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President of Russia Vladimir Putin: Mr Murashko, I would like to start – as your colleagues have probably prompted you – with the development of the part of the healthcare system that is the closest to the people – primary care.

Health Minister Mikhail Murashko: This is really one of the most important and comprehensive types of medical assistance. Overall, there are more than 1.2 billion requests for medical care per year. This is the most needed assistance.

As part of implementing the project on upgrading primary medical care, 4,000 new facilities, including outpatient clinics and, of course, paramedical and obstetrical centres (FAPs) were built. About 2,800 medical facilities have been repaired.

I must say that this is really changing the appearance of healthcare facilities. Importantly, in addition to repairs, medical institutions have received 85,000 units of equipment. We decided from the start that this would be only digital equipment that can transfer data – this is very important for rural areas.

The Digital FAP programme has already been developed. It provides the opportunity for tele-medical consultations. In such cases, when paramedics need a consultation, they don’t have to run around to ask questions or get advice on issues that can be resolved via a tele-medical consultation.

Vladimir Putin: Yes, a consultation with a narrow specialist.

Mikhail Murashko: Yes, Mr President.

A change in the overall technology is of fundamental importance because supplies and repairs of equipment are only part of this process.

Almost 35,000 FAPs have now received licenses for the sale of medications and drugs. There were many requests to open pharmacies in some places, but the population in some rural areas is so low that a pharmacy would simply be unprofitable. So we followed your instructions – in a very short span of time, we drafted regulations and trained personnel to resolve this problem, and now, 35,000 FAPs without pharmacies have received licenses and are selling medications. This is a great and quick result.

Vladimir Putin: FAPs are selling them, right?

Mikhail Murashko: Yes.

Next, the vehicle fleet. Healthcare includes the transportation of patients and doctors on their visits. We have been strongly reminded of the importance of delivering medical tests and other things in the past few years.

Domestically made vehicles are being delivered on schedule. I am grateful to our colleagues in the Ministry of Industry and Trade, who have made all the planned deliveries on time. We have all the vehicles we need for medical personnel at our medical establishments, and new vehicles are being supplied.

The new regions have joined this process as well. First of all, we have provided new ambulances to them because emergency assistance is the core element you must begin with. Over 2,000 pharmacies, both state-owned and private ones, have opened in the new regions. In fact, this is enough for now. Using the experience of FAPs, we are issuing licences so that they can receive medical assistance and medicines at a single location.

In addition, we have prepared a modernisation programme for primary care. I hope we will be able to launch some of its elements this year.

Vladimir Putin: Do you mean in Novorossiya, in Donbass?

Mikhail Murashko: Yes, I do.

We have spared about 2.5 billion rubles, and we would like to send some of these funds there. If you support this idea…

Vladimir Putin: Of course I do.

Mikhail Murashko: …we would also like to begin modernising the primary care system, which needs major investment there. It should be said that we are already doing this jointly with the patron regions, because modernisation is ongoing at 200 facilities, and I believe that it has been competed at 89 establishments. We plan to finish it at another 90–93 facilities this year.

Plus, this also involves technology. We have revised the directive for the outpatient treatment of patients. It is a key element because patients with chronic diseases must be able to visit their doctors in a routine manner. We call it the secondary prevention of complications.

Vladimir Putin: I see. There will be a high demand for this service after medical screening.

Mikhail Murashko: Yes. I have a number of slides – I can demonstrate this. It concerns medical examinations and preventive health checkups.

The first slide shows how many people we examined in previous years and plan to examine in the next period. These are enormous figures. In 2022, we planned to examine 52 million people despite the raging pandemic in the first quarter of the year. This was the plan, but in fact, 67 million people were examined.

Vladimir Putin: Almost 68 million.

Mikghail Murashko: We have an even more ambitious figure for this year – 87 million or 59.7 percent of the population.

Following your instructions, we have already drafted plans and started preventive health checkups in Novorossiya because they are much needed there.

Vladimir Putin: They have probably never been done there, right?

Mikhail Murashko: Yes. Unfortunately, preventive medicine was neglected there.

The fifth slide shows a list of detected diseases. We identified 12.5 million cases of blood circulation disorders and over 2 million cases of digestive diseases. These are high figures. New onset diabetes mellitus, especially type 2 diabetes, and malignant neoplasms are being diagnosed which is vital for timely treatment.

I must say that last year, early detection (at the first and second stages) reached 59.5 percent for the first time. This is the highest figure in the entire history of the Russian Federation. This works – in oncology, for one, the death rate went down by more than 7.5 percent from 2019 during the introduction of the programme. This is, of course, a unique result.

Naturally, all available high-technology is being used as well. The number of visits and hospital admissions has more than doubled. This is a very impressive figure.

Today, we have access to almost all currently available modern cancer treatment techniques such as radiation therapy, surgery, chemotherapy, cell therapy, and radiopharmaceuticals. Rosatom is very helpful. I can say that this area is on track to be a success.

I would also like to show how…

Vladimir Putin: Rosatom reports that their technical capabilities are expanding.

Mikhail Murashko: Rosatom and the Health Ministry are building a plant, the largest radiopharmaceutical plant in Europe; construction is underway. Our neighbours from the CIS countries have shown interest in it. We brought them together in St Petersburg as you instructed us to do and showed them our unique capabilities. Everyone was impressed with the centres and the production facilities.

With regard to preventive medical examinations for adults, we plan to provide checkups for at least 1 million adults in Novorossiya, including the urban and rural populations, as well as the organised workforce.

Regarding the examination itself, it will be based on slightly expanded screening with a focus on a number of malignant and most widespread diseases.

There is a slightly higher number of tuberculosis cases there, so we will focus on detecting and treating that. All constituent entities of the Russian Federation have seen a decline in mortality and morbidity, and we have introduced new medicines this year. We need to expand the treatment plan which will really help.

Vladimir Putin: Personnel training, too, of course.

Mikhail Murashko: Staff training is a separate matter and it is very much needed. Every federal medical research centre has been there to conduct joint examinations and in-person and distance training. When it comes to medicine, it always makes sense to show how “infectious” knowledge can be.

Vladimir Putin: We should not forget about nationwide personnel training and retraining. I am aware that you are on top of this personally and are doing it persistently. Failure is unacceptable, because high-quality use of cutting-edge equipment and the quality of medical care depend on proper training.

Mikhail Murashko: You are absolutely right.

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