Policy
Without aggressive intervention, the current heath care situation in the Russian Federation could lead to longer-term demographic problems in Russia. The noted scholar and prominent demographer, Murray Fishback, has speculated that absent intervention to reverse current trends, Russia's population could drop from 140 million to less than 100 million people by the middle of this century. This crisis has occurred because of an accumulation of unresolved issues surrounding reproductive health after the collapse of the former Soviet Union which has led to poor health of reproductive age women, badly managed pregnancies, a poor referral system, and flawed childbirth practices. This total systems failure resulted in an abrupt drop (50%) in the total number of births and an infant mortality rate two to three times higher than in European Union countries.
When these problems are combined with Russia’s sustained low fertility rate of 1.2 births per woman, new births are not at replacement levels, causing a dramatic reduction in the Russian population. The magnitude of this demographic crisis is unprecedented for a major world power, absent war or national disaster. Even though displaying some early signs of resolution, this crisis continues to have a profound adverse impact on Russia – its families, its competitiveness as an extractive economy, and its national security.
The result of former President Putin’s pronouncement has been a heightened sensitivity to this demographic crisis at the level of both Federation and Oblast officials; increased funding in selected oblasts to reestablish the infrastructure for supporting improved maternal and perinatal care; and legislation to provide financial support to encourage and support families desiring more children.
It is hard to imagine a Russia with the decline in economic prosperity that would result from such a population decline as a stable part of modern civilization. In addition to the evident economic crisis and emerging humanitarian tragedy, this would not be a productive development for international cooperation and peaceful economic progress.
FOR’s health care professionals, in turn, have learned much of use in their U.S. medical practices as a result of working with their Russian colleagues. The dialogue and cooperation on common problems called for by President Obama’s July Moscow statements have been the reality at FOR from its inception. FOR Medical Director, Dr. Alfred. W. Brann, Jr., continues to work not only in Russia and several other countries but also in the United States to reverse the incidence of less than full-term pregnancies which correlates directly increased infant mortality and morbidity.
