Daily Archives: April 25, 2007

Another Original LR Translation: Illarionov Speaks

In the past, Russia has been likened to an African nation with Atlantic magazine’s famous “Zaire with permafrost” moniker. The analogy is a compelling one, more so with each day that passes. Now, leading Russian dissident Andrei Illarionov (pictured), made available in English through the efforts of LR’s illustrious and industrious original translator (of “Spare Organs” and “Commissars of the Internet” fame), declares Russia to be on the road to Zimbabwe status. The world is lucky to have a pair of hard-working translators making this material, which might otherwise never see the light of day in English, made available to the non-Russian-speaking world (that is, virtually everybody on the planet). Following is Der Spiegel’s recent interview with Illarionov:

Approaching Zimbabwe

Andrei Illarionov

16 April 2007

Yezhednevniy Zhurnal

In Russia a new model has been formed for the government, economic and socio-political order – the Power Model (silovaya model’). It is a model distinct from any seen in our country before, including at the beginning of this century or in the 70 years of Communist power. While much as been said and written about the separate elements of this system, its treatment as a whole has been lacking.

What are the basic characteristics of the Power Model? In this model, the entire body of state power has been taken over by a group called the “siloviki”, which includes not only the “siloviki” themselves [TN: generally understood to be current and former intelligence officers], but also intelligence service collaborators, members of the Corporation of Intelligence Service Collaborators (Korporatsiya Sotrudniki SpetsSluzhb) – the KSSS. [TN: A play on the initials of the late Communist Party of the Soviet Union, or KPSS.]

As in any corporation, members of the KSSS have both individual and group interests. For example, on issues surrounding the ownership of one or another asset seized by the Corporation, ferocious arguments take place between its members. But the intensity of conflict within the Corporation is much weaker than between the Corporation and the rest of society.

Because the Corporation preserves the traditions, hierarchies, skills and habits of the intelligence services, its members show a certain degree of obedience, loyalty to one another, and discipline. There are both formal and informal means of enforcing these norms. There is, for example, something like an “omerta” [TN: Mafia term for a code of silence]. Violators of the code of conduct are subject to the harshest forms of punishment, including the highest form.

Members of the Corporation exude a sense of being the “masters of the country” and superior to other citizens who are not members of the Corporation. Members of the Corporation are given instruments conferring power over others – membership “perks”, such as the right to carry and use weapons.

The Corporation has seized key government agencies – the Tax Service, Ministry of Defense, Ministry of Foreign Affairs, Parliament, and the government-controlled mass media – which are now used to advance the interests of KSSS members. Through these agencies, every significant resource of the country – security/intelligence, political, economic, informational and financial – is being monopolized in the hands of Corporation members.

The legal order, previously much in doubt, is now being destroyed completely and replaced by new “rules of the game”, the main one being “selective enforcement of the law.” KSSS members have been placed above the law. The ideology of KSSS is “Nashism” (“ours-ism”), the selective application of rights.

In economics, the efforts of the KSSS are focused on strengthening and advancing quasi-governmental monopolies (governmental in form, privatized in essence, but not formally under the control of any governmental agency), the main purpose of which is the privatization of profits and the nationalization of losses. A strong government-private partnership gathers revenues in order to force nominally private businesses to fulfill the demands of the Corporation. Members of the KSSS exercise control over the primary financial flows. The highest reward conferred by the Corporation is appointment of members to positions on the boards of directors of government- and quasi-government-owned companies. This principle holds for all members of the Corporation, whether they are citizens of Russia or former Chancellors of a foreign country.

The traditions, habits and modus operandi characteristic of the intelligence services are being spread by the Corporation to all levels of Russian society. Secrecy and informational asymmetry are being imposed on the entire country.

The ideology of the KSSS is the ideology of the fortress, under siege by outside enemies and undermined by traitors and apostates from within. The primary means used by the KSSS for resolving governmental and social problems is force, unrestrained by the rules of law, tradition or morals, and completely absent of any experience, ability or desire to reach solutions by negotiating between competing interests. The relative success of the KSSS is also in large part dependent upon personal bonds with several leaders of countries in the West and East.

Initial results from the implementation of the Power Model in Russia indicate an inexorably deepening catastrophe. The key indicator of the effectiveness of any government is the security of its citizens. The number of serious crimes against persons – murder, robbery, assault, rape – per 100,000 residents in Russia is today over twice as high as it was in 1998, a year when the country suffered its most devastating financial crisis ever, accompanied by a significant depression and decline in the standard of living, but when the Siloviki were not in power.

In rate of economic growth between the periods 1999-2000 and 2004-2006, Russia fell from third to 13th place among the countries of the former USSR. And this despite the price of oil increasing by five times over the same period.

The Power Model of governance is not capable of securing the same tempo of growth as observed in other countries of the former USSR, including those that have neither oil nor gas. The Power Model does not strengthen the government – it destroys the very institutions of government and society. And the Power Model does not strengthen the diplomatic position of Russia – it leads to her isolation.

