Russia Policy Monitor No. 2675

AN ACUTE MEDICAL SHORTAGE
Medical services in Russia have long been sub-par, but conditions have deteriorated further in recent years amid a growing shortage of qualified medical personnel. According to statistics from Russia's Ministry of Health, there is now a deficit of nearly 24,000 doctors and 63,000 medical staff across the country. The reasons for the deficit vary, from a lack of adequate compensation to poor treatment of professionals by medical institutions to declining resources in the medical field as a whole. The results have been pronounced; in a recent survey by the People's Front, the findings of which were cited in the Duma, Russia's lower house of parliament, 86% of respondents noted the shortage of doctors in general, while 55% said that their respective medical institutions simply did not have specialists capable of addressing their ailments. (Svobodnaya Pressa, March 31, 2025)

CHANGING UKRAINE, ONE STEP AT A TIME
Much has been written about how, in Ukrainian territories now under Russian control, authorities have systematically attempted to reshape various aspects of local life. Religion is no exception, and Russia's Orthodox Church has been "working with the Russian military and Russian officials... to take full control over religious life, forcing other churches to cooperate fully with it or in many cases shutting down their parishes and other institutions, jailing or expelling religious leaders, and imposing a distinctly Russian pattern of religious activity," writes Paul Goble. Citing a new expose by Novaya Gazeta, he notes that the campaign isn't just aimed at diminishing the power of the rival Orthodox Church of Ukraine, but also to suppress other religions. The Moscow Patriarchate of the Russian Orthodox Church and the Russian state "have worked against other religious groups in the occupied territories as well, including Roman Catholics, Protestants, Muslims, Jews and Buddhists; and much of their activity has been completely stopped," Goble lays out. (Window on Eurasia, April 4, 2025)

OMINOUS PLANS FOR SPACE
NATO officials are raising the alarm over possible Russian plans to militarize space. In a recent interview with German newspaper Welt am Sonntag, Mark Rutte, the Secretary-General of NATO, laid out concerns that Moscow may be planning to deploy nuclear weapons in orbit as part of a new, more aggressive military posture designed to counter Alliance capabilities. "The development of nuclear weapons in space is a way for Russia to improve its capabilities," Rutte said. "This is very worrying." (Newsweek, April 12, 2025)

MOSCOW'S SHRINKING MIDDLE EASTERN MARITIME FOOTPRINT
When Syrian strongman Bashar al-Assad was ousted by Islamist forces back in December, Russia became one of the major losers. Since taking power, Syria's new rulers have taken a much more skeptical stance toward the Kremlin, including curtailing the Russian military's ability to utilize the naval port in Tartus, a longstanding stronghold for the Russian navy. "Effectively, it is now a foreign body of water for them," Dmytro Pletenchuk, the spokesman for Ukraine's navy, has noted. "Sure, there are some friendly regimes in Africa, and there are even ports where they occasionally dock for refueling — they may still be serviced there. However, they no longer have a proper base." (The New Voice of Ukraine, April 10, 2025)

RUSSIA RAMPS UP THE RHETORIC...
Over the past three years, Russia's relations with the West have deteriorated precipitously – to the point that Kremlin officials are now issuing threats against NATO members. According to Sergei Naryshkin, the head of Russia's SVR foreign intelligence agency, Russian and Belarusian security services are prepared to take "preemptive" measures against NATO countries. "We feel and see that European countries, especially France, Britain and Germany, are increasing the level of escalation around the Ukrainian conflict, so we need to act preemptively," Naryshkin said publicly during talks with Belarusian president Alexander Lukashenko in Minsk. "We are ready for this."

Naryshkin has also suggested that the Kremlin plans to make Poland and the three Baltic states (Latvia, Estonia and Lithuania) its first targets in the event of an all-out conflict. "In the event of aggression by the North Atlantic Alliance against the Union State [between Russia and Belarus], the damage will be done, of course, to the entire NATO bloc," he said. "But to a greater extent, the first to suffer will be the carriers of such ideas among the political circles of Poland and the Baltic countries." (Times of London, April 15, 2025; Express, April 16, 2025)

...CAUSING THE BALTICS AND POLAND TO EYE THEIR DEFENSES
Russia's saber-rattling, in turn, is forcing frontline states to rethink their defenses – and their international commitments. Last month, the Baltic states, together with Poland, decided to leave the 1997 Ottawa Treaty, which bans the use, stockpiling or production of land mines. Latvia's parliament has now voted formally in favor of such a move, on the grounds that it would provide Riga with "greater freedom of choice and operational flexibility [in] protecting borders."

Latvia's decision could be the start of a larger exodus. Lithuania has also signaled its intent to vacate the convention, based upon a sober calculus. "Get out of all these conventions — Russia follows no laws or customs of war," the country's former defense minister, Laurynas Kasciunas, has counseled. "Do it while you still have time." (New York Times, April 16, 2025)