NPOs: NEW CHALLENGES — NEW SOLUTIONS

State and NPOs: expanding social interaction based on trust and support

IN RECENT YEARS, THE ROLE OF THE THIRD SECTOR IN THE LIFE OF RUSSIAN SOCIETY HAS INCREASED MANY TIMES OVER, AS EVIDENCED BY THE UNPRECEDENTED GROWTH OF CIVIC INVOLVEMENT IN THE NPO AND VOLUNTEER ACTIVITIES. OWING TO THE GROWTH OF PUBLIC TRUST IN THE THIRD SECTOR ACTIVITIES, NPOs TODAY ACT THE MAJOR PARTICIPANT IN PUBLIC RELATIONS, AND THEIR PROBLEMS AND DEVELOPMENT ISSUES HAVE BECOME A SIGNIFICANT PART OF THE STATE AUTHORITIES AGENDA.

Having faced new challenges that have become a major threat to national security, the nonprofit sector has shown its best qualities – involvement, integrity, charity, and self-sacrificing approach.

It was the representatives of NPOs, civil activists, volunteers, philanthropists who, from the very first days were took an active part in helping refugees who were forced to leave their homes caught by military aggravation of the Donbass conflict. To further coordinate volunteer efforts, the All-Russian Student Rescue Corps (ARSRC), the Russian Red Cross (RRC), in cooperation with the Civic Chamber, have set up a volunteer crisis headquarters.¹³⁹

The volunteers coordinated the distribution of humanitarian aid 24 hours a day, extended psychological support to citizens residing in temporary accommodation centers, and organized leisure activities for children.

The volunteers were further involved in sending and escorting humanitarian aid to the Donetsk and Lugansk People’s Republics. Student rescuers delivered necessities to the Lugansk Republican Clinical Hospital intended to help children with cancer, their mothers and employees of the oncohematological department.¹⁴⁰

A huge portion of work was done by the Russian Red Cross representatives. Through the combined efforts of the organization, from February to July 2022, over 1,442 tons of humanitarian aid were collected and transported, more than 90,000 people received humanitarian support, and over 480 million rubles of financial assistance were raised.¹⁴¹ The organization ensured the work of temporary accommodation points, procured personal hygiene items, water, infant formula, dishes, household appliances, as well as vitamins for children and adults. In addition, the Russian Red Cross extended targeted assistance by tackling problems and supporting people in need.¹⁴²

Assistance to seriously ill and wounded children has made up for a separate area of work for nonprofit bodies. Since 2014, the Doctor Liza’s Fair Aid charitable foundation has been treating seriously ill and wounded children from the DPR and LPR territories. In 2021, 824 appeals for assistance were received from Donbass, all addressed and satisfied.¹⁴³ On June 11, 2022, the project of the organization To Live and Win, aimed at extending medical care to seriously ill children and adults from Donbass, won the competition of the Presidential Grants Foundation. 36.8 million rubles were allocated for continuing these socially relevant activities.¹⁴⁴

The consolidation of numerous Russian nonprofit bodies that acted as a united civil front produced a synergistic effect in civil society, making it possible to both reinforce multilateral support and systematize common efforts in its major areas.

Representatives of the Donetsk and Lugansk People’s Republics civil society highly appreciated the work of Russian NPOs.145 On July 12, at the active citizens’ forum “Community” forum, the Civic Chambers of the LPR and the DPR signed memoranda of cooperation with the Civic Chamber of the Russian Federation.

The document sets forth the provisions on cooperation in common spiritual and moral values, preserving interethnic and interreligious harmony, as well as enhancing cultural ties between fellow countrymen. The memo touched upon the issues of restoring the economic and cultural infrastructure of Donbass, as well as the return of its inhabitants to their ordinary lives.

In addition, the LPR and the DPR Civic Chambers have signed cooperation agreements with regional civic chambers covering over 20 regions of the country. These include Sevastopol, the Khanty-Mansi Autonomous Okrug – Yugra, Voronezh Region, Kaluga Region, Nizhny Novgorod Region, Rostov Region, Ryazan Region, Saratov Region, Altai Region, Krasnodar Region, and others.