The change in the external world’s attitude Russia can be summed up by the following comparative progression. At the beginning of the 1990’s, the prevailing view of Russia was as a “large Poland”, albeit somewhat poorer and less developed. In order to follow the Polish path and approach the standard of living of developed countries, it was expected that Russia would require 10-15 years more than Poland.

Toward the end of the 1990’s, this view had to undergo some revision. It became clear that Russia was not Poland. It would be more accurate to compare it to Bulgaria, Romania, Serbia or Bosnia. And hence the building of quality institutions would take not 10-15 years, but more like 20-30.

Toward the middle of the current decade it became obvious that even a comparison with the Balkan countries would be inaccurate. In both the level of institutional degradation and the direction of movement, it would be more accurate to compare modern Russia with countries such as Venezuela and Iran.

In more recent years, however, it is becoming clear that even comparison with Venezuela and Iran would be incorrect. Russia now appears to be at an even lower level of institutional development, at the level of just a very few African countries. From the point of view of international comparison, we are somewhere between Nigeria and Zimbabwe, quickly approaching specifically Zimbabwe.

The rule of the “siloviki” has not meant an increase in the security of the Russian people. On the contrary, the siloviki in power are increasing the level of danger for our people in the most everyday sense of the word. In today’s Russia there is no more important cause than changing the current socio-political and economic order.

There are possibilities for changing the situation. But they are not lying on the surface. As concerns the KSSS itself, it is not demonstrating any kind of capability for transformation. The dynamic of the past seven years has shown that the rate of degradation in the institutions of the Russian state is increasing. A change in the regime from outside is also unacceptable. There remains only Russian society itself, the Russian people. Before us, before all of Russian society, stands the non-trivial challenge of changing the model by whatever means we have.

[TN: In the discussion forum that accompanied the above article in Yezhednevniy Zhurnal a reader noted that a longer version of this article had appeared on another forum, of the information portal Dom Druzey (House of Friends). That posting, dated April 2nd, in turn credited the home page of the daily Kommersant, but I was unable to locate the article on that website. Interestingly, the longer version, written prior to recent the protest actions in Moscow, did not contain the last paragraph of the above version.]

From the pages of Der Spiegel:

Former Putin Advisor Discusses Brutality Against Russian Opposition

Andrei Illarionov, 45, a senior fellow at the Washington-based Cato Institute and former chief economic advisor to Russian President Vladimir Putin, discusses the reasons for the Kremlin’s brutal treatment of the political opposition and the West’s attitudes toward Moscow.

SPIEGEL: We see the same images in the news almost every weekend: The powerful state has its police officers converge with clubs on small groups of protestors. Given his popularity, does President Vladimir Putin really need this?

Illarionov: Those in power deliberately use violence to intimidate. They want to break the people’s will to resist and act independently, and to do so they are constantly raising the level of aggression. Unlike the mass terror under Hitler, Stalin and Mao, we in Russia are currently experiencing a campaign of terror against individuals and groups.

SPIEGEL: Who is conducting it?

Illarionov: Employees of the intelligence agencies. These people now occupy more than 70 percent of all top positions in the state machinery. The destruction of Mikhail Khodorkovsky’s Yukos oil company, the murder of journalist Anna Politkovskaya, the polonium poisoning of former agent Alexander Litvinenko — the goal in each of these cases is to keep society in a state of constant fear. That makes it easier to control the people. This is the only reason the state-controlled media are allowed to report at length on these cases. It contributes to the climate of fear.

SPIEGEL: Who decided to deal with the protestors so harshly, the president or his advisors?

Illarionov: It certainly didn’t happen at the level of Interior Minister Rashid Nurgaliyev alone. It’s hard to imagine that such decisions were made without the knowledge of our country’s top leadership.

SPIEGEL: There is no evidence whatsoever of any threat to the government. The economy is growing by upwards of six percent, and Russians are traveling abroad on vacation and buying cars. Why doesn’t the Kremlin simply accept peaceful demonstrations?

Illarionov: Our rulers act according to a different logic. Putin himself said, and he was probably right, that there are no former intelligence agents. They were specifically trained to hunt down enemies. And if there are none, then they create them.

SPIEGEL: Is Russia a dictatorship?

Illarionov: Russia is certainly no longer a free country. We are moving in the direction of Zimbabwe.

SPIEGEL: Now you’re exaggerating.

Illarionov: No. All our democratic institutions are also being dismantled. We suffer from the Zimbabwean disease. This is why Russia is becoming more isolated diplomatically, and why economic growth is slowing. In a comparison with the 15 former Soviet republics, Russia is now third to last when it comes to economic growth.

SPIEGEL: Western companies value the stability Putin has brought to the country. Should they stop investing in Russia?

Illarionov: That’s their decision. They’ll have to evaluate the political risk themselves.

SPIEGEL: Boris Gryzlov, the president of the Russian parliament, has praised the police, with their grandmother-beating tactics, for having “done everything right.” He is scheduled to meet with German Foreign Minister Frank-Walter Steinmeier and the leaders of Germany’s major political parties in Berlin on Monday and Tuesday.

