Summary Ukraine is in the grip of a demographic crisis. Yet as tragic as the situation is, the growing impact of HIV and tuberculosis guarantee that the current troubles are only a shadow of what is to come for Ukraine - and Russia as well. Analysis Western governments once hoped that Ukraine would become a major regional power when it achieved independence from the Soviet Union. Instead, Ukraine is in rapid decline, touting one of the world's fastest rates of depopulation. Social breakdown, economic collapse, emigration, soaring death rates and plummeting birth rates have subtracted more than 3 million people from Ukraine's 52.1 million population in 1991, when the country upon independence. Now, the scourges of HIV and tuberculosis are further devastating Ukraine's demographic outlook. Over the next 10 years, the most able-bodied segment of Ukraine's population will shrivel, leading to economic collapse if the pandemic remains unchecked.