Serving as an additional impetus to the further development of civil society institutions, these agreements have become efficient tools for interaction and the spread of civic activity in the LPR and DPR territories even before they became part of Russia.¹⁴⁶

The major project to support public initiatives and expand the third sector in the Donbass territories was the work establishing resource centers for NPOs, which was guided by the Civic Chamber of the Russian Federation. As part of this work, a unified database of nonprofit organizations from Russian regions is maintained, helping and staying at ready to help expand the nonprofit sector in new territories. Together with the Institute of Public Administration and Management of the RANEPA and in cooperation with the civic chambers of the Lugansk and Donetsk People’s Republics, a series of training seminars was held for the public of the new Russian regions, dedicated to the issues of state support and registration of NPOs, establishment of partnerships and interaction of NPOs. For representatives of the public and authorities involved in elaborating and implementing programs and measures aimed to support public associations and SO NPOs of the Lugansk People’s Republic, Donetsk People’s Republic, Zaporozhye and Kherson Regions, targeted free training was organized at the IGSU RANEPA under the advanced training program “Issues of interaction with socially oriented nonprofit organizations and involvement of socially oriented nonprofit organizations in service provision in the social sector”. The training aims to foster the rapid development of the nonprofit sector in the new Russian regions and the formation of regional teams hosting modern practices, technologies and methods for implementing measures to support socially oriented NPOs.

The work of nonprofit organizations in the Donbass has shown that the third sector appears the most structured part of civil society, providing the entire Russian society with opportunities and tools to implement a whole range of public, humanitarian, social, and economic initiatives. The third sector does not replace the state but complements it, ensuring the required level of horizontal interaction in society, based on long-term ties, practices of joint activities and mutual assistance, making it possible to efficiently, quickly and specifically address socially significant tasks, raising state resources as necessary.

For its part, the state has significantly expanded the interaction with nonprofit organizations over the past few years.

An example of this work was the gradual expansion of access for NPOs to providing services in the social sector. The social order has proven a mechanism in demand for expanding such of NPOs involvement in the social sphere in 2022. One of the goals of implementing the law on social contracting¹⁴⁷ in 2020 was to expand the share of NPOs in providing services in the social sphere. Today, with this mechanism introduced, social services are becoming more accessible and offer higher quality for vulnerable categories of citizens.¹⁴⁸ Based on the Report on the Status and Problems of the NPO Supplier involvement in the System of State Social Procurement,¹⁴⁹ the number of nonprofit organizations (SO NPOs and small and medium-sized businesses) participating in and winning the competitive selection is also growing. If we take 2021, when 63 organizations took part in such a selection and 45 nonstate service providers became its winners, the number of participants in the competitive selection almost tripled in 2022 and amounted to 184 organizations, and 138 nonstate organizations have won.

One of the most notable effects of the practical approval of the law on state social order for the provision of public services in the social sector was the establishment of coordination platforms (“dialogue platforms”).¹⁵⁰ Such platforms are mainly formed based on the civic chambers of the regions of Russia, as well as on regional branches of the All-Russian public organization of small and medium-sized businesses “OPORA Russia”. Civic chambers being engaged in testing the new mechanisms of this law has made a significant contribution to further enhancing the efficiency of NPO involvement in the provision of state (municipal) services in the social sphere in the Khanty-Mansi Autonomous Okrug, Novosibirsk, Pskov, and Kaliningrad Regions.

At the “Head-to-head competition” conference held in the Civic Chamber, the experience of coordinating platforms aimed to promote the implementation of social contracting mechanisms in pilot regions was presented, and steps were introduced to extend the NPO involvement in its implementation.

On January 1, 2022, with the amendments to the Tax Code of the Russian Federation taking effect, a unified register of SO NPOs receiving support was launched. Today it includes over 46 thousand NPOs from all country regions. The register is tasked primarily with implementing the Tax Code provisions, based on which a business that donates to an NPO in the register is entitled to certain tax preferences.¹⁵¹

The large-scale sanctions imposed by Western countries against Russia, coupled the subsequent restructuring of the Russian economy, yielded an impact on the third sector as well. A major step of the state aimed at expanding the third sector in the current conditions was the decision to take extra measures to support NPOs.

On March 16, 2022, the President of Russia signed a Decree,¹⁵² which includes the adoption of extra measures to support socially oriented NPOs engaged in social services, social support, and civil protection, extending assistance to refugees, implementing activities in patriotic education, as well as contributing to the development of internal labor migration. For over a year, a number of changes were adopted at the legislative level, including administrative relaxations, the abolition of scheduled inspections of NPOs in 2022, easing penalties for administrative offenses committed by NPOs for the first time, etc.

On July 14, 2022, the President signed a law aimed at preserving the target capital of NPOs faced with external pressure imposed by sanctions.¹⁵³

The new wording considered the proposal of the Civic Chamber on suspending the legal norms established in clauses 5 and 6 of part 1 of Article 14 of the Federal Law of December 30, 2006 No. 275-FZ “On the Procedure for the Formation and Use of Endowment Capital of NonProfit Organizations”. These articles laid down the grounds for the forced dissolution of endowment capital in response to a decrease in the value of net assets as a result of property trust management.

