Russia is a country of exceptionally high spirituality. Therefore, modern foreign cars have airbags, our cars have icons. In "overprivileged" capitalist countries, medicine deals with the treatment of children under the supervision of the state, but we raise funds all over the world. All this while 21 million people in Russia live in poverty and another 40 million are on the very edge of the financial "pit".
TV channels, all news feeds on social networks are full of appeals to help children. We will not mention that help for adults is asked much less often, apparently, everyone is calmer to look at how an adult or an elderly person passes away, and they are less likely to be assisted. How did it happen that the health of children ceased to be the concern of the state or the Ministry of Health, and fell on the shoulders of the "Good Samaritans"?
The statesmen have 5 reasons for this.
Russian medicine is on the periphery of development and is lagging behind more and more every year
According to experts, we have no training system that allows us to provide a high average level of doctors. Outdated training programs, the disappearance of the tradition of transferring experience- when every young professional after graduation has a personal curator for 5-7 years and he helps to master the practice of working in the relevant field. The low level of language skills leads to the fact that both old and young specialists lack information on new relevant research, and teachers hint that the level of pre-university training and motivation for learning has fallen*.
As a result, we have separate centers and brilliant world-class specialists in Russia, but all this is not because of the existing system, but in spite of it. And doctors in most difficult cases immediately say that "this is not treated in our country" and they send to their colleagues from other countries. And the life of the parents of sick children automatically turns into a quest to raise money for the journey, treatment and living in a foreign country.
Failure of the program of transition to high-quality Russian medications
But even if we are just talking about buying medicines, the cost of an annual course of other foreign drugs is more than buying a Mercedes of executive class. The backlog in the production of drugs was planned to be overcome. It is a pity that nothing ever happens without a "but" in Russia.
In 2012, during the administration of the unforgettable Mr. Medvedev, the Ministry of Industry and Trade of the Russian Federation approved the "Pharma-2020" strategy. By 2020, Russia promised to create production facilities for 90% of the list of vital and essential drugs (VED). Result: for 8 years, production facilities were created, where about 40 Russian analogues began to be produced, and instead of the promised 90% of the market, Russian drugs closed about 10%**. The level of incompetence and sloppiness in the implementation of the strategy was so off the scale that even the corruption component was shown slightly. The allocated funds - about 8 billion rubles annually- were used by 50% on average. The Ministry of Industry and Trade was unable to identify key drugs for which it is necessary to create production, or to attract investors. Worst of all, in some cases, it turned out that it was not possible to set up production with a more favorable cost of Russian drugs compared to western ones, and the use of a Russian analogue is no more profitable than purchasing a foreign one. Immediately there are questions for those who, on behalf of the ministry, reviewed business plans, coordinated the creation of production sites and transferred the allocated funds.
Mr. Tsyb (First Deputy Minister of Industry and Trade of the Russian Federation) in 2018, officially announced that the share of Russian drugs in the market for 10 years has increased from 20 to 30%, while in the list of VED for 2018, local drugs make up more than 80 %***. Which, to put it mildly, was not true. So in 2020, out of the list of 735 drugs, 2/3 were still produced abroad****. "Pharma-2020" in the highest echelons of power is confidently turning into "Pharma-2030"; and patients, if they are not lucky with raising of funds, still easily and casually migrate to cemeteries.
Transition from a full-fledged foreign drugs to the Russian generics
In parallel with the games of creating Russian medicines, in 2015 the Ministry of Industry and Trade issued a resolution "on imposing restrictions on the admission of foreign medicines for public procurement" - purchases of foreign drugs have been reduced many times and only Russian generics remain for the patients, many of which have a weaker effect and allow them to survive, but not to contain the symptoms.
It is sad that Russian doctors do not have the right to prescribe drugs that actually work but are not registered in Russia, and even more so they can not help their purchase in any way.
Corruption and disruption of tenders in a situation of inadequately strict price requirements
According to experts, the corruption component is up to 30% of the total budget for medicine*****. Taking into account the needs of Russians, 30% of funds does not solve all problems, but it will not be superfluous.
There is also a reverse situation, when the price requirements are brought to idiocy. Manufacturers simply refuse to participate and tenders are disrupted. According to the public procurement website, 692 out of 2,800 tenders for the supply of insulin were disrupted in 2019. For rabies vaccine, 429 out of 573 announced tenders were disrupted, etc.******.
As a result, the most reliable way is not to break the road to an expensive and scarce drug through the levels of the official vertical, but to get "to the people" with an outstretched hand.
Discrepancy between the budget for medicine in Russia and the actual needs of patients. Refusal of the Ministry of Health to fight for the budget for treatment and medicines for patients
Yes, objectively, not enough funds are allocated for medicine. For comparison, only the medicines for patients with SMA (spinal muscular atrophy) in Russia need 65 billion rubles a year, and the entire budget for medicine in 2019 was 459.5 billion rubles, and in 2020 it will be 563 billion rubles. For comparison, 1.6 trillion rubles was allocated for the 2014 Olympics, 0.9 trillion rubles for the World Cup, about 250 billion rubles are allocated annually for subsidies to Crimea, which has long had to give funds to the budget. The value of our health is much lower than the projects that make the image of Putin and Co.
And the last "finishing blow" - at the end of 2019, the Ministry of Health gathers representatives of charitable foundations and offers to solve the issue "together", but in fact it was reporting in disguise that "there is no budget" and the problem of raising funds and saving patients in a number of areas is now exclusively in their hands.*******
5 reasons and we have the result- the rescue of drowning people is in the hands of other drowning people and their volunteer helpers. Now it is clear that the creation of several dozen platforms in Russia for operations that are most often sent abroad and production for drugs was quite realistic in the past 8 years. All the necessary resources were available. But the Medvedev government demonstrated its incompetence and actually dealt with this issue at 10% of the required design capacity. Moreover, by "optimizing" Russian medicine, it has increased the destruction and general mess in this sector. Today, the monster that stands in the way of professional medical care and support for severe cases has too many heads and one shot will not kill it – you need to demolish the entire system.
- https://lenta.ru/articles/2017/02/09/egorov/
https://yandex.ru/turbo?text=https%3A%2F%2Fsntch.com%2F5-prichin-togo-chto-rossijskaya-meditsina-tak-otstayot-ot-mirovoj%2F
https://obzor.press/russian/55483
**https://ru.wikipedia.org/wiki/Жизненнонеобходимыеиважнейшиелекарственные_препараты
*** https://rg.ru/2018/10/07/farma-2020-dala-impuls-k-razvitiiu-otechestvennoj-farmindustrii.html
**** https://vademec.ru/news/2019/02/19/sp-farma-2020-stala-khudshey-gosprogrammoy-po-urovnyu-osvoeniya-byudzheta-v-2018-godu/
https://gmpnews.ru/2013/07/chto-meshaet-realizacii-strategii-farma-2020/
***** https://news.rambler.ru/other/41381361-skolko-rossiya-teryaet-iz-za-korruptsii/
****** https://novayagazeta.ru/articles/2020/01/18/83504-kuda-katyatsya-tabletki
*******https://www.miloserdie.ru/news/na-lekarstvo-dlya-bolnyh-sma-nuzhno-65-mlrd-rub-v-god-minzdrav-predlozhil-nko-reshat-problemu-vmeste/