Socially significant infections as the causes of losses in quality of main components of public health in Russia

In Russia, more and more attention is being paid to strengthening public health as a system that covers all spheres of human life. Meanwhile, the medical and social causes of human resources losses as a foundation of public health have not been sufficiently studied. The study aim is to determine structure, rank, and government regulation of medical, biological, and socio-economic causes of losses in quality of human resources (military, labor, reproductive) – the basis of public health as a medical and social resource of Russia caused by socially significant infectious diseases (SSID).

Material and methods. In the study an information-analytical method was used with search on leading websites of main regulatory legal acts and publications corresponding to study aim and analysis of them was conducted.

Results and discussion. The frequency of SSID registration in regulatory documents governing quality of country’s military reserve, as causes of medical and social losses, amounted to 9.0 % of ICD-10 class I diseases; labor reserve – 6.0 %, reproductive resources – 2.5 %. Among socially significant infections, active tuberculosis and its severe manifestations/ outcomes has become leading cause of medical and social losses of main components of public health: military, labor and reproductive reserves.

Conclusions. SSID, despite their small list or low frequency of registration in regulatory documents governing quality of individual components of public health, play significant role in medical and social causes of losses of strategically important public health structures, especially in military reserve.

1. Constitution of the Russian Federation of 12.12.1993 (as amended on 14.03.2020). Available at: http://government.ru/constitution/ [In Russian].

2. Order of the Ministry of Labor and Social Protection of the Russian Federation of 07.11.2017 No. 768n “On approval of the professional standard “Specialist in the field of organization of healthcare and public health”. Available at: https://base.garant.ru/71822794/ [In Russian].

3. WHO. The World Health Report 2000: health systems: improving performance. Available at: clck.ru/3MeB9v

4. WHO. The World Health Report. Life in the 21st century: A vision for all. Available at: clck.ru/3MeBAy

5. Aksenova E.I., Grechushkina N.A., Kameneva T.N., Kamynina N.N. Public health: the evolution of the concept in strategic documents on health protection and health care development in the countries worldwide. Moscow: SBI “Research institute of public health and medical management of Moscow Department of Health”, 2021. 42 p. [In Russian].

6. Tsomartova F.V., Putilo N.V. Public health: from the principle of healthcare management to the constitutional and legal value. Zhurnal rossiyskogo prava= Journal of Russian Law. 2023;27(1):93–109. [In Russian]. doi: 10.12737/jrp.2023.008

7. Vasilieva T.P., Larionov A.V., Russkikh S.V., Zudin A.B., Vasunina A.E., Vasiliev M.D. Methodological approaches to measuring public health as the sociomedical resource and potential of the society. Zdorov’ye naseleniya i sreda obitaniya = Public Health and Life Environment. 2022;30(11): 7–15. [In Russian]. doi: 10.35627/2219-5238/2022-30-11-7-15

8. Orlov S.A., Aleksandrova O.Yu., Gorenkov R.V., Vasil′yeva T.P., Zudin A.B. Methodological and methodical approaches to assessing the impact of global challenges on population health indicators and healthcare system. Menedzher zdravookhraneniya = Manager of Health Care. 2023;(8):4–16. [In Russian]. doi: 10.21045/1811-0185-2023-8-4-16

9. Vasilieva T.P., Larionov A.V., Russkikh S.V., Zudin A.B., Vasunina A.E., Vasiliev M.D. Calculation of the public health index in the regions of the Russian Federation. Zdorov’ye naseleniya i sreda obitaniya = Public Health and Life Environment. 2022;30(7):7–16. [In Russian]. doi: 10.35627/2219-5238/2022-30-12-7-16

10. Zagdyn Z.M., Kobesov N.V., Russkikh S.V., Vasilyeva T.P., Galoyan A.S. The methodological approaches to evaluation of effect of tuberculosis as socially significant infection on decreasing of public health quality. Problemy sotsial’noy gigieny, zdravookhraneniya i istorii meditsiny = Problems of Social Hygiene, Public Health and History of Medicine. 2024;32(2):187–195. [In Russian]. doi: 10.32687/0869-866X-2024-32-2-187-195

11. WHO. Global Tuberculosis Report. 2024. Available at: clck.ru/3MduzP

12. The urgency of now. AIDS at a crossroads. 2024 Global AIDS update. UNAIDS. Available at: clck.ru/3MdvCJ

13. WHO. Global hepatitis report, 2024. Action for access in low-and middle-income countries. Available at: clck.ru/3MdvK3

