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The meeting was attended by President of the Republic of Azerbaijan Ilham Aliyev, Prime Minister of the Republic of Armenia Nikol Pashinyan, President of the Republic of Belarus Alexander Lukashenko, President of the Republic of Kazakhstan Kassym-Jomart Tokayev, President of the Kyrgyz Republic Sadyr Japarov, President of the Republic of Tajikistan Emomali Rahmon, President of Turkmenistan Gurbanguly Berdimuhamedov, and President of the Republic of Uzbekistan Shavkat Mirziyoyev, as well as First President of the Republic of Kazakhstan – Leader of the Nation Nursultan Nazarbayev. Anna Popova, Head of the Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor) and Chief State Sanitary Physician of the Russian Federation, was also invited to attend the meeting.

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Vladimir Putin: Colleagues, good afternoon.

Allow me to begin by thanking you for accepting my invitation and coming to Russia, to St Petersburg, to attend a meeting which has already become a tradition of sorts. Before the pandemic, we used to come together in St Petersburg ahead of New Year holidays every year.

This was a special year for the CIS. Only recently, in December, we marked the organisation’s 30^th anniversary. I had the pleasure to convey to all of you my greetings on the 30 years of your countries’ independence, and now I have the pleasure of doing this in person.

It is not usual for us to meet in this format since we mostly hold our meetings online. However, presented with this opportunity, we must use it. I fully agree with you on this point and would like to thank those who initiated this meeting for arranging today’s event. We are here in Russia, St Petersburg, but despite this fact almost all of you spoke out, in one way or another, in favour of holding the meeting in this format.

We have witnessed monumental shifts over the past years and decades. At the same time, let me note that the very idea of establishing this organisation was justified, there is no doubt about that. We have been deepening our integration in its multiple aspects, including in terms of ensuring national security, and in the economy. I must note the lingering positive impact from the ties we have been sharing since the Soviet era.

These are common infrastructure facilities, common businesses that work as partners, chains of creating added value with a high level of cooperation – all this has been preserved and, moreover, developed on an entirely new foundation, a completely new base.

This allows us to get through the hard times of the pandemic. All countries in the world have faced it, and this has serious economic and social consequences. However, preserving the opportunities and competitive advantages that we have inherited from the past, we are able to overcome these difficulties much better than many other countries. I must say that we in Russia have supported these relations and will support them in the future.

One of the main topics that brought us together at this current meeting, which required a more extensive discussion, as I have already mentioned, is our common efforts to counter the coronavirus pandemic. Our colleagues engage in extensive, practical cooperation every day. This applies to joint scientific activities, the development of medications and preventive drugs, as well as exchanges of test kits and means of overcoming this disease.

To start our work, I have invited today Russia’s Chief Sanitary Physician, Ms Anna Popova. She heads the Government structure that is in charge of all work in this area and cooperation with our colleagues in all CIS countries. She will share her perspective on where we are on this road, and what, in the opinion of our experts, we should do together in order to make progress in overcoming this problem, the pandemic.

Ms Popova, go ahead please.

Anna Popova, Head of the Federal Service for the Oversight of Consumer Protection and Welfare (Rospotrebnadzor): Thank you.

Mr President, Mr Nazarbayev, leaders of the CIS countries.

Epidemiological stability and biological safety in the CIS countries is undoubtedly a condition for the region’s sustainable social and economic development. Considering the proximity of our states, the commonality of epidemic threats and the level of integration, one of our key tasks is to build a unified system for epidemic response and relief.

The significant advances achieved through biotechnology and synthetic biology are spurring progress in medicine, pharmaceuticals, agriculture and industry. Using modern biotechnology, Russian virologists have developed and registered five COVID-19 vaccines. Russia’s Sputnik V was the first vaccine registered in the world, and we have been sharing the benefits with our partners in the Commonwealth of Independent States. Russia has transferred vaccine production technology to other CIS states where production facilities have been built, and the vaccine is being produced.