Illarionov: It is not my place to make recommendations to German members of parliament. If Gryzlov is justifying violence against the opposition, then he is approving what our criminal code refers to as banditry. It was not the demonstrators but the police officers that behaved like bandits. The police, with the blessing of those in power, acted like a terrorist group.

SPIEGEL: You served under Putin as liaison to the G8 for five years. Should the West exclude Russia from the group of key industrialized nations for its abuses of democracy?

Illarionov: One cannot overestimate the options the West has available with which it can apply pressure on Russia.

SPIEGEL: Will Putin enter a third term next March, despite the fact that it would not be sanctioned under the constitution?

Illarionov: Putin has often said that he will not do this. But there are people around him who are urging him to do so. They are taking many steps to ensure that he will feel compelled to stay.


Annals of Neo-Soviet Cold WarTactics: The London Conference Pullout

The Financial Times reports in an editorial:

There is something very disturbing about the last-minute mass pullout of Russian business leaders from London’s Russian Economic Forum, which started Monday. Some called the organizers, complaining of late diary changes. Others did not bother with excuses — it was obvious that behind the boycott lay the dread hand of the Kremlin. Officials have long been unhappy with London hosting the premier annual Russian economic conference and have steadily cut ministerial representation. But businesspeople were free to come until last week, when the top names suddenly cancelled.

The authorities gave no reasons. But they left no doubt they wanted to punish London, probably over the Boris Berezovsky affair. Officials are furious at Britain’s failure to respond to the exiled oligarch’s recent anti-Kremlin outburst. Moscow is also angry at the harm done to Russia’s global image by the row over the poisoning in London of former KGB agent Alexander Litvinenko. The conference pullout highlights the challenges of doing business with Russia. While the economy is booming, creating opportunities for many companies, the Kremlin is increasingly ready to intervene in the economy — even, it seems, in the conference sector. Officials argue that after the turmoil of the 1990s they had to restore order and give the state a leading role in key sectors, including energy. They say recent rapid growth proves they were right.

They have a point. But they are not telling the whole story. First, the recent boom owes almost everything to high oil prices, not government policies. Next, those policies have been implemented in nontransparent ways that have done nothing to restore respect for the law — and have instead created a chilling fear of officialdom. Also, the resurgence of the bureaucracy has been matched by growing corruption. There is little prospect of change. President Vladimir Putin will soon pick a successor, who will almost certainly win next year’s election. The front-runners, Dmitry Medvedev and Sergei Ivanov, both promise continuity. For foreign investors these are rich but dangerous waters. Even large groups are not immune from arbitrary actions, as Royal Dutch Shell found when it was pressed to sell control of the Sakhalin-2 scheme to Gazprom. Even companies not involved in strategic sectors may be hurt in the crossfire, as the forum organizers have learned. Investors who think they can avoid political risk are fooling themselves. In Russia almost everything is political and almost everything potentially carries political risk.

An article by reporter James Wilson adds more information:

he Kremlin yesterday continued to deny that it ordered a boycott by senior Russian officials and oligarchs of London’s Russian Economic Forum, for years the premier Russian business conference. But Itar-Tass, the state-owned news agency, gave an account that betrayed official Moscow’s attitude and could have come straight from the days when the agency was plain Tass, a Russian acronym for the Telegraph Agency of the Soviet Union.

“In recent years the Russian Economic Forum has lost its significance and is no longer a key event in defining economic co-operation between Russia and western capital,” the news agency explained in a dispatch. Russia’s internal markets, not the London markets, now played the decisive role in investment decisions in Russia. “And precisely because of this, it has become a logical step for the centre of gravity to shift from London to St Petersburg, where the St Petersburg Economic Forum will take place this summer.”

The Kremlin has teamed up with the World Economic Forum to try to turn the St Petersburg event into a “Russian Davos”. Expect to see Russsian president Vladimir Putin lead a phalanx of Russian ministers and businessmen at the event in June.

Welcome to the neo-Soviet Union! When Russia can’t win an argument, it takes its marbles and runs home crying to mommy (or sometimes it just kills you).

Russia’s Broken Heart

Writing in the Moscow Times, Dr. Harald M. Lipman, the former senior medical adviser to Britain’s Foreign and Commonwealth Office, who served as the regional medical adviser to the British Embassy in Moscow in 1983-1985 and 1987-1991, tells the tale of Russia’s broken heart:

Heart disease and related circulatory illnesses like strokes are arguably the single largest threat to Russia’s economic well-being and political future that the country will have to face in the 21st century. Fortunately, they are also problems that can, with appropriate measures, be controlled most easily. Cardiovascular disease is not a new problem. Deaths from heart disease in the Soviet Union doubled from 1965 to 1989.

Russia’s population is declining at a rate of 700,000 people per year, and it fell by 6 million during the 10 years leading up to 2003. If present trends continue, it is estimated that the total population will have fallen by a further 40 million, to about 100 million by 2050.