In 2022, the state showed its willingness for its multilateral support towards the third sector, which was shown at the legislative level as well as in the financial provision of nonprofit organizations by way of subsidies and grants from development institutions, such as the Presidential Grants Foundation and the Presidential Foundation for Cultural Initiatives.

Despite the systemic support measures and the widespread demand for the NPO activities, one of the major problems of the third sector today is its imbalanced development at the regional level.

To identify and eliminate discrepancies in the development of the third sector in the Russian regions, the project of the Civic Chamber rating “Region-NPO” is introduced. The results of the third sector rating for 2022 were presented at the final “Community” forum in Moscow . Over the years of the project implementation, the rating of the “Region-NPO” third sector has proven an effective management mechanism for making strategic decisions on the NPOs expansion, its results are taken into account by the Russian government, and the rating in the regions is used as a basic basis for elaborating roadmaps for its further development.

Given the high importance of the NPO sector in the social sphere expansion, Tatyana Golikova instructed the Ministry of Economic Development of Russia and the Civic Chamber to work out possible mechanisms to stimulate the executive authorities of the Russian regions to take measures to reduce disproportions in developing the nonprofit sector.¹⁵⁴

The Deputy Prime Minister asked further to elaborate on proposals for reducing bureaucratic barriers in extending subsidies and grants to SO NPOs and to develop recommendations for more active SO NPO involvement in implementing regional programs of national projects.

The Civic Chamber submitted its proposals to the Ministry of Economic Development of Russia, where it noted that in overcoming the disproportions in the third sector development, supplementing the list of indicators for assessing the efficiency of the senior official activities of Russia’s regions and the activities of the executive authorities with the indicator “The number of people employed in socially oriented NPOs” and establishing incentives for achieving the indicators of this assessment.¹⁵⁵

Establishing an inclusive culture in Russian society

FOR THE PAST FEW YEARS, THE DEVELOPMENT OF AN INCLUSIVE CULTURE HAS BEEN IN SPOTLIGHT OF BOTH SOCIETY AND THE STATE, AND IT HAS BEEN ACTIVELY DISCUSSED IN THE SCIENTIFIC AND EXPERT COMMUNITY AT THE DISCUSSION PLATFORMS HOUSTED BY PROFESSIONAL CONFERENCES AND IN ONLINE COMMUNITIES.

Up until now, the concept of inclusion as a process of practical involvement of people experiencing difficulties in physical development, including those with disabilities and mental disabilities in the active life of the society, was limited to consideration of the development of social practices, related to a greater extent to educational processes.

Today, owing to the active nonprofit sector interaction, the expert community and the state, the concept of inclusion as involvement in the everyday life of society is considered in a broad socio-cultural context that embraces all possible forms of social adaptation of people with disabilities.

Sociological research results say over 60% of Russians are personally acquainted with people with disabilities. Russian citizens are also well aware of the problems of people with disabilities and believe that such people require state support and care. At the same time, 69% our fellow citizen believe that the state currently puts insufficient or too little effort on the disabilities agenda.¹⁵⁶

In May 2022, the House of Human Rights, with wide involvement of civil society representatives held public hearings on analyzing the implementation in Russia of the provisions of the UN Convention on the Rights of Persons with Disabilities over a 10-year period.

The event participants discussed the implementation of the action plan for exercising the recommendations listed in the Concluding Observations of the Committee on the Rights of Persons with Disabilities on the initial Report of Russia on implementing the Convention provisions, prepared in 2014, as well as the involvement of all-Russian organizations of persons with disabilities in public oversight over the UN Convention implementation.¹⁵⁷ The hearings participants noted that Russia, having assumed obligations for the urgent transition of all authorities to active actions for the comprehensive integration of persons with disabilities, the identification and suppression of discrimination against their rights, is meeting these expectations to a large extent. At the same time, an analysis of citizens’ appeals to authorities and civil society institutions yields that certain problems in this area still remain and urge proper decisions by state bodies.¹⁵⁸

The problem of protecting the rights and interests of citizens with mental disabilities, employing people with disabilities, accompanying them in employment and enhancing the system of job quotas, increasing the level of accessibility of services and objects in culture, establishing equal access to technical and other services, including high-quality equipment for rehabilitation, for people with disabilities living in territories with different levels of infrastructure development.

In medium and small towns of Russian regions, the issues of expanding the availability of public transport, free parking spaces, and creating an accessible environment in residential premises and yard areas remain on the agenda. The introduction of all buildings and structures of the rules of universal design at the design stage, ensuring the ubiquitous accessibility of objects without the need for further adjustment to the needs of people with disabilities remains, which will save significant both temporary and financial resources, is still pressing.¹⁵⁹

A need for citizens with disabilities to use digital tools and resources to help them overcome limitations and to set up opportunities for full involvement in modern society is imperative.