The development of biotechnology and synthetic biology, the availability of tools to modify and create viruses and bacteria also pose risks to biological security. The uncontrolled use of biotechnology can lead to unpredictable consequences.

I will give just two examples. In 2016, Canadian virologist [David] Evans brought back to life the extinct equine pox virus from components he purchased online and using some regular equipment – he revived the virus to show the deadliest human smallpox virus, completely eradicated in 1980, can be reconstituted the same way. This year, molecular biologists in the UK have created a bacterium (a bacterium, not a virus, a larger biological entity), Syn61, which is a bacteriophage-proof variant of Escherichia coli. Bacteriophages are viruses that infect bacteria and can be used to treat such diseases. But biotechnology can make it difficult to distinguish between natural and intentional threats to biosafety.

Destructive forces are trying to implement a radical reform of the international healthcare system against the backdrop of the pandemic. The goal is to create instruments to influence a policy on biological safety, give international organisations the right to investigate infection or virus outbreaks on states’ territories, and introduce mandatory external inspections of their biotechnological potential. A response to these steps requires the consolidated position of the CIS states at the WHO and on BTWC platforms. We have repeatedly discussed these problems.

Many countries are increasing their investments in creating laboratories with high biological security. Obviously, investment, personnel, infrastructure, research centres and laboratories are needed for research in molecular epidemiology and to ensure biosafety.

The following measures are important for countering the threats to biosafety in the CIS space.

First, we must build a common regional system of measures aimed at developing research, providing mutual assistance and exchanging technology and research results.

Second, we must ensure independence in technology and research and create our own facilities and laboratories.

Third, we must strengthen common mechanisms of preventing and responding to biosafety risks, including deliberate threats.

Our countries have a substantial advantage over Soviet times – a powerful sanitary-epidemiological service and science, common approaches to epidemic-prevention measures and a similar personnel-training system. Plus we have a common language of communication.

We have already done much to create a common epidemiological space in the CIS countries. We are not starting from scratch. We are upgrading our legislation on biosafety, and the Russian Federation has adopted a law on biosafety. Other CIS countries are also drafting related laws. We are closely cooperating with our colleagues to make these documents effective and use their knowledge for drafting our documents. We have seven bilateral agreements on introducing medical and sanitary rules and four memorandums of understanding on biosafety. The CIS countries are jointly developing warning and response systems for sanitary-epidemiological emergencies.

Nineteen programmes to assist the CIS countries have been carried out with support from the Russian Federation over the past 10 years, among them the measles eradication programme, fighting the threat of the transboundary spread of the plague, combatting poliomyelitis, expanding the laboratory network, including mobile labs, fighting HIV, AIDS and all forms of hepatitis, and countering the spread of antibiotic-resistant microorganisms.

The amount of funds allocated by the Russian Federation for these purposes has exceeded 18 billion rubles over 10 years. In all, over 2,000 pieces of equipment have been supplied to dozens of laboratories, more than 5,000 specialists have been trained, millions of doses of measles and hepatitis vaccines and more than 7 million tests for diagnosing various infections have been donated. These efforts led to ensuring epidemiological safety with regard to many infections. So, amid a surge of measles cases in Europe in 2014–2017, we managed to contain its spread and prevent large outbreaks of measles in the CIS countries.

Acting as a team, we have prevented the import and spread of the wild poliovirus in the CIS countries, reduced the incidence of HIV and hepatitis and prevented the transborder spread of dangerous infections, primarily the plague, from natural foci. If you do not mind, I have more to say on this subject.

There are 45 natural plague foci in the CIS countries. Thanks to the joint programme funded by the Russian Federation, which was created at your instruction, Mr President, we have managed to ensure complete sanitary and epidemiological plague safety in all our countries over the past four years, despite the annual number of recorded cases of plague in neighbouring countries. There were eight cases in Mongolia, 10 cases in China, and nine cases in the United States, of which almost half were fatal. Plague is a big problem worldwide, however, all natural foci of plague are under control today as a result of our interaction. Since 2017, not a single plague case has been detected in the CIS countries.

