The health crisis management system in Russia is regulated by a number of laws and statutory documents issued by federal and regional authorities. The Federal Service for the Surveillance of Consumer Rights Protection and Human Well-Being (Rospotrebnadzor) is the leading government agency in the field and coordinates the activities of military and civilian government agencies and social organizations whose aim is to protect Russia’s population and territory from epidemic outbreaks. This report contains a comprehensive analysis of the legislation in force and its implementation.
I. Structure of Public Health Crisis Management System
The Russian health care system is based on a strong governmental role in ensuring the country’s sanitary and epidemiologic well-being. The fight against epidemics and overcoming of emergencies are included in the joint jurisdiction of federal and provincial authorities. Government policy in the area of protection from medical emergencies is formulated in a number of federal and provincial legislative acts, presidential decrees, government regulations, and government programs. There is no special legislation aimed at the regulation of issues related to public health emergencies and epidemics. The outbreak of epidemics is considered an emergency situation, and all rules prescribed by the Federal Constitutional Law on Emergency Situations apply. Also, these issues are regulated by the following legislative acts:
- Federal Law on the Protection of the Population and Territories from Emergency Situations of Natural and Technogenic Character
- Federal Law on Civil Defense
- Federal Law on the Sanitary and Epidemiological Welfare of the Population
- Federal Law on the Immunoprophylaxis of Infectious Diseases
- Government Regulation on the Unified State System for the Prevention and Elimination of Emergency Situations
These pieces of legislation determine the powers of Russian authorities in the event of health care emergencies.
The President of the Russian Federation defines public policy and makes the most important decisions related to protecting the population and territory from emergencies. He leads Russia’s Security Council and makes decisions regarding the involvement of troops and other militarized units in eliminating the consequences of emergencies. According to the Law on Emergency Situations, the President has the power to declare a state of emergency for thirty days for the entire nation or for sixty days for a particular region when a threat to the health of population exists. Approval of the upper house of the legislature is needed to declare or extend a state of emergency.
Russia’s Federal Assembly (the legislature) provides for unified legislation and approves budget allocations to finance activities necessary to manage a health crisis. Parliamentary hearings on related issues can be conducted.
Implementing laws and federal programs aimed at protecting the population from epidemics is the duty of the Russian Federation government. Collecting related information, preparing for emergencies, and managing activities to eliminate crises, on the other hand, are included in the sphere of responsibility of regional executive authorities, who must also make decisions regarding the evacuation or isolation of the population. Each region has its own set of laws on related issues.
The Federal Service for the Surveillance of Consumer Rights Protection and Human Well-Being (Rospotrebnadzor) is the leading government institution in the area of epidemiological security. It reports directly to the government of the Russian Federation and coordinates the efforts of various departments and agencies (the Ministry of Defense, Ministry of Internal Affairs, Federal Security Service, etc.) to prevent and eliminate the consequences of mass epidemics. The Federal Civil Defense Medical Service and the Medical Service Used for Catastrophes were established under the Ministry of Health Protection. They are used depending on the situation—for example, a war, the consequences of an emergency, or the outbreak of an infectious disease. These services provide medical and sanitation services to the population during epidemics and work to prevent adverse consequences.
The Rospotrebnadzor includes administrative offices in the constituent provinces, centers of hygiene and epidemiology, research institutes, and antiplague facilities, and cooperates with sanitary and epidemiological services within the following government agencies: the Ministry of Defense, Ministry of Internal Affairs, Federal Security Service, Federal Protection Service, Directorate of Special Programs Under the President, Federal Penitentiary Service, and Federal Biomedical Agency.
II. Implementation of the Emergency/Crisis Response System
The management of antiepidemic measures is one of the duties of Rospotrebnadzor. These measures may include
- organizing and conducting sanitary and epidemiological monitoring;
- preventing infectious diseases from entering an emergency zone;
- locating, mandatorily isolating, and evacuating patients with infectious diseases;
- locating and monitoring persons with chronic forms of infectious diseases;
- maintaining an antiepidemic regime during medical evacuations;
- disinfection measures;
- preventive and urgent immunization; and
- sanitary education and psychological assistance to the population and responders.
