CIAO DATE: 07/03

Russian Health and Social Welfare: Limited Progress

Summary

It has become routine for Russian policy makers to characterize their various health and social problems—rising male mortality, HIV/AIDS, illegal drug use, even pension system reform—as threats to the stability and national security of their country. Russia's importance to American national interests was thrown in sharp relief by the events of September 11 and their aftermath. A stable, prosperous Russia is a crucial partner in the war on terrorism. The fact that so many of Russia's health and social indicators remain stagnant or in decline, despite limited improvement along some dimensions, should therefore be troubling to the United States.

Russia's sheer population numbers continue their precipitous decline, with life expectancy falling and the death rate far outpacing the birth rate. The tentative good news is that fertility and infant mortality are showing some recent gains. Although the tuberculosis epidemic has been brought under control, HIV and AIDS pose a staggering challenge. Russia's HIV infection rate is the fastest growing in the world, with over a million current cases likely to overwhelm the country's health care system in five to seven years.

Despite persistent and serious health challenges, Russia's overall social mood has improved markedly over the last two years. Relatively prosperous economic circumstance and widespread confidence in the nation's leadership seem to be responsible. American partnership and assistance programs can take advantage of this window of opportunity to encourage newly energetic, less pessimistic Russians to take their fate into their own hands. Along these lines in the health arena, the U.S. model of health education and promotion offers much to emulate. Facilitating analogous efforts in Russia, in the form of locally-based public-private partnerships and cooperation across all levels of government and with the community, is likely to prove successful and cost-effective.

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