Mobile laboratories, a network of which is being created in our region, is an effective collaboration tool. Eighteen mobile labs mounted on GAZ trucks and six labs mounted on KAMAZ trucks are operational in six countries. They were donated by Russia over the past five years. These laboratories have a proven track record of countering the novel coronavirus. They are being used for running tests with methodological support from Rospotrebnadzor specialists. We are prepared to continue to support the CIS countries in this regard.

The mobile labs’ high operational level in the region made it possible, in conjunction with the WHO, to hold the first international exercises with mobile labs of various types with the participation of 120 specialists from eight CIS countries and France, Germany, and Belgium. The exercises were held in Kazan in October, and our labs received high praise from the WHO. The approaches practiced during the exercise will form the basis of international standards for WHO-operated mobile anti-epidemic units.

The pandemic has tested the entire region, and demonstrated the value of practical cooperation, mutual assistance, and support among the CIS countries. Russia has consistently been up to the task of fighting the pandemic thanks to its top-down system of governance, proactive response model and ongoing commitment to evidence-based public health measures. Today, Russia ranks 94^th in the world by the number of cases per 100,000 people, and in the past week it ranked 72^nd, also per 100,000 people.

The Russian Federation has had leading indicators in terms of testing coverage practically since the very onset of the pandemic. Today, Russia ranks fourth in terms of overall testing figures.

In January 2020, at the instructions of the President of the Russian Federation, Russia was the first country to supply COVID-19 testing kits to the CIS countries. It was with Russian test kits that Kazakhstan, Belarus, Armenia, Kyrgyzstan, and Tajikistan diagnosed their first covid cases. The Federal Service for the Oversight of Consumer Protection and Welfare and the Health Ministry sent more than 40 expert missions to provide methodological and practical support, as well as train staff to fight COVID-19. My colleagues and I meet regularly via videoconference, almost every two weeks, to discuss current issues and work out solutions.

These efforts have yielded results. In 2021, with support from the Russian Government, we launched joint studies on herd immunity to the virus and strain variants and their mutations that were circulating in the CIS member countries. Data obtained from these studies enable us to forecast how the situation will unfold and plan our public health measures. We obtained meaningful results in Belarus and Kyrgyzstan. Studies are already underway in Kazakhstan, while Tajikistan and Armenia are almost ready. Overall, we prepared 14 joint publications, while post-graduate studies are underway in several Russian research institutions.

Today, we believe it is important to move to the next phase, which is ensuring regional biosafety, or developing self-sufficient regional infrastructure and joint scientific centres with high-security laboratories.

The pandemic has shown the inefficiency of the Western practices of decentralising public health services and dismantling laboratory networks. As a result, several CIS member countries are taking measures to enhance their public health services, create new research centres and revert to earlier approaches that were developed by Soviet science.

In Russia, in keeping with the instructions of the Russian President, the Government has developed the “sanitary shield” initiative in order to strengthen and update the entire public health monitoring system, including the laboratory infrastructure. This initiative also provides for promoting international cooperation to form a single “sanitary shield” across the CIS; this is practically being carried out already, including joint research projects, personnel training and efforts to provide laboratories with equipment.

The single “sanitary shield” requires developed and self-sufficient infrastructure, including laboratories, research centres and sanitary and quarantine checkpoints created to uniform standards. Drawing on our own experience, we are ready to assist in designing, building and outfitting research centres with laboratories that meet high biosecurity standards, train personnel for them and develop research programmes. We know how to create these types of facilities and how to, among other things, create the necessary conditions for ensuring biosafety and biosecurity, and technological self-sufficiency and operation.

