The newly independent Eurasian states of the former Soviet Union faced problems sustaining the huge, expensive, and ineffective healthcare systems they inherited. The Eurasian states and international organizations are the sources of data used in this report. Overview of U.S. Policy

U.S. health assistance to Eurasia began even before the collapse of the Soviet Union with a public-private medical aid program to distribute pharmaceuticals and medical supplies to the Soviet republics. U.S. Security and Health Assistance to Eurasia

In recent years, U.S. policymakers have increasingly been concerned with global disease threats and other health problems. According to the NIE, infectious diseases could add to political, military, social, and economic disorder in the Eurasian states and otherwise set back democratic and free market reforms. Such instability might further complicate U.S. arms control cooperation and efforts to contain the proliferation of weapons of mass destruction. In addition, the NIE cautioned that Eurasian militaries and populations could face increased health problems, harming the national security of the Eurasian states and diminishing the effectiveness of the militaries in international peacekeeping. Also, military forces and populations with significant health problems could become agents for the spread of diseases among U.S. forces involved in international exercises and training and to the U.S. homeland population. However, the terrorist attacks on the United States on September 11, 2001, the spread of anthrax in the United States by mail later in the year, and the more recent foreign threats of new or lesser-known diseases such as the West Nile virus, severe acute respiratory syndrome (SARS), the H5N1 ("bird flu") virus, and the H1N1 ("swine flu") virus have heightened policy concerns about biological terrorism and international disease threats to the U.S. homeland and U.S. foreign interests. 110-293 ), HIV/AIDS efforts were integrated into efforts to address global healthcare challenges. Health aid has been dwarfed by that provided for democratization, economic reform, and arms control. However, after the terrorist attacks on the United States on September 11, 2001, and other events heightened U.S. concerns about U.S. vulnerabilities, including global health issues, a somewhat greater percentage of foreign assistance for Eurasia has consisted of health aid. The U.N. Population Fund (UNFPA) also has programs in all the Eurasian states. Either of these changes would require further shifts in U.S. policy, which for a long time focused on democratization and economic reforms and arms control in Eurasia.
After the collapse of the Soviet Union in 1991, all the newly independent Eurasian states faced economic dislocations, conflicts and population shifts, and more porous borders that contributed to rising communicable and non-communicable diseases such as HIV/AIDS and drug addiction. At the same time, the inherited healthcare systems were obsolete and unable to cope with existing health problems, let alone new challenges.
Even before the Soviet Union collapsed, the United States provided it with some health assistance to address urgent needs, including vaccines for children. Since then, Eurasian Health issues have received increased U.S. attention. As part of recent concerns, a December 2008 Intelligence Community Assessment highlighted global threats posed to U.S. citizens and interests by increasing infectious diseases and other health problems originating outside U.S. borders, including in Eurasia. The assessment and estimate warned that increased political, military, social, and economic disorder in the Eurasian states could be worsened by the spread of disease and declining health, thereby setting back their democratic and free market reforms, and that such instability might further complicate U.S. arms control cooperation, efforts to contain the proliferation of weapons of mass destruction, and trade relations. In addition, the assessment and estimate cautioned that Eurasian militaries and populations could face increased ill-health, harming the national security of the Eurasian states and diminishing the effectiveness of the militaries in international peacekeeping. Also, military forces and populations with significant health-related problems could become agents for the spread of diseases among U.S. forces involved in international exercises and training and to the U.S. homeland population.
After the terrorist attacks on the United States on September 11, 2001, the spread of anthrax by mail in the United States later in the year, and the rising global incidence of the West Nile virus, severe acute respiratory syndrome (SARS), the H5N1 ("bird flu") virus and the H1N1 ("swine flu") virus, there were heightened policy concerns about disease threats to the U.S. homeland. These concerns are increasingly shaping the debate over health policy and aid, including to Eurasia, where the major foci of U.S. policy long have been democratic and economic reforms and arms control, with health aid viewed as complementing reforms and as justified on humanitarian grounds.
Although U.S. health aid for Eurasia has long been overshadowed by other U.S. aid priorities, it increased as a percentage of all U.S. foreign assistance to Eurasia after FY2002. This report provides an overview of health conditions in the Eurasian states, U.S. aid efforts in recent years, and issues which Congress might consider in providing health assistance to the Eurasian states.