“About Your Articles about Russia”

Inkedyour articles_LIA concerned reader sent me this letter the other day. I was especially touched by the closing sentence: “When I was in Russia it appeared that common citizens were living comfortably, more-so than in USA.” The reader’s keen observations about life in Russia (about which I know next to nothing, despite having lived there for twenty-five years or so) are borne out by the article below.

Staff at Russia’s Main Cancer Center Quit En Masse, Citing Low Wages and Dire Conditions
Matthew Luxmoore
Radio Free Europe/Radio Liberty
October 01, 2019

MOSCOW—Russia’s main cancer treatment center has been rocked by a wave of resignations amid complaints about low wages and deteriorating conditions at its wards, in the latest indication of what medical professionals say is a systemic crisis that is endangering the quality and availability of critical care in the country.

At least 10 doctors have resigned over the past two days from the N.N. Blokhin Cancer Research Center, which bills itself as the biggest oncology clinic in Europe, following the publication of a video address from 26 staff members of its childhood cancer institute calling for the institution to reform its management and improve conditions for employees.

In the clip, which was posted to YouTube on September 30, four doctors from the institute decry falling salaries and alleged intimidation on the part of management and paint a picture of a health-care center that has fallen into serious disrepair.

“For years, children with cancer have been treated in terrible conditions. There’s no ventilation, mold is eating through the walls, and the wards are overcrowded with sick patients,” they say in their video address, which had gathered almost 250,000 views by the afternoon of October 1.

According to Maksim Rykov, deputy director of the childhood cancer institute and one of the doctors who features in the video, at least 12 of his staff handed in their resignations on October 1 and dozens more are set to follow. He told RFE/RL the walkout may ultimately result in a loss of more than half of the entire cancer center’s workforce, which amounts to over 3,500 people.

Conflicts at the institution arose following the June appointment of Svetlana Varfolomeyeva as director of the childhood cancer institute. Rykov accused Varfolomeyeva, his boss, of using intimidation and manipulation to force out current staff with a view to replacing them with new people.

Staff who opposed changes Varfolomeyeva introduced were pressured to quit, Rykov said, and many were saddled with an extra administrative burden that left less time for treating patients.

“She urged everyone to leave. So we did,” Rykov said in a phone interview. “Management got what they wanted.”

Navalny Support
In their video address, the doctors demanded the dismissal of Varfolomeyeva and her team and a greater degree of transparency in the allocation of pay to employees.

“We reached out to all government representatives, but no one listened to us,” Rykov says in the clip.

Rykov and his colleagues have been given support from the Alliance of Doctors, a medical workers’ union backed by Russian opposition leader Aleksei Navalny which has helped organize dozens of protests over health care in Russia and now has branches in at least 20 regions.

In recent weeks, doctors across Russia have publicly complained about what they say are low salaries and dire work conditions, and many have quit. In Perm, medical workers are staging a mass walkout over a lack of staff and decent pay. In Nizhny Tagil, the entire team of surgeons at the city hospital quit in August, also over wages.

Anastasiya Vasilyeva, the head of the Alliance of Doctors, told RFE/RL that clinics across Russia are reaching the crisis point. In a telephone interview, she called the spate of resignations at the Blokhin Cancer Center “one part of a broken system of health care which exists across Russia” and “a link in the same chain” as the incidents in Nizhny Tagil, Perm, and elsewhere.

She said the trade union’s regional branches are helping doctors speak out and publicizing their efforts, but the various clinics and hospitals that have publicly condemned conditions for its staff are not coordinating activities. “This is all spontaneously happening across the country,” she said.

The management of the Blokhin Cancer Center has been quick to counter the allegations by Rykov and others. In comments to the press on September 30, its director Ivan Stilidi suggested that the doctors who authored the video address “had personal ambitions to take over” Varfolomeyeva’s position.

Stilidi then alleged they were being “steered” by “people outside the cancer center,” appearing to echo a narrative about foreign meddling commonly advanced among officials in Russia. He did not specify what people he was referring to.

But doctors who have quit their jobs at the institution, or claimed to have been pressured to do so, say that the current wave of resignations is likely to continue. Georgy Mentkevich, who appeared in the video address alongside Rykov, said that some may stay temporarily to offer critical care to the patients they oversee, but few plan to remain for long in the current circumstances.

“People see whom they’re being forced to work with, and they see what’s happened with the cancer center over the past two years under this new management,” Mentkevich told the online news site Podyom on September 30. “Today people are giving notice. And they will leave.”