In response to requests from our colleagues in Uzbekistan, Kyrgyzstan, Tajikistan and Turkmenistan, Rospotrebnadzor [the Federal Service for the Oversight of Consumer Protection and Welfare] is providing methodological and consultative support in creating research laboratory complexes.

My visits to Turkmenistan, Uzbekistan, and Tajikistan, organised on behalf of the Russian Government, included substantive talks where we outlined further joint steps. Top officials from those countries’ ministries and departments have visited Russian facilities; in December, they visited our flagship facility for responding to especially dangerous infections – the Microbe Russian Plague Research Institute in Saratov. Rospotrebnadzor and the Ministry of Health of Uzbekistan have signed a roadmap, and a draft plan has been prepared with the Ministry of Health of Tajikistan.

Joint research centres will be established in these countries by 2025, with co-financing from Russia. These centres will be cutting-edge facilities to support research in biological safety, in training national personnel, and developing diagnostic and treatment tools.

The main guidelines for developing a unified infrastructure in a common epidemiological space are to strengthen the legal framework for biological safety; to promote collaboration on exploring evaluations of epidemiological situations; to develop a research lab infrastructure; to cooperate in addressing biosafety at United Nations platforms, including the World Health Organisation; and to strengthen control, at the national level, over biological activity carried out by foreign states and their representatives.

This approach is consistent with the Statement of the CIS Heads of State on cooperation in the field of biological ыфауен, as adopted on October 15 in Minsk, and with the new CIS Cooperation Agreement on Sanitary Protection of the Territories, signed in May 2021. In 2022, the member states are preparing to sign an agreement on cooperation in response to and relief from sanitary and epidemiological emergencies.

The biological and epidemiological security of the CIS countries is indivisible, which means that its response architecture should not be divisible either.

Thank you.

Vladimir Putin: Thank you very much, Ms Popova.

Colleagues, are there any questions for Ms Popova about cooperation, or about the current situation?

Yes, Mr Berdymuhamedov, go ahead please.

President of Turkmenistan Gurbanguly Berdymuhamedov: May I have a minute.

Mr Putin,

First, we are very grateful to the Russian Federation. This pandemic has not been recorded in Turkmenistan as of today, and I must say that we owe this to the Russian Federation. We were one of the first to register Sputnik V and EpiVacCorona. Now our people have received both Sputnik V and EpiVacCorona jabs. Just the other day we received Sputnik Light and people are getting booster jabs. So, we are grateful.

As for threats to biosafety in the CIS space, it would be good if we studied the issue again and signed a uniform document. Incidentally, we, Turkmenistan, have signed this document with the Russian Federation.

I would also like to say the following. We have different zones: Kyrgyzstan, Kazakhstan, Uzbekistan, Turkmenistan and Tajikistan. These are arid zones and the clinical picture is different, say, from Russia where the climate is more humid. Therefore, it was proposed that we study the genome of the virus in our zones, and this would be correct, of course. As Ms Popova said, we need methodological assistance in this context. It would be good if Russia could give us, in a centralised way, its methodological instructions and manuals on both bacteriology and virology. We could have the same approaches on these issues.

This is what I wanted to add to Ms Popova’s remarks and, of course, to thank Russia once again for what it is doing for all of us today.

Thank you.

Vladimir Putin: Thank you very much, Mr Berdymuhamedov.

We will, of course be moving forward in this direction. Thank you for this generalisation and the proposal on further cooperation.

Colleagues, take the floor please.

President of the Republic of Kazakhstan Kassym-Jomart Tokayev: Mr Putin,

First, I would like to thank you for the idea of this report on the status of biological safety. I would like to recall that in the CSTO we have already signed agreements on cooperation on biosafety. I would also like to thank you for your aid to Kazakhstan in the most difficult time. Indeed, we managed to develop joint production of vaccines based on Russian Sputnik V technology in Karaganda as part of our common agreement. The Sputnik V vaccine has played a decisive role in stopping the spread of COVID-19.