Life expectancy for Russian men is currently 58 years, compared with 77 years in Britain and 74 years in France and Germany. Over half of all early deaths are caused by heart and circulatory illness, with 1.25 million Russian men below retirement age dying from heart disease every year.

Some of the factors that increase the risk and likelihood of developing heart and circulatory disease, such as genetic predisposition, severe stress and infections cannot be modified significantly. The good news is that many of the risk factors are related to lifestyle and potentially modifiable. These include diet, obesity and level of physical activity. Eating too much animal fat and dairy products, for example, raises blood-cholesterol levels and the likelihood of blockage of blood vessels. Too much salt increases the risk of developing high blood pressure, which is associated with increased risk of heart disease and stroke. Smoking constricts blood vessels and reduces blood supply to the heart and brain, while diabetes also increases risks. All of these factors can be modified. The excessive consumption of alcohol, and binge drinking in particular, has a direct toxic effect on heart muscle and is a major cause of sudden deaths in Russian men.

Ongoing studies in the United States over the last 60 years and in Finland since 1970 have shown convincingly that the modification of lifestyle risk factors significantly reduces illness and death due to heart and circulatory disease. Similar small-scale trials in Karelia, Chelayabinsk, Yekaterinburg Tver and other regions have confirmed these findings.

Early deaths often cause devastating family and social problems, contributing to increased individual stress, depression and alcoholism. By further fueling the problem, this is creating more widows, destabilizing families and reducing their incomes. It is a never-ending spiral.

At the national level the economy is already experiencing serious losses as a result of early deaths and illness — at a rate of about $11 billion per year, or 1 percent of total gross domestic product. According to the World Bank, in the absence of successful measures to remedy the situation, this could rise to an annual loss of as much as $66 billion, or 5 percent of total GDP.

There will be increasing medical costs and worker absenteeism along with reductions in productivity, tax revenues, savings and healthy men to serve in the military. At a more general level, there will also be a greater risk of political instability.

President Vladimir Putin has publicly discussed the problem of Russia’s declining population on numerous occasions and has initiated and financed measures to combat it. These have largely concentrated on increasing family size, improving standards of healthcare and reducing the imbalance between immigration and emigration. These measures are essential, but unless the numbers of men who die early can be significantly reduced, the population will continue to fall.

A team of British experts in medicine, public health and medical education will be launching a project in London on Wednesday titled “Reducing Early Mortality in the Russian Federation” with the aim of helping Russia combat this problem.

A holistic project has been devised to give postgraduate training to Russian polyclinic doctors and other healthcare workers in recognizing the causes of heart and circulatory disease, as well as diagnosing and treating it. Simultaneously, intensive long-term public education programs will be undertaken at the local level involving all levels of society — families, schools, educational institutions, factories and workplaces — with the objective of educating people about cardiovascular illnesses and their causes, prevention and treatment. This will be combined with the preventative use by those at risk of developing heart disease of small daily doses of aspirin to thin the blood and of a medication known as statins to reduce blood-cholesterol levels.

For this program to be implemented and succeed it will have to receive authorization from the federal and regional governments and be planned and implemented in conjunction with Russian cardiologists, preventive medicine specialists and medical educators. Our initial experiences lead us to believe that this initiative will be welcomed by the Russian authorities.

We are proposing to begin with a three-year pilot project in a region yet to be determined, with the objective of demonstrating the benefits of the program on the ground and modifying it where necessary. Subsequently, similar programs will be initiated in other regions, ultimately stretching to cover the entire country.

Funding for the pilot scheme will probably come largely from non-Russian sources, but due to the vast scope of the project and the need to continue it indefinitely, subsequent funding will have to come from Russian sources — federal and regional governments, the corporate sector and individuals.

The benefits will be felt at the personal level as fathers, sons, brothers and uncles live longer and healthier lives, and at the national level in the form of a markedly improved economy. A 20 percent reduction in deaths from heart disease by 2025 will increase male life expectancy by six years and restore the anticipated 5 percent annual loss in GDP.

Changing long-established life styles will not be easy. But evidence from other projects show that it is not only possible, but can be highly successful. Many other healthcare problems will continue to exist, with those to combat infectious diseases, cancer and trauma to name just a few. But if this single project can save the lives of 250,000 men per year and improve the quality of life for many, many more, it must be implemented. For the sake of Russia’s future and the future of its people such a program has to succeed.

Russia’s Broken Heart

Writing in the Moscow Times, Dr. Harald M. Lipman, the former senior medical adviser to Britain’s Foreign and Commonwealth Office, who served as the regional medical adviser to the British Embassy in Moscow in 1983-1985 and 1987-1991, tells the tale of Russia’s broken heart:

Heart disease and related circulatory illnesses like strokes are arguably the single largest threat to Russia’s economic well-being and political future that the country will have to face in the 21st century. Fortunately, they are also problems that can, with appropriate measures, be controlled most easily. Cardiovascular disease is not a new problem. Deaths from heart disease in the Soviet Union doubled from 1965 to 1989.

Russia’s population is declining at a rate of 700,000 people per year, and it fell by 6 million during the 10 years leading up to 2003. If present trends continue, it is estimated that the total population will have fallen by a further 40 million, to about 100 million by 2050.