14. Yablonskiy P.K., Vishnevskiy B.I., Solovyova N.S., Galkin V.B. Frequency and structure of drug resistance of M. tuberculosis in pulmonary and extrapulmonary tuberculosis. Tuberkulez i bolezni legkikh = Tuberculosis and Lung Diseases. 2024;102(1):40– 45. [In Russian]. doi: 10.58838/2075-1230-2024-102-1-40-45

15. Chulanov V.P., Gorodin V.N., Sagalova O.I., Ivanova M.P., Kravchenko I.E., Simakova A.I., Tragira I.N., Chabudaev V.A., Esaulenko E.V., Schestakova I.V. Hepatitis C disease burden in the Russian Federation: fromthe real-life situation to strategy. Infektsionnye bolezni = Infectious Diseases. 2021;19(4):52– 63. [In Russian]. doi: 10.20953/1729-9225-2021-4-52-63

16. Nechaeva O.B. Socially important infectious diseases posing a biological threat to the population of Russia. Tuberculosis and Lung Diseases. 2019;97(11):7–17. [In Russian]. doi: 10.21292/2075-1230-2019-97-11-7-17

17. Vasileva I.A., Belilovskiy E.M., Borisov S.E., Sterlikov S.A. Tuberculosis with concurrent HiV infection in the Russian Federation and the world. Tuberkulez i bolezni legkikh = Tuberculosis and Lung Diseases. 2017;95(9):8–18. [In Russian]. doi: 10.21292/2075-1230-2017-95-9-8-18

18. International Classification of Diseases, 10th revision (ICD-10). Available at: https://mkb-10.com/ [In Russian].

19. WHO remains firmly committed to the principles set out in the preamble to the Constitution. [In Russian]. Available at: clck.ru/3MeBDg

20. Federal Law of 21.11.2011 No. 323-FZ (as amended on 28.12.2024) “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation”. Available at: clck.ru/3MeB7b [In Russian].

21. Federal Law of 28.03.1998 No. 53-FZ (as amended on 02.10.2024) “On Military Duty and Military Service”. Available at: clck.ru/3MeB6e [In Russian].

22. Resolution of the Government of the Russian Federation of 04.07.2013 No. 565 “On approval of the Regulation on military medical examination”. Available at: clck.ru/3MeB6B [In Russian].

23. Order of the Minister of Defense of the Russian Federation dated 07.08.2023 No. 506 “On approval of the List of diseases in the presence of which a citizen (foreign citizen) recognized as partially fit for military service cannot be accepted for military service under a contract in the Armed Forces of the Russian Federation during mobilization, during martial law and in wartime. [In Russian]. Available at: clck.ru/3MeB58

24. Procedure for conducting sanitary and epidemiological supervision (control) at the customs border of the Eurasian Economic Union and on the customs territory of the Eurasian Economic Union. Appendix 2. List of infectious (parasitic) diseases requiring sanitary protection measures for the customs territory of the Eurasian Economic Union. Available at: clck.ru/3MdwiJ [In Russian].

25. Resolution of the Government of the Russian Federation of 01.12.2004 No. 715 “On approval of the list of socially significant diseases and the list of diseases posing a danger to others”. Available at: https:// base.garant.ru/12137881/ [In Russian].

26. Order of the Minister of Defense of the Republic of Kazakhstan dated December 22, 2020 No. 722 “On approval of requirements for the health status of individuals for service in the Armed Forces, other troops and military formations of the Republic of Kazakhstan”. Available at: clck.ru/3MeB4W [In Russian].

27. Resolution of the Ministry of Defense of the Republic of Belarus and the Ministry of Health of the Republic of Belarus dated January 3, 2020 No. 1/1 “On approval of the Instruction on determining the requirements for the health status of citizens related to military duty”. Available at: clck.ru/3MeB32 [In Russian].

28. HIV/AIDS in the Military. CDC. Updated March 21, 2023. Available at: https://crsreports.congress.gov

29. Grillo M.P., Sloan M., Wankie C., Woodland K., Reader E., Porter B., Macera C.A., Shaffer R.A. Prevention interventions for people living with HIV in military settings. Curr. HIV Res. 2017;15(2):90–94. doi: 10.2174/1570162X15666170516165331

30. Muchaidze R.D., Dantsev V.V., Shitov Yu.N., Balasanyants G.S. Social prevention of tuberculosis in the Armed Forces of the Russian Federation. Tuberkulez i bolezni legkikh = Tuberculosis and Lung Diseases. 2015;(3):6–9. [In Russian].