In this regard, I have a question for the speaker. Everyone is talking about “Omicron” now. What attitude should we have toward this new strain? What are the prospects for a concerted response? And, last, what can you tell us about the harmful consequences of this new strain?

Anna Popova: Thank you very much.

President Tokayev,

Indeed, this was an anticipated change in the virus and yet it caught us off guard. The virus has not changed in the course of 2020. We have seen very little mutation. Unfortunately, the virus showed its ability to mutate in late 2020 with the first new Delta variant detected in South Africa and the UK. Viruses change, this is what they do, or they will stop developing.

When we saw the unfolded sequence of the most recent variant that had been first detected in the Republic of South Africa, we became concerned, because it had a fairly large number of mutations. I want to thank our President, Mr Putin, who instructed us to go on a mission to South Africa. Specialists from the Ministry of Health and us were there within 24 hours. We were the first and, probably, the only foreign specialists, doctors, virologists and epidemiologists, who went on site. We saw what was happening there. The virus spreads very quickly, since it is highly contagious, much more contagious than the variants and mutations that we have seen before.

In the Republic of South Africa we found that this strain does not cause severe illness. It affects large numbers of people at once, but severe cases develop only in non-vaccinated people – this is absolutely true – and in people with concurrent conditions like severe cases of diabetes or cancer.

Our colleagues from the Republic of South Africa opened their doors to us, and I am very grateful to them, because our colleagues from Russia had the opportunity to tour the hospitals that were then open to visitors in Johannesburg and the laboratories. Since there are large numbers of Omicron cases around the world, this variant began to prevail over the Delta variant. Clearly, it will be a dominant strain and gradually replace other strains.

This is not yet happening in the Russian Federation. We secured our borders from day one. I am aware that our colleagues from the CIS countries did exactly the same. In conjunction with our colleagues, we are following the developments in the CIS, which is critically important for us.

In order to improve observation and monitoring, we have teamed up with several countries and made our capabilities available to them. We are conducting research on genetic variability as a team. That is, we are helping improve sequencing in other countries and are ready to engage our sequencing facilities, since, as directed by President Putin, we set up a major sequencing platform in January. We are willing to share our capabilities and to do this work for our colleagues from other countries. We are doing this for our colleagues in Belarus and Armenia, and we are willing to make our capabilities available to anyone to avoid missing the emergence and development of these viruses.

Thank you.

Vladimir Putin: Thank you.

President of the Republic of Belarus Alexander Lukashenko: Ms Popova, this is all good but some things matter more than others for the heads of state. We will provide people with medical treatment in any case. You gave a very good example: when this new strain emerged in the Republic of South Africa, you were there to see what was happening.

After all, the main question for us is predicting. I have demanded that my specialists give us a forecast of the developments from the first months of the pandemic. I wanted to have a forecast for a particular strain, hoping that one of them would take a risk and give a forecast. But frankly, not a single forecast on the strains circulating in Belarus has been correct. Several groups worked on it and they gave different forecasts but not a single one proved right in terms of timeframes. I spoke personally to your lower ranked experts and to scientists and they said it was very difficult to predict this into the future. They said they could not forecast a precise period of a strain's development.

Maybe you can tell us what will happen tomorrow. It was Delta yesterday or today and it will be Omicron tomorrow. And what will happen the day after tomorrow? What can we expect?

Anna Popova: Thank you very much, President Lukashenko.

This question is, of course, extremely complicated. I think that nobody in the world can say unequivocally what will happen tomorrow. But I am absolutely certain that if we do not get vaccinated and take sanitary precautions today, the situation tomorrow will be worse.

Considering that Omicron is spreading very quickly, the measures we have taken, and we have two areas… first, people should have as few contacts as possible so as not to pass on this infection to others. Second, people must be vaccinated, or maybe this is the first requirement. They need to be immune to the virus. No matter what strain develops, it will be a strain of the same virus. So vaccine protection will work better in some cases and worse in others, but it will work. So, the policy of the Russian Federation is to ensure maximum herd immunity. This is what we think today.