A Holiday in Chernobyl

Watch Kate Brown’s stunning lecture about the real, terrifying aftermath of the disaster at the Chernobyl Nuclear Plant.

Then buy her fabulous, groundbreaking new book Manual for Survival: A Chernobyl Guide to the Future and read it from cover to cover.

Once you have done this, ask yourself what kind of cynical lunatics would take people on holidays to the Chernobyl Exclusion Zone.

Chernobyl Cooling Tower

Day 5: Chernobyl Nuclear Power Plant
Friday, July 31, 2020

Leaving early from our hotel, we’ll travel by private bus to the Chernobyl Exclusion Zone. We’ll meet our Chernobyl guide, while a documentary film playing on the bus will bring us up to speed on the accident, its causes, and its many repercussions. On our first day in Chernobyl we’ll visit the reactors themselves to witness ground zero of the accident, admire the new containment structure installed in 2016, as well as check out some of the other facilities around the nuclear power plant. Between excursions, we’ll take lunch in the Chernobyl workers’ canteen, surrounded by scientists and engineers currently stationed at the plant. Later, after a long day of exploring, dinner will be served at a restaurant in Chernobyl town. Our accommodation for the night is at a hotel nearby, located inside the Chernobyl Exclusion Zone.

Day 6: The Streets of Pripyat
Saturday, August 1, 2020

At the time of the Chernobyl accident, the workers’ city Pripyat had a population of 49,000 people. It was evacuated soon after the event, and now survives as one of the world’s most famous ghost towns. Today, we’ll get to know this empty city intimately, walking its desolate streets, and visitings its abandoned schools, hospitals, and theaters. We’ll see all of Pripyat’s main landmarks, including the fairground, swimming pools, and also some fabulous street murals. After lunch back at the Chernobyl canteen, we’ll then get to visit one of the Exclusion Zone’s best-kept secrets: the DUGA radar installation, or “Russian Woodpecker,” that rises to a height of 150 meters at the heart of an abandoned Soviet military base. Late in the day we’ll return to the capital for one last night at our Kyiv hotel.

Source: Atlas Obscura. Photo of Chernobyl Cooling Tower by Darmon Richter. Courtesy of Atlas Obscura. Thanks to Louis Proyect for the heads-up on the lecture.

The Syrian Breakthrough

kuzminNikolai Kuzmin during his solo picket outside the exhibition The Syrian Breakthrough, in Pskov. His placard reads, “Spend budget money on our own schools and hospitals, not on someone else’s war.” Photo by Lyudmila Savitskaya. Courtesy of Radio Free Europe/Radio Liberty

Yabloko Activist Detained in Pskov at “Syrian Breakthrough” Exhibition
Lyudmila Savitskaya
Radio Svoboda
April 26, 2019

In Pskov, police have detained local Yabloko Party activist Nikolai Kuzmin, who held a solo picket outside an exhibition of military equipment entitled The Syrian Breakthrough. Kuzmin stood behind servicemen queued at the city’s train station to see the exhibition.

He held a placard that read, “Spend budget money on our own schools and hospitals, not on someone else’s war.”

Commenting on his actions, Kuzmin claimed over 25,000 schools had been closed in Russia over the past twenty years. The activist argued that, outside Moscow and Petersburg, it was nearly impossible to get an ambulance, and half of the men in Pskov Region did not live to retirement age.

“As in a dystopia, however, instead of being productive and saving the lives of Russians, we have raised war into a cult that we worship. Lacking reasons to feel proud, we are administered daily injections of patriotism. But patriotism does not mean fighting wars in someone else’s countries. It means building things in your own country and having a critical attitude toward the mania for military victory,” Kuzmin added.

Kuzmin’s picket lasted around ten minutes. During this time, members of the pro-regime organization Team 2018 managed to have their picture taken with him. Kuzmin was then surrounded by military police who asked him to leave. Kuzmin responded by asking them to identify themselves [as required by Russian laws regulating the police] and explain their grounds for wanting to remove him from a public event.

The military policemen were unable to fulfill Kuzmin’s request, so Sergei Surin, head of the Interior Ministry Directorate for Pskov [i.e., the local police chief] came to their aid. He personally detained Kuzmin while repeatedly refusing to explain the grounds for the arrest to Kuzmin and comment on it to reporters who were present.