Rospotrebnadzor is in charge of conducting planning and training exercises, which are considered the major actions aimed at preventing emergencies and eliminating their consequences. The main purpose of these planning and training exercises is to ensure the sufficiency and full use of existing resources. The elimination of an emergency’s consequences must be conducted by the authorities of Russia’s constituent components and the territorial branches of the federal agencies where the emergency has occurred. If necessary, federal resources can be used.
To ensure that all resources are gathered in one place in order to provide the most efficient response, the federal Ministry of Health Protection has designated one hospital in each of Russia’s constituent components to respond in case of an infectious disease outbreak. These hospitals focus on treating patients who have been diagnosed with diseases as a consequence of a health crisis. Support is provided to these hospitals by the National Institute of Emergency Medical Services, which conducts research in the field of emergency medical services and supplementary professional education of medical staff. Services of other state and private medical establishments can be enlisted for the duration of an emergency situation.
A quarantine regime can be introduced where danger of an epidemic outbreak appears. The quarantine of a particular territory incurs travel restrictions, mandatory vaccinations, and the cancellation of all mass events. Special procedures are prescribed for the distribution or sale of food and basic commodities, and local authorities can restrict the sale of alcoholic beverages. During the quarantine period, police have extended authority to take quarantine violators into custody.
Implementation mechanisms are prescribed by federal target-program documents, which define means for conducting practical health care activities. Several federal target programs for preventing health care emergencies have been approved, financed, and implemented, including
- emergency measures to ensure the public’s sanitary and epidemiologic well-being;
- prevention of the most prevalent diseases;
- disaster medicine;
- protecting the territory from the influence of especially dangerous human, animal, and plant diseases and toxic chemicals; and
- a vaccination program.
Within the vaccination program framework, a one-hundred-million-dose stockpile of vaccines for all major known infectious diseases has been established, and federal control over the vaccines’ quality introduced. The federal registration of the producers of products potentially dangerous to humans, the registration of specific kinds of products being imported into Russia for the first time, and the registration of all potentially dangerous chemical and biological substances has been in force since June 2001. The legal basis for the vaccination against major communicable diseases is determined by the Law on the Immunoprophylaxis of Infectious Diseases. The Law recognizes vaccination as a national security instrument. It provides for federal budget funding of all preventive vaccination and states that those who become incapacitated because of postvaccination complications are subject to social security protection. The National Calendar of Preventive Vaccination and deadlines for vaccinating different categories of the population against particular diseases were developed following the adoption of this Law. Enforcement measures can be applied to those who refuse vaccination. These may include a prohibition on traveling abroad, an employment hiring ban, and university admission restrictions. In order to increase incentives, all firms specializing in the research on and production of medical and veterinary vaccines for the purpose of fighting epidemics are exempt from federal property taxes.
All activities related to fighting epidemics are financed by the federal budget from a special reserve fund. In 2000, Russia’s Supreme Court confirmed that all services provided by the National Sanitary Service (predecessor of Rospotrebnadzor) to the population are to be free of charge. Budget appropriations for fighting epidemics can be spent on special measures aimed at eliminating outbreaks of epidemic illnesses. One quarter of these funds can be appropriated for unscheduled antiepidemic measures in the event of a threat of an epidemic or increase in morbidity. These funds can be spent by local governments for
- the creation of temporary infectious hospitals, according to a regional executive government resolution if the existing regular hospital network cannot satisfy needs;
- the organization and activities of temporary antiepidemic teams and creation of isolation points;
- the payment of salaries to detailed medical personnel;
- related transportation and communication expenditures; and
- the organization and activities of temporary antiepidemic laboratories.
In 2006, the Government Reserve Fund was used to finance measures aimed at preventing the expansion of the SARS epidemic in Russia. According to a government resolution, an amount equal to US$3 million was allocated for this purpose. This money was divided between the Ministry of Health Protection and the Ministry of Defense.
After the Chernobyl catastrophe when information about radioactive contamination was concealed by Soviet leaders, the management of health- and safety-related information became a sensitive issue regulated by legislative acts. Information on protecting the population from health emergencies consists of data on previously occurring or forecasted emergencies and their consequences, and data on the radiation, chemical, medical, biological, explosive, fire, and environmental security of related territories. Information about government activities in this area must be open to public access and cannot be classified.
