CEELBAS/BEARR Conference, 9 May 2008

“Russia Under a New President: Opportunities and Challenges for NGOs in the Health Field”

This conference inaugurated the NGO Development Programme, a joint venture of CEELBAS and The BEARR Trust, a charity that promotes cooperation between the third sector in the UK and partners in Russia and its neighbours, especially in health and social welfare, with a view to strengthening civil society. The conference, and the programme as a whole, are designed to promote fruitful interaction between the academic world and NGOs.

The theme of this first conference was chosen to give NGOs access to the substantial evidence compiled by universities on what is happening to the health of the Russian population, on developments in healthcare in Russia and on the Russian government’s health policies; and to pass on to academics the hands-on experience of a variety of NGOs working in related fields. Possible future elements in the programme were discussed in the final session of the day.

Dr Christopher Gerry (SSEES, UCL) examined the Political Economy Context of Health Reforms in Russia after the Presidential Election. Medvedev inherits the resources to invest in improved health care, but also structural weaknesses in the economy that create an immense challenge for modernising the country. Medvedev’s anti-corruption vocabulary and his proclamation of “innovations, institutions, infrastructure and investment” are encouraging. But the new political elite may not support tackling the behavioural causes of Russia’s high morbidity and mortality rates.

Larisa Popovich (Deputy Chairman of the Social Council for Patients’ Rights at the Russian Public Health Inspectorate, and CEO of ROSNO-MS medical insurance company) gave a Russian Perspective on the Evolution of Russia’s Health Reforms. Rising government revenues since 2000 have allowed the government to focus on the efficiency of services provided, and there are already some encouraging indicators. The government is now studying public – private partnership models for health provision, and envisages a role for NGOs.

Dr Alena Ledeneva (SSEES, UCL) described the development of Civil Society in Russia under Putin and Medvedev. She highlighted the low awareness in Russia of what civil society means, and the decline in indicators of its development. The number of registered NGOs has fallen, and although there is a great deal of informal, unregistered activity, it is not effectively organised.

Floriana Fossato (SSEES, UCL) confirmed this in her study of Civil Society Online. The Russian ‘blogoshere’ reflects a cultural preference for individual, informal activity over organised membership. The internet is not used to form alliances for action. Instead, blogs are used to reinforce clusters of like-minded people who are unwilling to cooperate with other groups.

Anna Sevortian (Deputy Director, Centre for the Development of Democracy and Human Rights in Moscow, and Visiting Fellow, Cambridge University and UCL) described the toughening up of the environment for Domestic and Foreign NGOs during the Putin Era. Most affected are NGOs that receive foreign funding, which can expect to be scrutinised to the point of paralysis by the Registration Department and the tax authorities. NGOs set up to help children or the elderly, in contrast, have often been successful. The key to survival is to avoid alternative political agendas.

Four leaders and managers of NGOs gave their personal experience of Health NGOs in Russia during the Putin Era. Maria von Moltke’s charity, Rehabilitation of the Child, has survived by carefully following rules and reducing foreign involvement. It now successfully raises funds in Russia, but fears for its long-term autonomy. Nicholas Colloff of Oxfam and Oscar Franklin of Age Concern England both had experience of creating groups and alliances of Russian NGOs. Oxfam’s success in promoting legislation to improve the treatment of the disabled was based on demonstrating expertise, and dealing with the Health Ministry from the bottom up. Age Concern found they were not pushing at an open door in the same way, since the problems of the elderly are still overlooked at government level. Dr Alexei Bobrik, deputy director of the Open Health Institute in Moscow, had initially used Soros funding to introduce internationally validated practices for HIV/AIDS treatment. The OHI has made a successful transition to domestic funding and now exercises influence on government policy.

In the discussion of future work, participants spoke in favour of a comparative approach to issues across the post-Soviet world. It was felt useful to concentrate on health and welfare because this covers most sections of the populations, and touches on aspects of health and care on which UK NGOs have expertise. Most important, access to healthcare was cited throughout the day’s proceedings as the cause of simmering anger in Russia and its neighbouring countries, and an issue to which government antennae are therefore well tuned.

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