Lev Schlosberg, leader of the Yabloko Party in Pskov, demanded Kuzmin’s immediate release and the removal from Pskov of The Syrian Breakthrough, which he dubbed a “propaganda scrap heap.”

“Russia must cease military operations in Syria, while government funds should be spent on peaceful goals that further the interests of Russia’s citizens,” Schlosberg said.

In February 2019, the Russian Defense Ministry launched a train containing weapons seized, it claimed, by Russian servicemen during combat in Syria. The train departed Moscow on an itinerary of sixty cities and towns. When it reaches Vladivostok, the train will head back to Moscow. It is scheduled to arrive there on the eve of Victory Day, May 9.

Thanks to Nikolai Boyarshinov for the heads-up. Translated by the Russian Reader

Buggered

rossiya This bankrupt agribusiness was called Rossiya (“Russia”). Photo courtesy of Maxim Kemmerling/Kommersant and Republic

“The Data Leaves Us at a Loss”: A Few Figures That Might Surprise the Kremlin
Yevgeny Karasyuk
Republic
April 4, 2019

“Why on shoes? Why a third? Where did they get these figures?”

Dmitry Peskov, President Putin’s press secretary, responded with questions to journalists who questioned him yesterday about Rosstat’s depressing report for 2018.

According to Rosstat’s study, in which sixty thousand Russian households were surveyed, every fifth Russian skimps on fruits and vegetables. Every other Russian family cannot afford to travel anywhere when they have a week’s vacation, while every fourth family does not have enough money to invite people over to celebrate birthdays and the New Year’s holiday.

And, indeed, the report does conclude that 35% of Russians are unable to purchase each family member two pairs of seasonally appropriate footwear.

“I would be grateful to Rosstat if they clarified these figures. The data leaves us at a loss,” Peskov added.

Meanwhile, there are other figures—lots of figures—that would probably also bedevil the Kremlin if they were aired in public. Let us recall a few of them.

Nutrition
Consumer watchdog Rospotrebnadzor concluded that 63% of deaths in Russia were associated with bad food and poor nutrition. According to official figures, Russians spend approximately 35% of their household budgets on food, while independent researchers put that figure at over fifty percent. However, the average Russian household skimps on all purchases and tries to do without everything it can, claim the researchers behind Romir’s Coffee with Milk Index, which charts the quantities of chocolate, coffee, milk, and bottled water purchased by Russians. Researchers at RANEPA recently described the diets of Russians as unhealthy, unbalanced, and lacking in energy.

Health
According to a report by RANEPA’s Institute for Social Analysis and Forecasting, 22% of Russians who live in straitened circumstances face the stark choice of whether to buy the bare minimum of the cheapest produce or the cheapest drugs, drugs they need to survive. It is typical of Russians, not only those below the poverty line, to postpone going to the doctor, if it involves costs, noted researchers at the Institute for Health Economics at the Higher School of Economics.

Education
According to the pollsters at VTsIOM, fifty percent of Russian parents experience serious financial difficulties when getting their children ready for the first day of the school year. Over the past five years, the average sum of money Russians claim to spend getting children ready for school has increased by sixty percent, rising from 13,600 rubles to 21,100 rubles.

Housing
According to the Construction Ministry, the Russian populace’s debts for utilities and housing maintenance bills have grown by five and a half times since 2015. The ministry reported that, as of the end of last year, the total amount of this debt was 1.2 trillion rubles [approx. 16.34 billion euros]. The rates for water, electricity, gas, and other utilities and services increase rhythmically year after year, and yet the real incomes of Russians have continued to fall five years in a row.

Transportation
Forty percent of Russian car owners “try not to use their own vehicles, taking public transport instead.” Another 22% of car owners follow their lead, but do it less frequently. VTsIOM has explained the outcome of its January opinion poll by citing the concern of Russians for the environment while failing to note that the price of petrol has skyrocketed in recent years. Last year, a liter of AI-95 rose in price three times faster than inflation. The government has resorted to artificial, decidedly non-market measures to depress prices, and yet petrol in Russia is now twice as expensive as it was when the decade kicked off.

Only twelve percent of Russians believe that, when it describes the economy and the social sector, the Russian regime always or mostly tells the truth. The Levada Center has done polls on the same subject since 2010. Russian society’s confidence in what the country’s leaders and senior officials say has never been as low as it is now.