31. Lesnic E., Kulcitkaia S., Niguleanu A. Clinical presentation, risk factors and outcomes of tuberculosis in military recruits. The Moldovan Medical Journal. 2017;60(3):37–41. doi: 10.5281/zenodo.1051142

32. Mancusa J.D. Tuberculosis screening and control in the US military in war and peace. Am. J. Public Health. 2017;107(1):60–67. doi: 10.2105/AJPH.2016.303502

33. “Convention on the Rights of Persons with Disabilities”, UN Assembly. 2006. Available at: https://base.garant.ru/2565085/ [In Russian].

34. Federal Law of 24.11.1995 No. 181-FZ “On Social Protection of Disabled Persons in the Russian Federation” (as amended on 29.10.2024). Available at: https://base.garant.ru/10164504/ [In Russian].

35. Order of the Ministry of Labor and Social Protection of the Russian Federation of August 27, 2019 No. 585n “On classifications and criteria used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination” (as amended by orders of the Ministry of Labor of the Russian Federation of January 19, 2021 No. 17n, of October 6, 2021 No. 680n). Available at: clck.ru/3MeAnQ [In Russian].

36. Order of the Ministry of Labor of Russia dated July 26, 2024 No. 374n “On approval of classifications and criteria used in the implementation of medical and social examination of citizens by federal institutions of medical and social examination”. Available at: clck. ru/3MeAmP [In Russian].

37. Alene K.A., Wangdi K., Colquhoun S., Chani K., Islam T., Rahevar K., Morishita F., Byrne A., Clark J., Viney K. Tuberculosis related disability: a systematic review and meta-analysis. BMC Medicine. 2021;19(1):203. doi: 10.1186/s12916-021-02063-9

38. Chowdhurya P.P., Beera L., Shub F., Fagana J., Shouse R.L. Disability among adults with diagnosed HIV in the United States, 2017. AIDS Care. 2021;33(12):1611–1615. doi: 10.1080/09540121.2020.1842318

39. Order of the Ministry of Health and Social Development of the Russian Federation of 03.12.2007 No. 736 “On approval of the list of medical indications for artificial termination of pregnancy”. Available at: https://base.garant.ru/12158174/ [In Russian].

40. Draft Order of the Ministry of Health of Russia “On approval of the list of medical indications for artificial termination of pregnancy”. Available at: https://base.garant.ru/56861066/ [In Russian].

41. Resolution of the Ministry of Health of the Republic of Belarus dated 10.12.2014 No. 88 “On establishing a list of medical indications for artificial termination of pregnancy and recognizing as invalid certain resolutions of the Ministry of Health of the Republic of Belarus and a separate structural element of the resolution of the Ministry of Health of the Republic of Belarus dated November 9, 2007 No. 105”. Available at: clck.ru/3MeAgp [In Russian].

42. Nordholm A.C., Suppli C.H., Norman A., Ekstrøm C.T., Ertberg P., Koch A., Lillebaek T., Andersen A.B. Pregnancy and post-partum tuberculosis; a nationwide register-based case–control study, Denmark, 1990 to 2018. Euro Surveill. 2022; 27(12):2100949. doi: 10.2807/1560-7917.ES.2022.27.12.2100949

43. Wen J., He J.Q. Clinical characteristics and pregnancy outcomes in pregnant women with TB: a retrospective cohort study. Ann. Med. 2024;56(1):2401108. doi: 10.1080/07853890.2024.2401108

44. Resolution of the Government of the Russian Federation of 06.02.2012 No. 98 “On the social indication for artificial termination of pregnancy”. Available at: https://base.garant.ru/70137312/ [In Russian].

45. Zhivodrova N.A. Social and regulation of artificial termination of pregnancy. Epomen = Epomen. 2020;(46):155–165. [In Russian].

46. Order of the Ministry of Health and Social Development of the Russian Federation of 07.04.2016. No. 216n “On approval of the form of informed voluntary consent for artificial termination of pregnancy at the request of a woman”. Available at: https://base.garant.ru/71391892/ [In Russian].

47. Order of the Ministry of Health of the Russian Federation of 12.11.2012 No. 572n “On approval of the procedure for providing medical care in the profile of “obstetrics and gynecology” (except for the use of assisted reproductive technologies) “(Chapter IX). Available at: https://base.garant.ru/70352632/ [In Russian].

48. Passport of the National Project “Demography” (approved by the Presidium of the Presidential Council of the Russian Federation for Strategic Development and National Projects (Minutes of December 24, 2018 No. 16)). Available at: https://base.garant.ru/72158122/ [In Russian].

49. Pellegrini L., Sorace L., Tortorella V., Baggio U., De Paola L., D’Antonio G., La Russa R., Frati P. Comparative analysis of legislation on voluntary interruption of pregnancy: Italy’s position relates to international panorama. Clin. Ter. 2024;175(Suppl 1(4)):117– 120. doi: 10.7417/CT.2024.5097