The concealment or distortion of information about developments, facts, or events endangering human life or health, or the environment, by a person whose duty is to provide such information to the population is a crime punishable by a fine or deprivation of freedom for a term of up to two years, with or without disqualification to hold specified offices or engage in specified activities for a term of up to three years. Stricter punishments are prescribed for the same acts committed by a person holding a post at any level of government.
III. Responsibilities for Failure to Comply with Sanitary Requirements
Russian criminal legislation considers the violation of sanitary rules and creation of health emergencies as attempts on human life regardless of the consequences and punishes the criminal according to the act committed, whether it was a murder or intentionally inflicting harm on health.
The violation of sanitary and epidemiological rules that results in the spread of a disease or poisoning of people is a crime under Russian criminal law. This also applies to individuals who violate quarantine requirements. Such actions are punishable by a fine, disqualification to hold specified offices or engage in specific activities for a term of up to three years, corrective labor for a term of up to one year, or imprisonment for one year. If the death of a person was the consequence, the term of imprisonment extends up to five years.
Also, individuals whose negligence in dealing with dangerous biological agents has inflicted harm on human health are held criminally responsible. Individuals who violate safety regulations for handling microbiological or other biological agents or toxins and thereby cause harm to human health or the spread of an epidemic or disease or other grave consequences are punishable by a fine, compulsory labor for a term of up to two years, or imprisonment for a term of up to two years.
Russian law provides for the possibility of imposing some restrictive measures on foreigners suspected of being infected with a communicable disease. Article 7 of the Law of June 21, 2002 on the Legal Status of Foreign Citizens in the Russian Federation allows authorities to reject a petition or annul previously issued permission for a foreigner to take up temporary residence in Russia if he/she is a drug addict, does not have a document certifying that he/she does not have a disease induced by the AIDS virus, or is suffering from an infectious disease considered dangerous to other people. The list of these diseases and the procedure for medical evaluation of a person suspected of being infected has been established by the federal government.
IV. Cooperation with the World Health Organization
Russia is a member of the World Health Organization (WHO) and has accepted the obligation to bring its health crisis management procedures in line with WHO requirements. In 2009, the Framework Cooperation Agreement was signed between the WHO and the Ministry of Health Protection, and ongoing developments in the Russian health care sector are tied to WHO strategic goals.
The Ministry of Health Protection has set a goal of bringing Federal Target Programs in line with WHO requirements and, in 2014, the Ministry of Health Protection reported that systemic changes recommended by the WHO had been implemented. Existing Russian rules and procedures for sanitation and epidemiological control do not contradict the requirements of the International Health and Sanitary Regulations of 2005, which were adopted by Russia without reservations, and are followed in case of emergencies.
V. Response to the Outbreak of Infectious Diseases
Recently, Russian authorities have undertaken preventive epidemiologic measures in response to two global health crises, the SARS epidemic in 2006 and the swine flu epidemic in 2009. When the WHO issued an emergency alert in April 2009 because of the spread of the swine flu, the Russian government formed an executive commission on preventing the introduction and spread in Russian territory of diseases caused by flu viruses. The Commission consisted of heads of all relevant government executive agencies. The government decree defined its duty as the coordination and supervision of the activities of federal and regional authorities in this regard.
The Commission ordered
- the surveillance of passengers coming from Mexico and other countries where cases of swine flu had been reported;
- the mandatory checking of the body temperature of all arriving travelers and the creation of quarantine points at the ports of entry;
- the monitoring of disease reporting by regional institutions;
- the allocation of increased funds for select major national research institutes; and
- the stockpiling of antiviral medicines.
In addition, the import of pork from the countries affected by the epidemic was stopped for several days.
In 2006, in order to prevent the spread of the SARS virus, the government ordered the Federal Border Service to close certain checkpoints on the Russian border with Mongolia and China. Airlines were ordered to reduce the number of flights to infection-affected regions, and eleven medical groups consisting of physicians and sanitary control specialists were formed. Placed on trains traveling between Russia and China, these groups conducted medical examinations of more than one thousand suspicious passengers and railroad personnel. A network of federal medical centers was set up in major Russian regional centers with the task of diagnosing the disease and identifying the presence of the virus. Airport terminals in Moscow were equipped with infrared detectors able to determine any traveler’s temperature at a distance of fifty yards. In order to protect the capital city, public transport and open markets were disinfected daily, and one million respiratory masks were acquired for public use.
