Strategies in Tackling Long-Term and Socially Determined Biological Challenges Worsening Public Health

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Introduction: The study continues our previous research into biological challenges to public health. At present, biological threats associated with long-term socially determined infections are becoming particularly relevant. Objective: To analyze and evaluate national strategies to address the spread of HIV, tuberculosis, and viral hepatitis as severe public health challenges. Materials and methods: Our sources of information were reporting forms of the Federal State Statistics Service (Rosstat) on HIV, tuberculosis and viral hepatitis for 2009–2023, WHO and UNAIDS global reports for the years 2021 and 2022, scientific publications issued in 2008–2023, and regulations adopted in 2004–2022. We used epidemiological, analytical, and statistical methods in the study. Results: Despite the improved tuberculosis situation, Russia is still among the countries with a high burden of HIV and viral hepatitis B and C. Meanwhile, the long-term strategy to end socially significant infectious diseases has been developed only for HIV infection. The Target Tuberculosis Program until 2024 has been already fulfilled in terms of main indicators. The plan to combat chronic viral hepatitis C by 2030, without defining target indicators, was approved only in 2022. Despite high rates of HIV/tuberculosis/hepatitis co-infections and their adverse effects on public health quality, target programs do not contain consolidated indicators for comorbidity, loss of human resources and related economic costs, staffing and materiel of specialized health facilities. Structural disconnection of the healthcare system for patients with socially significant infections complicates implementation of targeted programs to tackle their spread. Conclusions: To prevent the spread of HIV infection, tuberculosis, and viral hepatitis, the optimal solution is to organize Centers for Socially Significant Infections with a single strategy and established consolidated target indicators of co-infection, economic expenses, human losses, staffing and materiel of specialized health facilities.

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