Impact of economic sanctions on accessibility of medical care – experience of foreign countries[Влияние Санкций На Доступность Медицинской Помощи – Опыт Зарубежных Стран]

The paper analyzes the impact of economic sanctions on the availability of healthcare services and on public health. The relevance of the work is due to the peculiarities of the current economic and political situation in Russia. In the context of growing sanctions pressure, the issues of preserving public health are especially acute. The main objectives of the work are to analyze the effects of economic sanctions on various aspects of the availability of healthcare services in foreign countries, identify the most vulnerable groups of the population, and identify the best practices for managing such shocks in the field of healthcare. The research method is an analytical review of current scientific literature devoted to identifying the effects of sanctions. The experience of such countries as Cuba, Syria and Iran was considered. The results of the study show that economic sanctions can significantly reduce the availability of medical care and negatively affect the health of the population. The following groups are most vulnerable to sanctions pressure: children, the elderly, people with chronic diseases, those suffering from malignant neoplasms, diseases requiring high-tech diagnostics and treatment, rare diseases. The devastating impact of sanctions on public health is most pronounced in those countries where the commodity sector (and especially the pharmaceutical sector) strongly depends on imports; in countries where revenues are highly dependent on the export of one or few commodities; in countries that are isolated geographically and/or politically; in countries that were sanctioned very quickly and were unable to prepare and reorganize import chains and rebuild national industries to at least some extent; in countries where the health care system is heavily dependent on the export of one or few commodities; and in countries where the health care system is heavily dependent on imports. An additional factor reinforcing the negative impact of the sanctions is the lack of a sustainable developed system of information collection and processing, which allows for prompt and effective response to emerging problems. On the contrary, the factors of successful maintenance and development of public health system under sanctions are a high level of development of primary medical care and effective policy of counteraction to sanctions pressure in those areas where there is/can be a shortage of drugs, components, etc. The most important part of such a policy is an effective system of rapid collection and processing of information that allows prompt and effective response to emerging problems. The most important part of such a policy is an effective system of operational monitoring and forecasting of the situation. Based on the results of the study, recommendations were formulated for the development of measures aimed at increasing the availability of medicines in the current conditions The paper was written on the basis of the RANEPA state assignment research programme.