The grave digger wearing a t-shirt of Russia's ruling party "United Russia." (Image: social media)
Most analysts in Russia and the West argue that changes in the size of the prime child-bearing cohort of Russian women, long-standing secular trends to smaller family size in Russia as in other countries, and the impact of the economic crisis on family choices and mortality rates as the most important explanations for Russia’s demographic crisis.
Those three factors are undoubtedly the most important, and they are vectors that the Russian government can do little about at least in the short run. But this week brings news reports that spotlight three other factors, often ignored, where the Kremlin bears direct responsibility and that are making Russia’s demographic problems even worse.
First, Russia is in the midst of a dramatic increase in HIV inflections and AIDS-related deaths, the result of ever earlier and most often unprotected sexual contacts and drug use and of the government’s failure to ensure that there are sufficient supplies of anti-retroviral drugs to ensure that those infected do not die of the disease.
Russian medical experts say that HIV infections are up three to four percent in the last year alone, with some locations reporting even higher figures. And they are beginning to speak about HIV as “an epidemic” in Russia because the share of adults infected in many places is nearly two percent (see versia.ru and iz.ru).
What makes this contributing factor to Russia’s demographic decline so appalling is that Western countries have shown that HIV/AIDS can be brought under control with consistent albeit expensive government programs of education and treatment. Moscow, however, under Vladimir Putin has cut back medical programs under the euphemistic name “optimization.”
It may be optimization for the state budget, but it is not optimization for the Russian people and especially those suffering from this disease.
Second, largely because of the Kremlin’s counter-sanctions program, there is a serious shortage of medications more generally. Moscow has blocked both the medicines themselves and the components out of which it has manufactured needed drugs and people are suffering. Russian diabetics, for example, often are not getting insulin. Without that drug, many will die.
If the Kremlin was concerned about the health of its people rather than its geopolitical goals, it could import the needed drugs, many more people would survive, Russia’s third world-level adult male mortality rates would decline, and the country’s overall demographic numbers would improve.
And third, Putin’s promotion of urbanization and his neglect of rural areas is having a demographic effect few have commented upon until this week. Given the increasing impoverishment of rural areas, young men are fleeing the villages to the cities and thus not becoming the fathers they otherwise might have been.
In Russia as in other countries, birthrates in rural areas tend to be higher than in cities; but thanks to Putin’s megalopolis-focused policies, the young men who could make that possible are elsewhere. As a result, rural birthrates in Russia are lower than they would otherwise be; and consequently, Russia’s population is declining by more than it would if policies were otherwise.
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