VI. Response to the Ebola Virus Outbreak
Russia’s Foreign Ministry announced it had allocated the equivalent of US$3.8 million to help the country prepare for a possible outbreak of Ebola and the equivalent of US$3.95 million for research work. Russia also set aside the equivalent of US$5.2 million in humanitarian aid for the West African countries hit hardest by the outbreak.
Following the outbreak of Ebola in West Africa, a team of epidemiologists, virologists, and bacteriologists was sent by Rospotrebnadzor to Guinea to participate in fighting Ebola. The team delivered a mobile laboratory and took part in diagnosing and treating the Ebola virus. Russia is considering sending additional medics to Africa in order to stop the epidemic spread. The possibility of deploying planes with special medical equipment, including life-support capsules for transporting Ebola-infected patients, is being explored. Protective equipment, such as sealed medical suits, masks, eye shields, and disinfecting materials, was supplied to Guinea. Also, production of a trial batch of the Ebola vaccine Triazavirin has been launched. This vaccine will be sent to Africa for efficacy tests.
The Russian Ministry of Education and Science recommended that universities postpone the academic year for students from Africa because of the Ebola virus. It is estimated that Russia has about two thousand students from the Ebola-affected countries. About five hundred students from West Africa were tested for the virus and placed under observation. They were not isolated, but doctors checked their temperature and other vital signs. No Ebola case was confirmed.
The initiative to check all African residents in Russia for Ebola was discussed by the legislature; however, the Ministry of Health Protection deemed this measure excessive because Africans who already live in Russia do not need to be checked for Ebola, as control border controls are sufficient to keep the disease out of the country.
From August to October 2014, more than three million passengers arriving at the country’s airport from various countries were checked by the Rospotrebnadzor specialists. Of those checked, twenty-two people were hospitalized and examined for signs of Ebola, but all were found to be free of the disease. The agency also introduced a system of registration and mandatory twenty-one-day monitoring of people arriving from Ebola-affected African countries. According to the Ministry of Health Protection, Russia has an active antibacterial system that annually discovers and isolates about two hundred cases of exotic viruses. Reportedly, Russian airports will be provided with additional equipment to increase the effectiveness of examinations.
Prepared by Peter Roudik
Director of Legal Research*
* This report was prepared with the assistance of Nerses Isajanyan, Foreign Law Consultant.
 Federal Constitutional Law No. 3 on Emergency Situations, Sobranie Zakonodatelstva Rossiiskoi Federatsii [SZ RF] [Russian Federation Official Gazette], 2001, No. 23, Item 2277, available at http://base.garant.ru/12123122/ (in Russian).
 Federal Law No. 68 of Dec. 21, 1994 on the Protection of the Population and Territories from Emergency Situations of Natural and Technogenic Character, SZ RF 1994, No. 35, Item 3648, http://base.garant.ru/10107960/ (in Russian).
 Government Regulation No. 794 on the Unified State System for the Prevention and Elimination of Emergency Situations of Dec. 30, 2003 (amended Nov. 19, 2012), Rossiiskaia Gazeta [RG], No. 271, Nov. 23, 2012, http://base.garant. ru/186620/ (in Russian).
 Law on Emergency Situations arts. 4, 7, 9.
 Constitution of the Russian Federation art. 105.
 Law on Emergency Situations arts. 24, 25.
 Statute on Medical Service Used for Catastrophes, approved by Government Regulation No. 734 of Aug. 26, 2013, available on the Ministry of Health Protection website, at http://static-1.rosminzdrav.ru/system/attachments/ attaches/000/012/778/original/Ob_utverzhdenii_Polozheniya.pdf?1389715517 (in Russian).
 Statute on Rospotrebnadzor § 8.
 Id. § 5.
 Id. § 4.
