Sunday, September 21, 2008

4-5th June, Izhevsk, Russian Federation
Izhevsk, a city on the European side of the Urals, is the setting for a major Wellcome-funded study we are undertaking to understand the high level of adult mortality in Russia. Readers of this blog will be familiar with our earlier work highlighting the role of alcohol. In our current work, and in previous work in other parts of Russia, it has become clear that we are facing an enormous problem of untreated hypertension. The Soviet Union never managed to deal effectively with chronic diseases. It never developed a modern pharmaceutical industry and, even if it had, it would never have been able to distribute the drugs that those in the west take for granted and which, when taken regularly, can be life-saving. Now the drugs are available and the distribution system is in place, but we still face two problems. First, those taking drugs as outpatients have to pay for them. As they are often much more expensive than in the west because of mark-ups along the supply chain they are often effectively unaffordable. Second, there are very low expectations as to what can be achieved, so that physicians seem content to leave patients untreated even with what we would consider dangerously high pressures. This should be an entirely soluble problem but I suspect it will take some time to resolve it.

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