Life expectancy for Russian men is currently 58 years, compared with 77 years in Britain and 74 years in France and Germany. Over half of all early deaths are caused by heart and circulatory illness, with 1.25 million Russian men below retirement age dying from heart disease every year.

Some of the factors that increase the risk and likelihood of developing heart and circulatory disease, such as genetic predisposition, severe stress and infections cannot be modified significantly. The good news is that many of the risk factors are related to lifestyle and potentially modifiable. These include diet, obesity and level of physical activity. Eating too much animal fat and dairy products, for example, raises blood-cholesterol levels and the likelihood of blockage of blood vessels. Too much salt increases the risk of developing high blood pressure, which is associated with increased risk of heart disease and stroke. Smoking constricts blood vessels and reduces blood supply to the heart and brain, while diabetes also increases risks. All of these factors can be modified. The excessive consumption of alcohol, and binge drinking in particular, has a direct toxic effect on heart muscle and is a major cause of sudden deaths in Russian men.

Ongoing studies in the United States over the last 60 years and in Finland since 1970 have shown convincingly that the modification of lifestyle risk factors significantly reduces illness and death due to heart and circulatory disease. Similar small-scale trials in Karelia, Chelayabinsk, Yekaterinburg Tver and other regions have confirmed these findings.

Early deaths often cause devastating family and social problems, contributing to increased individual stress, depression and alcoholism. By further fueling the problem, this is creating more widows, destabilizing families and reducing their incomes. It is a never-ending spiral.

At the national level the economy is already experiencing serious losses as a result of early deaths and illness — at a rate of about $11 billion per year, or 1 percent of total gross domestic product. According to the World Bank, in the absence of successful measures to remedy the situation, this could rise to an annual loss of as much as $66 billion, or 5 percent of total GDP.

There will be increasing medical costs and worker absenteeism along with reductions in productivity, tax revenues, savings and healthy men to serve in the military. At a more general level, there will also be a greater risk of political instability.

President Vladimir Putin has publicly discussed the problem of Russia’s declining population on numerous occasions and has initiated and financed measures to combat it. These have largely concentrated on increasing family size, improving standards of healthcare and reducing the imbalance between immigration and emigration. These measures are essential, but unless the numbers of men who die early can be significantly reduced, the population will continue to fall.

A team of British experts in medicine, public health and medical education will be launching a project in London on Wednesday titled “Reducing Early Mortality in the Russian Federation” with the aim of helping Russia combat this problem.

A holistic project has been devised to give postgraduate training to Russian polyclinic doctors and other healthcare workers in recognizing the causes of heart and circulatory disease, as well as diagnosing and treating it. Simultaneously, intensive long-term public education programs will be undertaken at the local level involving all levels of society — families, schools, educational institutions, factories and workplaces — with the objective of educating people about cardiovascular illnesses and their causes, prevention and treatment. This will be combined with the preventative use by those at risk of developing heart disease of small daily doses of aspirin to thin the blood and of a medication known as statins to reduce blood-cholesterol levels.

For this program to be implemented and succeed it will have to receive authorization from the federal and regional governments and be planned and implemented in conjunction with Russian cardiologists, preventive medicine specialists and medical educators. Our initial experiences lead us to believe that this initiative will be welcomed by the Russian authorities.

We are proposing to begin with a three-year pilot project in a region yet to be determined, with the objective of demonstrating the benefits of the program on the ground and modifying it where necessary. Subsequently, similar programs will be initiated in other regions, ultimately stretching to cover the entire country.

Funding for the pilot scheme will probably come largely from non-Russian sources, but due to the vast scope of the project and the need to continue it indefinitely, subsequent funding will have to come from Russian sources — federal and regional governments, the corporate sector and individuals.

The benefits will be felt at the personal level as fathers, sons, brothers and uncles live longer and healthier lives, and at the national level in the form of a markedly improved economy. A 20 percent reduction in deaths from heart disease by 2025 will increase male life expectancy by six years and restore the anticipated 5 percent annual loss in GDP.

Changing long-established life styles will not be easy. But evidence from other projects show that it is not only possible, but can be highly successful. Many other healthcare problems will continue to exist, with those to combat infectious diseases, cancer and trauma to name just a few. But if this single project can save the lives of 250,000 men per year and improve the quality of life for many, many more, it must be implemented. For the sake of Russia’s future and the future of its people such a program has to succeed.

Russia’s Broken Heart

Writing in the Moscow Times, Dr. Harald M. Lipman, the former senior medical adviser to Britain’s Foreign and Commonwealth Office, who served as the regional medical adviser to the British Embassy in Moscow in 1983-1985 and 1987-1991, tells the tale of Russia’s broken heart:

Heart disease and related circulatory illnesses like strokes are arguably the single largest threat to Russia’s economic well-being and political future that the country will have to face in the 21st century. Fortunately, they are also problems that can, with appropriate measures, be controlled most easily. Cardiovascular disease is not a new problem. Deaths from heart disease in the Soviet Union doubled from 1965 to 1989.