By voicing surprise at Russia’s poverty, at least on paper, the Kremlin is, apparently, determined to convince people it inhabits a parallel reality in which Russia makes one breakthrough after another, and the rank and file enjoy “stability” by way of spiting the country’s numerous enemies. Peskov seemed genuinely puzzled by Rosstat’s claim that Russian families have trouble buying shoes, but he probably had not yet read the government’s report on the increase in mortality rates in every third region of Russia. Clearly, something is wrong with the figures. In short, we expect a reaction.

Translated by the Russian Reader

The World’s Largest Toxic Landfill

very toxicThe EU Dangerous Substances Directive classifies methyl mercaptan as “very toxic.” Why has the Russian government increased its maximum allowable concentration in the air by sixty times? Image courtesy of Wikipedia

Russia Raises Limits for Airborne Toxic Chemicals Sixtyfold
finanz.ru
February 19, 2019

The Russian Federal Sanitation and Epidemiology Service and national consumer watchdog Rospotrebnadzor have drastically raised the maximum allowable concentrations (MACs) of harmful substances in the air, including formaldehyde, nitrogen dioxide, and methyl mercaptan, a chemical typically emitted by waste landfills.

The current MAC of methyl mercaptan in the air is sixty times higher than it was ten years ago and 660 times higher than it was in 1999, Greenpeace Russia has reported in a press release.

Moreover, the new MAC for methyl mercaptan exceeds the odor threshold by one and a half to three times, meaning the level at which people living near waste landfills can smell the substance.

Greenpeace Russia noted that the MACs of a number of other air pollutants were increased in 2014 and 2015, for example, formaldehyde and nitrogen dioxide.

According to the previous standards, about 50 million Russians lived in cities where formaldehyde concentrations had been exceeded. After the MACs were relaxed, the statistics “improved.”  They now show, allegedly, that fewer cities are at risk, and only 20 million Russians may be affected by increased concentrations of carcinogens.

“However, according to assessments by Russian and international scientists, the risks presented by formaldehyde concentrations under the new, current guidelines correspond neither to the standards adopted by the Russian Federation nor common sense,” writes Greenpeace Russia, noting that phenol, formaldehyde, and methyl mercaptan are poisons. Constantly inhaling them increases toxicity in the body and reduces immunity.

“This is one of the factors contributing to a manifold increase of the incidence of flu and acute respiratory infections over the last twenty years,” Greenpeace Russia claimed  in its press release.

As grounds for its decision to raise the MACs, Rospotrebnadzor refers to complex toxicological, sanitary, and epidemiological studies, as well as an analysis of international practices, but it refused to provide the specific research findings, Greenpeace Russia reported.

The Human Ecology and Environmental Hygiene Research Institute, which reports to Rospotrebnadzor, claimed no such research had been conducted whatsoever, and all it had provided to Rospotrebnadzor were background, reference materials. But even they were not taken into account when the decision was taken to increase the MACs for phenol and formaldehyde.

On February 18, Greenpeace Russia sent an open letter to the relevant committees in State Duma, the Russian Security Council, the Russian Health Ministry, the Russian Natural Resources Ministry, Rospotrebnadzor, and Rosprirodnadzor, the Russian natural resources watchdog. In the letter, Greenpeace Russia pointed out that the unwarranted changes to the sanitary norms jeopardized the implementation of the priority national environment and health projects.

Thanks to Julia Murashova and the Coalition to Defend Petersburg for the heads-up. See my previous entry, “Denis Stark: Welcome to the Clean Country,” on the topic of waste management in Russia. Translated by the Russian Reader

The Postman Always Rings Twice

pochtaA rural post office, perhaps abandoned, in Novgorod Region. Photo courtesy of Novgorod.ru

Medical Care in Novgorod Region to Be Provided by Postmen 
Novgorod.ru
January 16, 2019

Yesterday, January 15, a meeting of the supervisory board of the Agency of Strategic Initiatives for Promoting New Projects (ASI) took place in Moscow. Novgorod Region Governor Andrei Nikitin attended the meeting, which recapped the work done by the ASI in 2018.

The meeting was chaired by President Vladimir Putin.

“The agency has developed a unique method for solving problems. Most import, it has brought together an entire community of people capable of generating and promoting positive change,” said Putin.

Attendees also discusses the new projects the ASI plans to implement in 2019–2021. They include support for urban communities and their leaders, creating a digital platform for handling appeals and complaints by entrepreneurs, and systematic measures for developing technological entrepreneurship in Russia.

