In the 1990s, Russia's prison system was widely reported by media and human rights groups as troubled. There were large case backlogs and trial delays, resulting in lengthy pre-trial detention. Prison conditions were viewed as well below international standards. Tuberculosis was a serious, pervasive problem. Human rights groups estimated that about 11,000 inmates and prison detainees die annually, most because of overcrowding, disease, and lack of medical care. A media report dated 2006 points to a campaign of prison reform that has resulted in apparent improvements in conditions. The Swiss Agency for Development and Cooperation has been working to reform Russia's prisons since 1997, in concert with reform efforts by the national government.