Many know about Africa's severe health problems, but few are aware of a parallel tragedy building in Russia. Devastated by disease and alcoholism, mortality rates have risen dramatically since the fall of communism. Furthermore, very little is being done either by the Russian government or the world community.

At the moment, deaths exceed births by about 700,000 a year. Some experts say Russia's population could drop to 80 million in 50 years from 150 million today. The loss of life from this quiet crisis in Russia has been a catastrophe of historic proportions. These grim views are based on economic, health, and demographic trends in Russia since the fall of communism, and no rapid way out of the disaster is easily visible. One hopes these views will serve as warnings.

Will Russian politicians and citizens, seeing the flashing red lights of danger, change direction and break through the damaging fog of alcoholism, sexually transmitted diseases, sharing of drug needles, and corruption? So far, Russia hasn't adequately tackled its catastrophic health scene - nor does it appear to be a matter of public concern.

While there are more than a dozen political parties fighting for votes this election season, none has chosen to make public health a major campaign issue. It wasn't mentioned much in the recent parliamentary elections. The Soviet Union was infamous for its staggering vodka consumption. Contemporary Russia's thirst for vodka has gotten worse. Russian men on average are drinking about five bottles of vodka per week.

The World Health Organization (WHO) stipulates that eight liters of alcohol per capita is the upper limit for consumption before major health problems ensue. Russians - adults and children alike - consume 14 to 15 liters per capita per year. And vodka output rose 65 percent in the first half of 1999. In effect, many Russians are drinking themselves to death.

More than 35,000 people died from accidental alcohol poisoning in 1996. In fact, daily headlines in Moscow during the winter include body counts of the inebriated people who died of exposure. In the United States, which has almost twice the population, about 300 a year die from the same cause.

Drinking is behind many of the violent and accidental deaths in Russia. With the present pattern, a baby boy stands almost a 1 in 4 probability of dying from some sort of external trauma. That compares with about 1 in 30 in Britain. Russian women are twice as likely to die from alcohol poisoning or injury as American men. Russians are also heavy tobacco users.

Two-thirds of men and one-third of women smoke. Medical authorities say smoking accounts for 20 to 30 percent of deaths from heart disease and cancer. And Russian death rates from these diseases are twice those in the United States. There is also a rapid spread of drug-resistant tuberculosis, AIDS and other sexually transmitted disease in Russia.

One study predicts HIV will infect some 13 million Russians by 2005. This is getting close to Africa. Russia is ranked 125th in average life expectancy among 188 nations studied by the United Nations. Without rapid policy measures, Russia's population will drop 45 percent in 50 years - the same period in which U.S. population is expected to rise 45 percent, from 272 million to 393 million.