 Order No. 220 of Sept. 17, 1993 of the Russian Federation Health Protection Ministry on the Development and Improvement of the Infectious Disease Service in the Russian Federation, available at http://www.consultant.ru/ document/cons_doc_law_100796/?frame=3 (in Russian).
 Information on the Federal Registry of Potentially Dangerous Chemical and Biological Substances is available on the Rospotrebnadzor website, at http://www.rpohv.ru/ (in Russian; last visited Nov. 20, 2014).
 Id. arts. 5.2, 6.
 Ruling of the Russian Federation Supreme Court No. GKPI2000-1453 of Feb. 5, 2001, available at http://www.consultant.ru/document/cons_doc_LAW_31907/.
 Rospotrebnadzor Letter No. 0100/1828 of Feb. 20, 2006 on the Accounting of Expenses Related to Fighting Epidemics, available at http://www.businesspravo.ru/Docum/DocumShow_DocumID_113411.html (in Russian).
 Criminal Code of the Russian Federation art. 237, SZ RF 1996, No. 25, Item 2954 (in Russian).
 A.B. Borisov, Commentaries on the Criminal Code of the Russian Federation 729 (Moscow, 2012) (in Russian).
 Criminal Code of the Russian Federation art. 236.
 Id. art. 248.
 Press Release, Russian Federation Ministry of Health Protection, Minister Skvotsova Participates in World Healthcare Assembly (May 19, 2014), http://www.rosminzdrav.ru/news/2014/05/19/1839-ministr-veronika-skvortsova-prinyala-uchastie-vo-vsemirnoy-assamblee-zdravoohraneniya (in Russian).
 Government Regulation No. 367 of April 27, 2009, on the Government Commission on Preventing the Spread of Highly Pathogenic Flu in Russia, RG, May 5, 2009, http://www.rg.ru/2009/05/05/virus-dok.html (in Russian).
 More Than 3 Million Travelers Checked for Ebola at Russian Airports, Moscow Times (Oct. 24, 2014), http://www.themoscowtimes.com/news/article/more-than-3-million-travelers-checked-for-ebola-at-russian-airports/510021.html.
 Russia’s Putin Vows Closer Cooperation with WHO in Ebola Fight, Sputnik (Oct. 13, 2014), http://en.ria.ru/ russia/20141013/194031322/Russias-Putin-Vows-Closer-Cooperation-with-WHO-in-Ebola-Fight.html.
 Russia Offers to Send More Experts to Tackle Ebola in West Africa, Moscow Times (Oct. 8, 2014), http://www.themoscowtimes.com/news/article/russia-offers-to-send-more-experts-to-tackle-ebola-in-west-africa/508598.html.
 Russia Ready to Introduce New Ebola Vaccines in Six Months: Russian Health Minister,Sputnik (Oct. 11, 2014), http://en.ria.ru/russia/20141011/193961655/Russia-Ready-to-Introduce-New-Ebola-Vaccines-in-6-Months-Russian.html.
 Gleb Fedorov, Chances of Ebola Epidemic Reaching Russia Are Slim, Say Researchers, Russia Beyond the Headlines (Oct. 13, 2014), http://rbth.co.uk/science_and_tech/2014/10/13/chances_of_ebola_epidemic_reaching_ russia_are_slim_say_resea_40553.html.
 Moscow Times, supra note 42.
 African Students Hospitalized in Russia Do Not Have Ebola: Russia’s Health Watchdog, Sputnik (Oct. 23, 2014), http://en.ria.ru/russia/20141018/194264877/African-Students-Hospitalized-in-Russia-Do-Not-Have-Ebola.html.
 Ebola Checks for African Residents in Russia Unnecessary: Health Ministry, Sputnik (Oct. 23, 2014), http://en.ria.ru/russia/20141023/194495826/Ebola-Checks-for-African-Residents-in-Russia-Unnecessary-Health.html.
 Moscow Times, supra note 39.
 On the Ebola Situation (as of 24.10.2014), Rospotrebnadzor (Oct. 24, 2014), http://rospotrebnadzor.ru/about/ info/news/news_details.php?ELEMENT_ID=2537&sphrase_id=191869 (in Russian).
 Fedorov, supra note 47.
Last Updated: 06/09/2015