Russia’s population is declining at a rate of 700,000 people per year, and it fell by 6 million during the 10 years leading up to 2003. If present trends continue, it is estimated that the total population will have fallen by a further 40 million, to about 100 million by 2050.

Life expectancy for Russian men is currently 58 years, compared with 77 years in Britain and 74 years in France and Germany. Over half of all early deaths are caused by heart and circulatory illness, with 1.25 million Russian men below retirement age dying from heart disease every year.

Some of the factors that increase the risk and likelihood of developing heart and circulatory disease, such as genetic predisposition, severe stress and infections cannot be modified significantly. The good news is that many of the risk factors are related to lifestyle and potentially modifiable. These include diet, obesity and level of physical activity. Eating too much animal fat and dairy products, for example, raises blood-cholesterol levels and the likelihood of blockage of blood vessels. Too much salt increases the risk of developing high blood pressure, which is associated with increased risk of heart disease and stroke. Smoking constricts blood vessels and reduces blood supply to the heart and brain, while diabetes also increases risks. All of these factors can be modified. The excessive consumption of alcohol, and binge drinking in particular, has a direct toxic effect on heart muscle and is a major cause of sudden deaths in Russian men.

Ongoing studies in the United States over the last 60 years and in Finland since 1970 have shown convincingly that the modification of lifestyle risk factors significantly reduces illness and death due to heart and circulatory disease. Similar small-scale trials in Karelia, Chelayabinsk, Yekaterinburg Tver and other regions have confirmed these findings.

Early deaths often cause devastating family and social problems, contributing to increased individual stress, depression and alcoholism. By further fueling the problem, this is creating more widows, destabilizing families and reducing their incomes. It is a never-ending spiral.

At the national level the economy is already experiencing serious losses as a result of early deaths and illness — at a rate of about $11 billion per year, or 1 percent of total gross domestic product. According to the World Bank, in the absence of successful measures to remedy the situation, this could rise to an annual loss of as much as $66 billion, or 5 percent of total GDP.

There will be increasing medical costs and worker absenteeism along with reductions in productivity, tax revenues, savings and healthy men to serve in the military. At a more general level, there will also be a greater risk of political instability.

President Vladimir Putin has publicly discussed the problem of Russia’s declining population on numerous occasions and has initiated and financed measures to combat it. These have largely concentrated on increasing family size, improving standards of healthcare and reducing the imbalance between immigration and emigration. These measures are essential, but unless the numbers of men who die early can be significantly reduced, the population will continue to fall.

A team of British experts in medicine, public health and medical education will be launching a project in London on Wednesday titled “Reducing Early Mortality in the Russian Federation” with the aim of helping Russia combat this problem.

A holistic project has been devised to give postgraduate training to Russian polyclinic doctors and other healthcare workers in recognizing the causes of heart and circulatory disease, as well as diagnosing and treating it. Simultaneously, intensive long-term public education programs will be undertaken at the local level involving all levels of society — families, schools, educational institutions, factories and workplaces — with the objective of educating people about cardiovascular illnesses and their causes, prevention and treatment. This will be combined with the preventative use by those at risk of developing heart disease of small daily doses of aspirin to thin the blood and of a medication known as statins to reduce blood-cholesterol levels.

For this program to be implemented and succeed it will have to receive authorization from the federal and regional governments and be planned and implemented in conjunction with Russian cardiologists, preventive medicine specialists and medical educators. Our initial experiences lead us to believe that this initiative will be welcomed by the Russian authorities.

We are proposing to begin with a three-year pilot project in a region yet to be determined, with the objective of demonstrating the benefits of the program on the ground and modifying it where necessary. Subsequently, similar programs will be initiated in other regions, ultimately stretching to cover the entire country.

Funding for the pilot scheme will probably come largely from non-Russian sources, but due to the vast scope of the project and the need to continue it indefinitely, subsequent funding will have to come from Russian sources — federal and regional governments, the corporate sector and individuals.

The benefits will be felt at the personal level as fathers, sons, brothers and uncles live longer and healthier lives, and at the national level in the form of a markedly improved economy. A 20 percent reduction in deaths from heart disease by 2025 will increase male life expectancy by six years and restore the anticipated 5 percent annual loss in GDP.

Changing long-established life styles will not be easy. But evidence from other projects show that it is not only possible, but can be highly successful. Many other healthcare problems will continue to exist, with those to combat infectious diseases, cancer and trauma to name just a few. But if this single project can save the lives of 250,000 men per year and improve the quality of life for many, many more, it must be implemented. For the sake of Russia’s future and the future of its people such a program has to succeed.

Russia’s Broken Heart

Writing in the Moscow Times, Dr. Harald M. Lipman, the former senior medical adviser to Britain’s Foreign and Commonwealth Office, who served as the regional medical adviser to the British Embassy in Moscow in 1983-1985 and 1987-1991, tells the tale of Russia’s broken heart:

Heart disease and related circulatory illnesses like strokes are arguably the single largest threat to Russia’s economic well-being and political future that the country will have to face in the 21st century. Fortunately, they are also problems that can, with appropriate measures, be controlled most easily. Cardiovascular disease is not a new problem. Deaths from heart disease in the Soviet Union doubled from 1965 to 1989.

