p The prophylactic trend of Soviet public health includes, as has already been pointed out, not only nationwide measures of a social and economic nature aimed at preventing disease, but also a number of specifically medical and medicotechnical undertakings. An important role in the prophylactic work is played by the sanitary and epidemiological service. Before the Revolution there was, in practice, no such service. Some sanitary control functions were performed l>v doctors in the towns. There were very few epidemiological specialists and sanitary inspectors, and then only in certain cities. Immediately after the establishment of Soviet power, 93 during the time oi Civil War and economic dislocation, when epidemics became rampant, particular importance was attached to organising a sanitary and epidemiological service. As early as 1922 the Council of People’s Commissars ol the RSFSR issued a decree on the sanitary agencies ol the Republic. This decree determined the range ol duties oi the state control bodies. It also established that sanitary workers in the public health services should have one sanitary inspector per 50,000 urban population, and defined the functions of sanitary inspectors in supervising housing conditions, controlling the sanitary norms of production and storage ol foodstuffs, etc.

p The first sanitary centre, which was the prototype of today’s sanitary and epidemiological stations, was organised at that time in Byelorussia in the town of Gomel. Similar sanitary and epidemiological stations began to be set up all over the country in 1932.

p The regulations concerning the sanitary agencies of the Republic were approved in 1927. These regulations defined the scope and duties of the sanitary and epidemiological organisations. One of the most important duties of the sanitary inspectors and corresponding institutions was deemed to be preventive sanitary supervision. From that time on preventive and current sanitary supervision became the most important line of the activities of the sanitary and epidemiological service.

p In order to enhance the responsibility of and impart greater authority to the sanitary and epidemiological service, an All-Union State Sanitary Inspectorate was established under the Council of People’s Commissars of the USSR in 1935. Its chief function was to direct all work in combating epidemic diseases. In 1936 the All-Union State Sanitary Inspectorate was put under the jurisdiction of the People’s Commissariat of Health. It was at that time that a clearly-defined system of sanitary and antiepidemiological institutions, with particular emphasis on sanitary and epidemiological stations was established. Close on 2,000 sanitary and epidemiological stations were already functioning in towns and in some rural areas in 1940. More than 50 specialised institutes developing problems of hygiene, epidemiology, microbiology, etc., had been set up.

p The efficient organisation of antiepidemic work made itself felt during the Great Patriotic War in that there were no 94 serious epidemics in the USSR, despite the fact that a large part of the country was occupied by nazi troops.

p The sanitary and epidemiological service continued to be consolidated and expanded after the war. In 1970 the number of doctors in the sanitary and epidemiological service (sanitary inspectors, epidemiologists, etc.) exceeded 40,000 and averaged 1.7 doctors per 10,000 population as against 12,500 doctors in 1940. Today the Soviet Union has close on 5,000 sanitary and epidemiological stations.

p Sanitary inspectors and epidemiologists have assistants (junior medical workers). Today the number of these assistants exceeds 31,000, not counting more than 68,000 disinsection and disinfection technical workers, whose job is to prevent the spread of infectious diseases by treating the foci of these diseases.

p The basic institution of the sanitary and epidemiological service is now, as formerly, the sanitary and epidemiological station, which organises sanitary and antiepidemic measures in its given area (district, town, etc.) and exercises sanitary supervision, i.e., sees to it that all sanitary rules and standards are strictly observed by all organisations and institutions. Work cannot be started on any construction project in the Soviet Union without the approval by agencies of the sanitary and epidemiological service. This service enjoys broad rights, which extend to the point of fining or even closing down enterprises which violate the state sanitary laws and fail to observe sanitary standards and rules.

p The sanitary and epidemiological stations employ doctors of different specialities. Among the sanitary doctors in the USSR there are specialists in labour hygiene, occupational diseases, communal hygiene, educational or school hygiene, nutritional hygiene, etc. The head doctor of a sanitary and epidemiological station is simultaneousy chief sanitary inspector of the corresponding administrative territorial unit— district, town, etc. The chief sanitary inspector of the Soviet Union responsible for the work of the entire sanitary and epidemiological service is Deputy Minister of Health of the USSR.

The USSR Ministry of Health thus directs all work of the institutions of the sanitary and epidemiological service through the corresponding public health bodies (ministries of health of the republics).