Healthcare is one of the functioning components of the Russian state that is relatively underestimated from a financial point of view. At present, pharmaceutical production, the pharmaceutical business and some separate areas in treatment medicine (dentistry, obstetrics and gynecology, plastic surgery and a number of others) are primarily among those that have been capitalized, but the state remains the leading player in this sphere.

The share of completely private clinics is approximately 5% of the total number, and private emergency medical services and medical laboratories working in the mass market are only present in the largest cities and their satellite towns. In general, medicine and pharmacies employ approximately 15% of the working population (more than 4.5 mln people according to data from 2011).


Historical Background

The history of Russian medicine starts only in the seventeenth century, as in Muscovy there was no medicine as a systematic phenomenon. Healers (mainly foreigners) and foreign drugstores could be found in large cities, but there was no comprehensive home training of doctors. Mass medicine was completely performed by craftsman doctors (i.e., self-educated doctors), potion shops (drugstore prototypes), where medicinal herbs and their mixtures were sold. At the end of the sixteenth century, in all of Novgorod (which was not a small town) there were only six healers and one foreign doctor, while (for example) in Pskov, only a few herbalists practiced.

Only in the middle of the seventeenth century, due to numerous wars and the demand for real medicine that they created, was the Pharmaceutical Prikaz (the centralized authority regulating the entire medical field) established, followed in 1654 by its subordinated Doctor’s School, which had a rather modern program for those times, including a practical course as well. During this same period, for the first time the government sent young people abroad to study medicine.

At the very beginning of the eighteenth century, during the first years of Peter the Great’s rule, serious reforms in medicine began. First, a decree of the czar was adopted in 1701 that completely banned the primitive potion shops and gave rise to modern drugstores. In 1706, a school was established at the Central Moscow Hospital for the training of home doctors and pharmacists for the needs of the Russian army. In 1719, the first pharmaceutical garden appeared in St. Petersburg, and only a few years later, the first Russian enterprise producing medical preparations. The history of the Russian pharmaceutical industry can be counted from 1720.

For a long time there were only state drugstores in Russia, but in 1726 private drugstores were permitted to open, and by the beginning of the nineteenth century, the drugstore network covered almost the entire country. In 1789, a special pharmaceutical regulation was developed, which became the main regulating document for all pharmacists, introducing progressive rules governing the function of drugstores and the preparation and storage of drugs and their sale.

By the beginning of the nineteenth century, Russian medical education, which had begun less than a century previously, had already become so strong that it had developed not only an educational sphere, but a scientific sphere as well. At the turn of the eighteenth to nineteenth centuries, the first national scientific works appeared in the area of medicine and pharmaceuticals, and with each year their number grew. An especially large number of works were devoted to studies of medicinal herbs and ways for preparing medicines from them.

In the nineteenth century, medicine in the large cities of Russia was equal to that in Europe, and in smaller towns (and even rural areas after the territorial reform of 1864) a territorial (municipal) medical establishment began to develop, and with every passing year their numbers grew and covered more and more of the population.

The reputation of Russian doctors, especially practitioners (and particularly surgeons) and scientists during those times was very high. For instance, N.I. Pirogov became the founder of military field surgery as a separate area of medical studies. I.M. Sechenov became one of the leading world experts in the area of physiology. I.I. Mechnikov, the Nobel laureate, became the founder of studies in evolutionary embryology, comparative inflammation pathology, phagocytal immunity theory, phagocytella theory and scientific gerontology. Finally, I.P. Pavlov, also a Nobel laureate, was not only an internationally recognized authority in the area of physiology, but the creator of scientific studies on higher nervous system activity.

The Revolution slowed the development of medical science in Russia for some time, but it soon started to develop as before. At the same time, medicine became available to the mass market and became generally accessible, as the new state saw this as one of its main tasks. The number of hospitals and drugstores grew rapidly, but the majority of medicines were still prepared in drugstores. Nevertheless, a number of dangerous illnesses were soon conquered on the territory of the country, and vaccination of the newborn became universal.

In the second half of the twentieth century, Soviet medicine was among the best in the world, although in terms of the percentage of recoveries it fell behind some countries, including the USA. Nevertheless, the system of high-quality, generally accessible medical help was established, making it possible to achieve world standards in life expectancy. The situation in the pharmaceutical field was worse, as the mass importation of drugs was impossible, which made it necessary to create domestic analogues with poorer characteristics as a rule.


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