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

Squandering Its Way to Superpowerdom

“Squandering”: Did the US Secretary of State Grasp the Russian Approach to Budget Spending?
The Kremlin Accused the State Department of Tactlessness and Unprofessionalism, Yet Pompeo’s Remarks Were on the Mark
Yevgeny Karasyuk
Republic
December 13, 2018

padrino.jpgVenezuelan Defence Minister Vladimir Padrino gives his thumb up as he sits on the cockpit of a Russian Tupolev Tu-160 strategic long-range heavy supersonic bomber after it landed at Maiquetia International Airport, north of Caracas, on December 10, 2018. Courtesy of Federico Parra/AFP/Getty Images

Russian’s decision to send strategic bombers on a junket to an airport near Caracas elicited a curious reaction from US Secretary of State Mike Pompeo, who publicly expressed his pity for Russian taxpapers, whose money the Kremlin, habitually disregarding the costs, has been spending on its geopolitical moves.

“The Russian and Venezuelan people should see this for what it is: two corrupt governments squandering public funds, and squelching liberty and freedom while their people suffer,” Pompeo wrote.

The Russian Foreign Ministry responded by calling Pompeo’s statement “utterly unprofessional” and even “villainous.” Pompeo’s remarks, which the Kremlin, in turn, dubbed “inappropriate” and “undiplomatic,” were apparently really lacking in nuance: the hardships of Russians, fortunately, cannot yet be compared with the suffering of Venezuelans. But, hand on heart, was Pompeo so wrong when he talked about the losses to the Russian federal budget and lack of oversight?

Russian society has an extremely vague notion about how much the Kremlin’s expansionism has ultimately cost the country. According to calculations made by IHS Jane’s at the outset of Russia’s operations in Syria in autumn 2015, Russia could have been spending as much as $4 million a day. Later, the Yabloko Democratic Party, which is not seated in the Russian parliament, estimated the Kremlin had spent a total of 108–140 billion rubles [between $1.6 and $2.1 billion] on Syria. A more accurate assessment would be difficult to make. Experts doubt that anyone, including the Finance Ministry, keeps tabs on such expenditures. Thus, nobody knows the real cost of Russia’s involvement in the Syrian conflict, argues the Gaidar Institute’s Military Economics Laboratory.

The budget’s fading transparency has been a trend in recent years. In 2016, secret and top-secret allocations accounted for 22% of total federal budget expenditures, a record for the entire post-Soviet period, and much higher than secret allocations in comparable countries, according to RANEPA’s March 2015 report on the Russian economy.

Quite naturally, this state of affairs has not improved the quality of the state’s financial decisions. In terms of effective state spending, Russia ranked nineteenth in a new rating of twenty-five countries, compiled by the Higher School of Economics using data from the World Bank and OECD. Since they are not priorities for the current regime, problems with child mortality and life expectancy were among the reasons Russia ranked so low in the survey: the government spends more on the army than on healthcare—4.3% of GDP versus 3.8% of GDP, respectively. In these circumstances, the chances the Kremlin’s strategic projects in the Middle East and Africa (e.g., the Central African Republic, Burkina Faso, the Democratic Republic of the Congo, and Mozambique) will be decently funded are always much greater than the national healthcare project, which stipulated increased government spending on cancer treatment. The government nixed the plan over summer.

Since it remains largely Soviet in spirit, Russia’s foreign policy has been categorically blind to history’s lessons. The Soviet Union’s exorbitant geopolitical ambitions and support for fringe regimes around the world left the country with a legacy of mostly toxic multi-billion-dollar debts. The process of writing them off has been disguised as a form of international charity or, speaking diplomatically, official development assistance (ODA). According to RANEPA, writing off the debts of developing countries accounted for 35% of all such “international aid” last year or $425 million. It has been the Russian government’s usual way of doing business. Previously, the Russian government wrote off the debts of Nicaragua ($6.3 billion), Iraq ($21.5 billion), North Korea ($10.9 billion), Syria ($9.8 billion), Afghanistan ($11 billion), and Cuba ($29 billion), among other countries. Venezuela risks joining this sad list. Over the past twelve years, Russia has invested a total of $17 billion in the country.

Russia’s Expenditures on Official Development Assistance (Excluding Humanitarian Aid), 2005–2017, in Millions of Dollars. Sources: OECD, Russian Finance Ministry. Courtesy of Republic

Since it was paid for by the Russian federal budget, which has been running a deficit for the last seven years, Russian officials probably did not see the transatlantic flight of its strategic bombers as too expensive. On the contrary, they saw it as a flashy display of Russia’s military prowess and proof of its influence in the region. However, the government of Nicolás Maduro signed off on the stunt. Subject to growing pressure from creditors and an angry, desperate population, it lives day by day. In all likelihood, it will soon collapse, leaving behind a mountain of unpaid bills and unfulfilled obligations to its allies. If this is the case, can we evaluate the Russian government’s action better than the tactless Mike Pompeo did? Probably not.

Translated by the Russian Reader

We Wouldn’t Mind If You Died of AIDS

nutter

HIV Prevention Organization in Altai Territory Closes Due to Inability to Pay Court Fine
Takie Dela
December 4, 2018

Choice (Vybor), a non-profit HIV service organization, has been forced to close its office in Biysk, Altai Territory, due to its inability to pay a court-imposed fine, reports Kommersant. The NGO had been found guilty of refusing to acknowledge it was a “foreign agent.”