One of the projects presented at the meeting has been underway in Novgorod Region’s Poddorye District. As part of a cooperation agreement between the regional health ministry and the Russian Post, postal carriers have undergone training and will now act as assistant paramedics.

While delivering the mail, they will perform primary medical diagnoses and communicate this information to paramedics. They will be able to measure blood pressure, check blood sugar levels, and perform emergency tests.

According to Nikolai Podguzov, director general of the Russian Post, around seven hundred letter carriers have undergone the training.

Thanks to Sergei Damberg for the heads-up. Translated by the Russian Reader

We Wouldn’t Mind If You Died of AIDS and Hepatitis C

aids flagRussia has an HIV epidemic. According to the Federal Aids Prevention Center, approximately a million Russians are infected. A third of them also have hepatitis C. At best, only hundreds of these patients receive state-of-the-art treatment. Image by Yaroslava Chingayev, special to Vedomosti

Officials Want to Replace Current Hepatitis C Treatment with Outmoded Therapy
Industry and Trade Ministry Supplied Money for Manufacture of Drugs
Irina Sinitsyna and Olga Sukhoveiko
Vedomosti
December 13, 2018

The Russian Health Ministry plans to significantly reduce procurements of the most effective treatment for viral hepatitis C, combined interferon-free treatment, thus reducing the availability of the drugs for patients infected with HIV in combination with hepatitis B and hepatitis C. Instead, the ministry has proposed putting these patients on interferon therapy. Maria Onufriyeva, director of Community of People Living with HIV, an interregional grassroots organization, has written about the matter to Health Minister Veronika Svkortsova. Ms. Onufriyeva has also sent a letter to Valery Alexeyev, director of the Honest Procurements Project at the Russian People’s Front (ONF). Vedomosti has seen copies of the letters. Ms. Onufriyeva confirmed she sent them. A spokesperson for Mr. Alexeyev said he received the letter. The Health Ministry has not responded to her query.

In November, Minister Skvortsova said that over 714,000 Russians were infected with HIV. According to the Federal Aids Prevention Center, whose figures Ms. Onufriyeva cites, there are 978,443 Russians infected with HIV. A third of them also have hepatitis C.

In late October, the Health Ministry published the final list and amounts of drugs it would be procuring in 2019 and providing to HIV patients, including HIV patients who also have hepatitis B and hepatitis C, writes Ms. Onufriyeva. (Vedomosti has seen a copy of this list.) In particular, the Health Ministry wants to reduce procument of dasabuvir by 750%, meaning one hundred patients would have access to the drug, while this year 748 people could count of getting it, according to the Community’s calculations.

In monetary terms, this would mean a drop in expenditures on the drug from 431.6 million rubles [approx. 5.7 million euros] to 57.9 million rubles [767, 754 euros].

The Health Ministry plans to switch to narlaprevir, intended for the treatment of hepatitis C in combination with other antiviral drugs. In 2018, as the Community has discovered, and as is borne out by information accessed on the federal procurements website, narlaprevir was not purchased by the Russian governmennt. In 2019, the Health Ministry could spend 139 million rubles [approx. 1.8 million euros] on procuring the drug in order to treat 430 people, the Community argues.

Dasabuvir is the most up-to-date antiviral drug. According to the Community, it can cure 98% of hepatitis C patients in twelve weeks.

This figure was confirmed by Vadim Pokrovsky, director of the Federal AIDS Prevention Center.

In Russia, HIV patients who also have hepatitis C have been treated with dasabuvir in combination with ombitasvir/paritaprevir/ritonavir, manufactured under the brand name Viekira Pak by the American company AbbVie. Dasabuvir was placed on the official Russian list of vital and essential drugs for this year. Two years ago, Alexey Repik’s R-Pharm and AbbVie agreed to partly localize manufacture of the drug at R-Pharm’s plant in Kostroma. As R-Pharm reported then, the deal covered repackaging of the drug and quality control. According to AbbVie, Viekira Pak is distributed in Russia by R-Pharm and Euroservice.

Ms. Onufriyeva writes that interferon therapy is much less effective in treating chronic hepatitis C patients with HIV. The treatment significantly reduces quality of life, since it requires weekly injections.

Mr. Pokrovsky explained the difference. Interferon treatment has almost no effect on the virus itself. It stimulates the body’s immune response, but it has numerous side effects, from impotence to mental disturbances. The treatment lasts a year.

