The following was published on The Borgen Project’s Magazine. You can read it here. 

SEATTLE — In recent years, Russia’s economic instability has increased due to rapidly falling oil prices, causing a spike in poverty and decreasing investments in infrastructure, such as healthcare. Though the Russian economy began its recovery in 2017 with a GDP increase of 1.5 percent, this is not significant enough to improve Russian quality of life or provide more funding for healthcare, which has led to a Russian healthcare crisis.

Poverty in Russia has increased from 10.7 percent in 2012 to 13.5 percent in 2016. This is drastically better than the country’s poverty rate in 2000, when 29 percent of the population was living in poverty. However, a World Bank report released in November 2017 stated that more than half of the population, 53.7 percent, was at risk of sinking into poverty and that 20 million Russians currently live below the poverty line.

Russia’s economic recession and its regional governments’ $100 billion in debt has caused Russia to run higher budget deficits and to increase borrowing. The economic instability of Russia has contributed to increased poverty, major cuts to the healthcare system, and a Russian healthcare crisis.

Explaining the Russian Healthcare Crisis

The Russian Federation has free and universal state healthcare, but in name only. Changes to Russian’s national healthcare system since the fall of the Soviet Union have attempted to provide Russians with an acceptable level of healthcare services. However, a continued lack of funds, a lack of medical and technical equipment and supplies and an outdated approach to medical training present major obstacles to alleviating the Russian healthcare crisis.

Throughout Russia, there is extreme regional variation regarding access to healthcare institutions. Wealthier regions were found to be more effective in implementing healthcare system reforms, according to a study conducted by Virginia Commonwealth University professor Judyth Twigg.

In rural areas, 17,500 towns and villages have no medical infrastructure whatsoever. According to the State Statistics Service, the number of health facilities in rural areas fell 75 percent between 2005 and 2013. This number includes a 95 percent drop in the number of district hospitals, and a 65 percent drop in the number of local health clinics.

For Russian healthcare, two major sources of public healthcare funding come from mandatory insurance funds (30 percent) and federal and regional budgets (70 percent). However, these two sources do not cover all healthcare expenses, requiring 20 percent of both public and private healthcare spending to be covered by the patient. Currently, it is estimated that approximately 20 percent of the Russian population has access to affordable healthcare.

On March 1, 2018, President Vladimir Putin stated that from 2019 to 2024, 4 percent of annual GDP must be spent on developing the healthcare system, though the goal is to reach 5 percent. From 2000 to 2018, government healthcare expenditures in Russia have fluctuated between 3 and 3.5 percent of the GDP–rates that are significantly lower than most of the developed world. In comparison, a Russian Center for Strategic Research report states that the average level of healthcare expenditures in OECD countries is 6.5 percent of annual GDP.

In addition to inadequate funding, other limitations contribute to the Russian healthcare crisis. For instance, Russia’s healthcare system is currently characterized by a neglect of primary care, an emphasis on treatment rather than prevention, overuse and misuse of doctors, underuse of nurses and inadequate access to medications.

These issues have contributed to a severe Russian healthcare crisis, affecting the health of the Russian population. Inequality in access to treatment has contributed to an epidemic of HIV and TB in Russia. In 1997, there were 11,000 cases of HIV in Russia. In the first half of 2015, there were 41,707 HIV cases–rates that are “unheard of in the developed world,” according to the Pitt Political Review.

Solutions to the Russian Healthcare Crisis

Despite the severity of the Russian healthcare crisis, there are many organizations working to promote healthcare and human rights in Russia.

Korea Telecom Corporation announced on June 26, 2018, the launch of a digital pilot project in Russia designed to enable remote medical diagnosis and treatment, in partnership with Russian Railways and Seoul National University Bundang Hospital. The “telemedicine system” connects Central Clinical Hospital No.1 of Russian Railways in Moscow to regional hospitals nearby, facilitating remote treatment by video and providing an opportunity for improved medical infrastructure via digital healthcare.

The Nordic-Russian Health Programme was established in March 2017 and funded by the Nordic Council of Ministers. Its primary aim is to increase Nordic-Russian efforts in the prevention of HIV and tuberculosis by improving primary healthcare’s ability to prevent their spread, as well as accurately diagnosing and counseling HIV-infected individuals.

Since 2013, AIDS Healthcare Foundation (AHF) Russia has supported projects to increase access to HIV testing and adequate medical care. AHF Russia partners with non-governmental organizations and the Ministry of Health in the Russian Federation to provide Russia with financial support for testing, education, and treatment for the 1.3 million Russians living with HIV.

World Bank CEO Kristalina Georgieva stated in an interview at the St. Petersburg International Economic Forum on June 1, 2017, that the primary solution to the Russian healthcare crisis is for the Russian state government to invest in quality healthcare programs.

Though there are many contributing factors to the Russian healthcare crisis, there are also many organizations working within Russia and internationally to alleviate the issues of the healthcare system and improve the health of the Russian population.