Russia’s population is declining at a rate of 700,000 people per year, and it fell by 6 million during the 10 years leading up to 2003. If present trends continue, it is estimated that the total population will have fallen by a further 40 million, to about 100 million by 2050.

Life expectancy for Russian men is currently 58 years, compared with 77 years in Britain and 74 years in France and Germany. Over half of all early deaths are caused by heart and circulatory illness, with 1.25 million Russian men below retirement age dying from heart disease every year.

Some of the factors that increase the risk and likelihood of developing heart and circulatory disease, such as genetic predisposition, severe stress and infections cannot be modified significantly. The good news is that many of the risk factors are related to lifestyle and potentially modifiable. These include diet, obesity and level of physical activity. Eating too much animal fat and dairy products, for example, raises blood-cholesterol levels and the likelihood of blockage of blood vessels. Too much salt increases the risk of developing high blood pressure, which is associated with increased risk of heart disease and stroke. Smoking constricts blood vessels and reduces blood supply to the heart and brain, while diabetes also increases risks. All of these factors can be modified. The excessive consumption of alcohol, and binge drinking in particular, has a direct toxic effect on heart muscle and is a major cause of sudden deaths in Russian men.

Ongoing studies in the United States over the last 60 years and in Finland since 1970 have shown convincingly that the modification of lifestyle risk factors significantly reduces illness and death due to heart and circulatory disease. Similar small-scale trials in Karelia, Chelayabinsk, Yekaterinburg Tver and other regions have confirmed these findings.

Early deaths often cause devastating family and social problems, contributing to increased individual stress, depression and alcoholism. By further fueling the problem, this is creating more widows, destabilizing families and reducing their incomes. It is a never-ending spiral.

At the national level the economy is already experiencing serious losses as a result of early deaths and illness — at a rate of about $11 billion per year, or 1 percent of total gross domestic product. According to the World Bank, in the absence of successful measures to remedy the situation, this could rise to an annual loss of as much as $66 billion, or 5 percent of total GDP.

There will be increasing medical costs and worker absenteeism along with reductions in productivity, tax revenues, savings and healthy men to serve in the military. At a more general level, there will also be a greater risk of political instability.

President Vladimir Putin has publicly discussed the problem of Russia’s declining population on numerous occasions and has initiated and financed measures to combat it. These have largely concentrated on increasing family size, improving standards of healthcare and reducing the imbalance between immigration and emigration. These measures are essential, but unless the numbers of men who die early can be significantly reduced, the population will continue to fall.

A team of British experts in medicine, public health and medical education will be launching a project in London on Wednesday titled “Reducing Early Mortality in the Russian Federation” with the aim of helping Russia combat this problem.

A holistic project has been devised to give postgraduate training to Russian polyclinic doctors and other healthcare workers in recognizing the causes of heart and circulatory disease, as well as diagnosing and treating it. Simultaneously, intensive long-term public education programs will be undertaken at the local level involving all levels of society — families, schools, educational institutions, factories and workplaces — with the objective of educating people about cardiovascular illnesses and their causes, prevention and treatment. This will be combined with the preventative use by those at risk of developing heart disease of small daily doses of aspirin to thin the blood and of a medication known as statins to reduce blood-cholesterol levels.

For this program to be implemented and succeed it will have to receive authorization from the federal and regional governments and be planned and implemented in conjunction with Russian cardiologists, preventive medicine specialists and medical educators. Our initial experiences lead us to believe that this initiative will be welcomed by the Russian authorities.

We are proposing to begin with a three-year pilot project in a region yet to be determined, with the objective of demonstrating the benefits of the program on the ground and modifying it where necessary. Subsequently, similar programs will be initiated in other regions, ultimately stretching to cover the entire country.

Funding for the pilot scheme will probably come largely from non-Russian sources, but due to the vast scope of the project and the need to continue it indefinitely, subsequent funding will have to come from Russian sources — federal and regional governments, the corporate sector and individuals.

The benefits will be felt at the personal level as fathers, sons, brothers and uncles live longer and healthier lives, and at the national level in the form of a markedly improved economy. A 20 percent reduction in deaths from heart disease by 2025 will increase male life expectancy by six years and restore the anticipated 5 percent annual loss in GDP.

Changing long-established life styles will not be easy. But evidence from other projects show that it is not only possible, but can be highly successful. Many other healthcare problems will continue to exist, with those to combat infectious diseases, cancer and trauma to name just a few. But if this single project can save the lives of 250,000 men per year and improve the quality of life for many, many more, it must be implemented. For the sake of Russia’s future and the future of its people such a program has to succeed.

