HIV epidemic blazes through his country.

Today, there are an estimated 1.5 million people who have been diagnosed with HIV or AIDS in Russia, which has a population of 140 million. Although the spread of HIV has been stemmed in sub-Saharan Africa, in Russia the rate of HIV infection is rising 10 to 15 percent each year — a pace comparable to the infection rate in the United States in the 1980s, when the basic biology of HIV was poorly understood and the antiretroviral drugs used to treat the disease were years away from discovery.

To demonstrate just how backward Russia's public health policy is, let's compare its HIV statistics to those of the United States.

Prevalence is the ratio of people who currently suffer from a disease. More than 1% of Russians have HIV (1.5 million HIV patients in a total population of 143.5 million). The United States has about 1.2 million HIV patients out of a total population of roughly 319 million, which converts into a prevalence of 0.4%. Thus, on a per capita basis, Russia has roughly 2.5 times as many HIV patients as the United States. 

The really scary number, however, is incidence, which measures the number of new cases of disease. Public health campaigns in the U.S. have caused the HIV infection rate to flatten. In 2014, there were just over 44,000 new cases of HIV diagnosed in America, giving an incidence of 13.8 per 100,000 people.* In Russia, the incidence rate is 35.7 per 100,000 people, again 2.5 times worse than the U.S. And it's increasing.

Many factors are colluding to create an AIDS epidemic in Russia. According to Stratfor, the problem began mostly with drug users. Now, sexual transmission and drug use share roughly equal blame. The government's negligence, lack of resources, and refusal to implement modern treatment regimens greatly exacerbate the problem.

For all of its obvious flaws, the American public health system is very good. That is never more obvious than when one travels to a country that lacks even the most basic health services.

*HIV incidence varies widely by U.S. state. CDC data shows that Montana has the lowest incidence (1.9 new cases per 100,000 people), while Louisiana has the highest incidence (36.6 per 100,000). (Washington, DC has an incidence of 66.9 per 100,000). By comparison, the worst regions in Russia, according to The Moscow Times, have an incidence greater than 100 per 100,000 (or 1 per 1,000).