As for epidemiological practice, our approach is as follows: we cannot expect anything for sure, but we prepare to take measures that will prevent a large number of cases. This is the main thing for us now. As for the virus, it will mutate and produce new strains. Scientists are telling us that it is already being or becoming seasonal today. It will come in a season of its choice. This is also uncertain at this point. It came in the autumn this time and will probably return in the spring. We will see what happens next.

Vladimir Putin: I talked to the head of the Gamaleya Institute. They conducted a study and concluded that Sputnik V does neutralise the new Omicron strain. He told me only a clinical picture can give us a final answer – to what extent. However, the neutralisation level is very high. I talked to him literally a couple of days ago. They conducted these studies but now they must move to the second stage – clinical studies to establish the extent to which the vaccine neutralises the virus. He said they were a hundred percent certain that the vaccine they developed at the institute is very effective at neutralising the new strain.

Alexander Lukashenko: Ms Popova, as I understand from your diplomatic statement, we should be anticipating more coronavirus variants, and Omicron is not the end of it, correct?

Anna Popova: Not a single virus stops evolving, so we cannot expect Omicron to be the final variant. Omicron is more contagious, but causes less severe symptoms. No one can say what the next strain will be. However, viruses continue to live only if they evolve.

President Putin, I will deliver the report if I may.

Experts from Vektor also conducted studies on the effectiveness of Sputnik's post-vaccination immunity, and they are absolutely positive that it remains as effective for Omicron as it was for previous variants. The level of protection remains very high.

Alexander Lukashenko: Ms Popova, my last question. I am sorry for asking these questions, but this is important to me.

In plain terms, is Omicron lighter than Delta?

Anna Popova: From what we see, it causes less severe illness. But so far we have seen it only in the Republic of South Africa with the average age of its population under 30 years, whereas in Russia it is much older. This could be a factor behind the lighter symptoms. We see the same thing in the UK, but their vaccination level is over 80 percent, which cannot be discounted, either. No other serious epidemiological surveys have yet been released, and we are following this very closely. But the fact that it is much more contagious and impacts more people at a time is also important. With the virus being so active, it is likely to affect people for whom getting ill with any variant represents high risk. This includes seniors, patients with severe conditions, including cancer, endocrine ailments, and diabetes. When a virus like this is widely spread among the population, getting sick with it is more likely. This is the scary part when it comes to Omicron.

Alexander Lukashenko: This overstretches public health capabilities as well, I guess.

Anna Popova: Yes, it can.

Alexander Lukashenko: Here is what I was getting at. I wanted to hear you say that you, the researchers, feel that Omicron is a lighter version of Delta, and maybe we are already seeing the pandemic taper off?

Anna Popova: Thank you, Mr President, we also really want to be hopeful, but are not getting our hopes up. So far, we have been focusing on the need to counteract the spread of the disease and to protect the public with jabs against the new variant.

Alexander Lukashenko: Thank you.

Vladimir Putin: Sputnik V is around 90 percent effective in terms of protection.

Our colleagues from other countries are striving to achieve 90 to 95 percent immunisation. What is the current level in Russia?

Anna Popova: We are getting close to 56 percent.

Vladimir Putin: 56?

Anna Popova: Correct, 56.

Vladimir Putin: That includes people who have been ill with COVID-19 and vaccinated people?

Anna Popova: This is all taken together, herd immunity. This is how it is calculated.

Vladimir Putin: Herd immunity is 56 percent.

Anna Popova: We are approaching 56.

Vladimir Putin: But we need 90 percent.

Anna Popova: Yes, 90 to 95 percent, as with measles or poliomyelitis, and then we will no longer have to deal with these infections.

Vladimir Putin: Thank you.

Ms Popova, thank you very much.

Anna Popova: Thank you very much, all the best.

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