The Altai Territorial Court upheld the ruling of the Biysk City Court, which had fined Choice 150,000 rubles [approx. €2,000] for failing to recognize itself as a “foreign agent” and voluntarily place itself on the registry of “foreign agents.”

According to Maxim Olenichev, a lawyer from Attorneys for Equal Rights who represented Choice in court, on November 30, the organization was forced to close its office and cancel its HIV prevention programs in the region, including programs for intravenous drug users and other risk groups.

“HIV-service NGOS have access to ‘closed’ groups of people who are unwilling to turn to state institutions for help,” Olenichev said in an interview with reporters. “Attacking such NGOS reflects a policy of ‘traditional values,’ a policy focused on criminalizing the actions of people who do not comply with these values or ignore them. By using the law on ‘foreign agents’ to destroy NGOs, the state promotes the growth of HIV-infected people, although by joining forces with NGOs the state could halt the epidemic’s growth.”

The court ruled that several of Choice’s campaigns, during which the NGO handed out HIV express tests (41 people tested positive — TD), over 100,000 clean syringes, and 20,000 condoms for free, were “political” in nature. Choice employees noted they worked with the primary vulnerable groups as defined by the Russian state, using the same methods as specified in the official rules for HIV prevention. The court chose to ignore these arguments.

The court also agreed with the Russian Justice Ministry’s claim that Choice had received foreign funding in 2014 and 2016. Choice received 147,000 rubles from ESVERO, a non-profit partnership, and 272,000 rubles from the AIDS Healthcare Foundation.

Olenichev pointed out that ESVERO had been implementing a project of the Global Fund for Fighting AIDs, Tuberculosis and Malaria, which receives funding from the Russian government, in thirty-four Russian regions. The NGO was thus using grants to put the money back into the Russian economy. As for the AIDS Healthcare Foundation, which sponsored Choice with funding in rubles, Olenichev claimed there was no evidence in the case file that the organization was foreign. Nevertheless, the court refused to reverse the fine.

According to the latest data from the Russian Health Ministry, in 2017, 53.5% of new cases of HIV infection were caused by sexual intercourse, while 43.6% of new infections were caused by the use of intravenous drugs. According to official statistics, the number of HIV-infected people in Russia is 998,525. Eighty-one percent of them know they are infected.

The World Health Organization (WHO) has recognized Russia as leading Europe in new cases of HIV infections at 71.1 cases per every 100,000 people. The virus is primarily transmitted through heterosexual sex (59%) and intravenous drug use (30%). The Russian Health Ministry has called these figures “extremely inaccurate.”

In late October, the Saratov Regional Organization of Chronic Diabetes Sufferers announced its closure: a court had also fined it 300,000 rubles for violating the law on “foreign agents.” The expert employed by the prosecutor’s office to audit the organization concluded it had “shape[d] preconditions for discrediting the authorities” and “report[ed] about the region’s so-called sore points to [its] foreign partners.”

Thanks to Alexander Feldberg for the heads-up. Translated by the Russian Reader

Suicide Invoice, Part 2

safonovo hospital homepageScreenshot of the Safonovo Central District Hospital’s website

14-Year-Old Girl Writes Letter to Putin, Kills Herself
Radio Svoboda
November 20, 2018

Identified only as Natasha, a fourteen-year-old girl who complained to Vladimir Putin about her mother’s low wages has committed suicide in the city of Safonovo in Smolensk Region.

According to local news media, the teenager also complained about bullying at school. She was visually impaired. Her classmates teased her by calling her “Cyclops.”

Shortly before her death, she posted the following message on her social network page: “Why are you all so mean?”

The newspaper Smolenskaya Narodnaya Gazeta writes that the fourteen-year-old girl’s mother worked as an orderly at the local hospital. After her daughter wrote a letter to Vladimir Putin and mailed it to the Kremlin, the women was summoned by hospital management and “scolded.”

As the newspaper writes, what happened to her mother was probably a huge blow to Natasha.

According to unconfirmed reports, a suicide note was found on the dead girl. She asked that no one be blamed for her death.

It is not known whether her letter reached the Russian president.

Translated by the Russian Reader. Thanks to Dmitry Kalugin for the heads-up.

The Injustice Ministry

rainbowWhile rainbows do occasionally appear in the skies above Russia, the Putin regime has pursued a consistent course of official homophobia and avoidance of the country’s out-of-control HIV epidemic. Photo by the Russian Reader

Russian Justice Ministry Proposes Tightening Oversight of Foreign HIV Prevention Programs
Mediazona
September 3, 2018

The Justice Ministry has drafted a law bill that would introduce a new procedure for running foreign programs in Russia for preventing the spread of HIV. The text of the draft law has been published for public discussion.

The ministry proposes introducing a mandatory notification procedure for all noncommercial organizations planning to combat HIV in Russia, but which receive foreign funding, whether from other countries, international organizations, foreign nationals, stateless persons, their representatives, and Russia legal entities and individuals receiving money and other property from these sources.

After receipt of such a notification, the Justice Ministry will have a month to review it. It will then either have to issue permission to operate in Russia or a substantiated rejection. If a noncommercial organization continues to work on preventing HIV after receiving a rejection notice, it will be abolished.

As the BBC has noted, four foundations preventing the spread of HIV in Russia have been registered as “foreign agents” by the Justice Ministry.

Approximately a million Russians are infected with HIV. In July, RBC reported a spike of infections in Moscow. The Russian Health Ministry responded to the report by claiming the situation was stable. It urged journalists to focus only on official statistics.

Translated by the Russian Reader