Due to the length of the treatment, Ms. Onufriyeva said, it was between 52% and 133% more expensive than interferon-free treatment.

Tableted by R-Pharma, narlaprevir has to be taken together with ritonavir, pegylated (long-acting) interferon, and ribavirin, as indicated in the instructions.

In 2012, R-Pharma acquired a license for the production and sale of narlaprevir from Merck & Co. It tried to refine the drug with support from a federal targeted program administered by the Russian Industry and Trade Ministry. Trade publication Vademecum wrote that R-Pharm invested 700 million rubles in narlaprevir. The Industry and Trade Ministry would allocate 120 million rubles on clinical trials, Sergei Tsyb, head of the ministry’s Department for Chemical Engineering and Bioengineering, promised in 2012.

A R-Pharm spokesperson confirmed receipt of the funds.

R-Pharm registered narlaprevir in 2016. In the spring of 2017, during a meeting with the business community, President Putin promised R-Pharm’s director general Vasily Ignatiev that the government would allocate funds to procure the company’s drugs for hepatitis C patients.

“I will also keep this in mind when allocating resources for healthcare in 2018 and the following years, in 2019 and 2020. It will be necessary, of course, to use what you have developed,” Putin said.

Mr. Pokrovsky is certain the Health Ministry’s decision to reduce procurements of interferon-free drugs could have been influenced by Russian manufacturers wanting to compensate their costs at the state’s expense.

The R-Pharm spokesperson insisted that the company, like other manufactures, received a request from the Health Ministry to quote its prices for narlaprevir and dasabuvir.

“Our price offers for the drugs were the same as last year’s,” he said.

In total, according to the Community’s calculations, in 2019, the Health Ministry can spend 473.5 million rubles [approx. 6.3 million euros] on the procurement of drugs for treating chronic hepatitis C, as opposed to 1.1 billion rubles [approx. 14.6 million euros] last year.

In November, Vademecum wrote that, in 2019, the Health Ministry would also reduce its overall procurement of antiretroviral drugs under its program for providing drugs to people infected with HIV, including patients who were infected with HIV in combination with the hepatitis B and C viruses. However, although it would spend far less money, it planned to expand coverage to a mere sixty percent of those needing treatment.

Ms. Onufriyeva has asked the Health Ministry to consider increasing procurements and moving away from the chronic hepatitis C drugs scheduled for purchase in 2019 and towards drugs that have proven effective. The latter should be supplied to patients with HIV plus viral hepatitis C, including those suffering from advanced liver fibrosis and cirrhosis.

She has asked Mr. Alexeyev to assist her in protecting the interests of patients by sending inquiries to the Health Ministry, asking them to explain the reasons for the cuts in procurements and the selection of outmoded drugs. She also asked him to verify whether the Health Ministry’s actions were in compliance with antitrust laws.

She told Vedomosti she had not received replies to her letters.

vich

“How the Numbers of HIV-Infected Patients Have Changed, 2013–2018.” The red columns indicate total numbers of patients; the orange columns, first-time infections. Figures are given in thousands of people. Source: Rosstat. Courtesy of Vedomosti

Mr. Alexeyev explained the delay in replying. The letter contained a good deal of specialized and medical information, and it was under review by independent experts working for the Russian People Front’s Honest Procurements Project.

“The Russian People’s Front has drawn attention to problems with the list of essential and vital drugs, and their procurements, and this letter is the latest alarm,” he said.

According to Mr. Alexeyev, the Russian People’s Front has been reviewing the Health Ministry’s procedure for including medicines on the list and had already been in touch with the government.

hep b and c

“How the Numbers of Hepatitis Patients Have Changed, 2013–2018.” The dark blue bars indicate first-time cases of chronic hepatitis B; the light blue bars, first-time cases of chronic hepatitis C. Figures are given in thousands of people. Source: Rospotrebnadzor. Courtesy of Vedomosti

If the grassroots organization Community of People Living with HIV believes the industry regulator acted in a way that violated specific regulations on procurements or antitrust statutes, it can file a complaint with the Federal Anti-Monopoly Service (FAS) in the manner prescribed by law, said Maxim Degtyarev, deputy head of the Department for Oversight of the Social Sector and Trade at FAS. For the time being, however, FAS had no grounds to perform an inspection.

The Industry and Trade Ministry did not respond to our request for information.

Elena Filimonova contributed to this article.

Translated by the Russian Reader