Russia’s Broken Heart

Writing in the Moscow Times, Dr. Harald M. Lipman, the former senior medical adviser to Britain’s Foreign and Commonwealth Office, who served as the regional medical adviser to the British Embassy in Moscow in 1983-1985 and 1987-1991, tells the tale of Russia’s broken heart:

Heart disease and related circulatory illnesses like strokes are arguably the single largest threat to Russia’s economic well-being and political future that the country will have to face in the 21st century. Fortunately, they are also problems that can, with appropriate measures, be controlled most easily. Cardiovascular disease is not a new problem. Deaths from heart disease in the Soviet Union doubled from 1965 to 1989.

Russia’s population is declining at a rate of 700,000 people per year, and it fell by 6 million during the 10 years leading up to 2003. If present trends continue, it is estimated that the total population will have fallen by a further 40 million, to about 100 million by 2050.

Life expectancy for Russian men is currently 58 years, compared with 77 years in Britain and 74 years in France and Germany. Over half of all early deaths are caused by heart and circulatory illness, with 1.25 million Russian men below retirement age dying from heart disease every year.

Some of the factors that increase the risk and likelihood of developing heart and circulatory disease, such as genetic predisposition, severe stress and infections cannot be modified significantly. The good news is that many of the risk factors are related to lifestyle and potentially modifiable. These include diet, obesity and level of physical activity. Eating too much animal fat and dairy products, for example, raises blood-cholesterol levels and the likelihood of blockage of blood vessels. Too much salt increases the risk of developing high blood pressure, which is associated with increased risk of heart disease and stroke. Smoking constricts blood vessels and reduces blood supply to the heart and brain, while diabetes also increases risks. All of these factors can be modified. The excessive consumption of alcohol, and binge drinking in particular, has a direct toxic effect on heart muscle and is a major cause of sudden deaths in Russian men.

Ongoing studies in the United States over the last 60 years and in Finland since 1970 have shown convincingly that the modification of lifestyle risk factors significantly reduces illness and death due to heart and circulatory disease. Similar small-scale trials in Karelia, Chelayabinsk, Yekaterinburg Tver and other regions have confirmed these findings.

Early deaths often cause devastating family and social problems, contributing to increased individual stress, depression and alcoholism. By further fueling the problem, this is creating more widows, destabilizing families and reducing their incomes. It is a never-ending spiral.

At the national level the economy is already experiencing serious losses as a result of early deaths and illness — at a rate of about $11 billion per year, or 1 percent of total gross domestic product. According to the World Bank, in the absence of successful measures to remedy the situation, this could rise to an annual loss of as much as $66 billion, or 5 percent of total GDP.

There will be increasing medical costs and worker absenteeism along with reductions in productivity, tax revenues, savings and healthy men to serve in the military. At a more general level, there will also be a greater risk of political instability.

President Vladimir Putin has publicly discussed the problem of Russia’s declining population on numerous occasions and has initiated and financed measures to combat it. These have largely concentrated on increasing family size, improving standards of healthcare and reducing the imbalance between immigration and emigration. These measures are essential, but unless the numbers of men who die early can be significantly reduced, the population will continue to fall.

A team of British experts in medicine, public health and medical education will be launching a project in London on Wednesday titled “Reducing Early Mortality in the Russian Federation” with the aim of helping Russia combat this problem.

A holistic project has been devised to give postgraduate training to Russian polyclinic doctors and other healthcare workers in recognizing the causes of heart and circulatory disease, as well as diagnosing and treating it. Simultaneously, intensive long-term public education programs will be undertaken at the local level involving all levels of society — families, schools, educational institutions, factories and workplaces — with the objective of educating people about cardiovascular illnesses and their causes, prevention and treatment. This will be combined with the preventative use by those at risk of developing heart disease of small daily doses of aspirin to thin the blood and of a medication known as statins to reduce blood-cholesterol levels.

For this program to be implemented and succeed it will have to receive authorization from the federal and regional governments and be planned and implemented in conjunction with Russian cardiologists, preventive medicine specialists and medical educators. Our initial experiences lead us to believe that this initiative will be welcomed by the Russian authorities.

We are proposing to begin with a three-year pilot project in a region yet to be determined, with the objective of demonstrating the benefits of the program on the ground and modifying it where necessary. Subsequently, similar programs will be initiated in other regions, ultimately stretching to cover the entire country.

Funding for the pilot scheme will probably come largely from non-Russian sources, but due to the vast scope of the project and the need to continue it indefinitely, subsequent funding will have to come from Russian sources — federal and regional governments, the corporate sector and individuals.

The benefits will be felt at the personal level as fathers, sons, brothers and uncles live longer and healthier lives, and at the national level in the form of a markedly improved economy. A 20 percent reduction in deaths from heart disease by 2025 will increase male life expectancy by six years and restore the anticipated 5 percent annual loss in GDP.

Changing long-established life styles will not be easy. But evidence from other projects show that it is not only possible, but can be highly successful. Many other healthcare problems will continue to exist, with those to combat infectious diseases, cancer and trauma to name just a few. But if this single project can save the lives of 250,000 men per year and improve the quality of life for many, many more, it must be implemented. For the sake of Russia’s future and the future of its people such a program has to succeed.