The departure of foreign IT companies from the Russian market has complicated the access of citizens with disabilities to the required software. This problem was addressed in detail at the Civic Chamber site.¹⁶⁰ The experts noted that the current situation urges the need to bring about special measures of state support (grants, subsidies) aimed at stimulating domestic IT companies to intensify work on the elaboration and implementation of domestic analogues of software and hardware used by people with disabilities in their everyday life, such as screen readers and speech recognition.

With that, the key point in this work should be the comprehensive involvement of people with disabilities as experts in creating and testing new digital solutions, which will help meet the needs of this social category to ensure their digital accessibility.

A successful example of work aimed to ensure the availability and safety of financial services for citizens with disabilities was the cooperation of the Civic Chamber with the Bank of Russia. Owing to that, with the direct participation of disabled people, adapted banking applications have been established, special units for servicing people with disabilities are being formed, and the physical office availability is expanded. The work yielded a high assessment of the financial institution accessibility by citizens – 70% of bank customers with disabilities consider financial institutions to be suitable for their service.¹⁶¹

As part of the public examination, the Civic Chamber conceptually supported the draft order for the Ministry of Digital Development of Russia, ensuring access to the state authorities and local self-government websites for people with disabilities, noting a number of comments and additions to the draft normative act that concerned the technical features of the site adjustments, their design, integration, and use of ready-made software solutions.¹⁶²

A promising project scheduled for short-run implementation will be a rating system for infrastructure facilities based on their accessibility for people with disabilities. It is assumed that the results of such a rating will be integrated into navigation systems based on accessible and popular Russian applications, which will help a person with a disability in determining the accessibility and assessing the comfort level of social, transport and engineering infrastructure, obtaining information on possible obstacles on a specific route to a hospital, shopping center, or financial institution.¹⁶³

The rating development has become one of the instructions of President Vladimir Putin to the Russian Government and the Civic Chamber following the meeting with people with disabilities and representatives of public organizations in 2020.

A letter with proposals for implementing the project was submitted to the Civic Chamber by the Ministry of Digital Development of Russia, proposing to create a rating system based on the federal state information system “Unified Digital Platform for Spatial Data”, which is scheduled to be launched in 2024. In addition, the agency proposed dividing objects into residential, social, public, cultural, sports, etc., and specifying information for people with disabilities of the motor system, vision, hearing, and mental disabilities on a separate basis.

As part of the Inclusive Platform project, the Russian Ministry of Culture also supported the proposal of the Civic Chamber on a user rating of the accessibility of cultural institutions. Thanks to the assessments given by citizens with disabilities, volunteers and employees of cultural institutions, the top 10 accessibility of cultural institutions in the regions of the Russian Federation was compiled.¹⁶⁴

“Blagosphera”— participation of charitable organizations in solving major social problems

BASED ON THE GLOBAL PHILANTHROPY INDEX, IN 2022 RUSSIA REACHED A HISTORICAL LEVEL OF DEVELOPMENT OF PHILANTHROPY. OUR COUNTRY HAS RISEN FROM 67TH POSITION IN 2021 TO 30th PLACE. THE RUSSIAN INDEX OVER THE PAST FEW YEARS HAS YIELDED SIGNIFICANT GROWTH – 6 YEARS AGO, THE COUNTRY OCCUPIED 124th PLACE IN THE RANKING. IN 2022, ALL THREE KEY INDICATORS – HELPING STRANGERS, DONATING MONEY, AND VOLUNTEERING – INCREASED.¹⁶⁶

The study results indicate the constant growth of the Russian citizens’ involvement in charity and their willingness to support each other. Another major indicator of transforming the culture of charity in our country is the growth of trust in charitable NPOs constantly recorded by polls.

2022 has proven a challenging year for many charities and organizations. Despite the general positive changes in charity, following the start of the special military operation, charitable foundations, like other representatives of the nonprofit sector, faced certain difficulties in their activities, primarily related to the reduction in the number of regular donations.

With the departure of international payment systems such as Visa and Mastercard from Russia, it has become difficult for charities to receive donations from abroad. In addition, contributors would often unsubscribe from regular write-offs in favor of charitable foundations on their own.

In some cases, there has been an increase in write-off errors due to lack of funds on the card, as contributors withdrew cash or transferred money to another bank.¹⁶⁷

Charitable organizations also faced difficulties in procuring specific medicines, in particular anticonvulsants and antidepressants. The reason for this was an increase in shipping prices, a growing demand in pharmacies for various drugs, and suspended supplies.

Another major problem was the exit of foreign companies that developed corporate philanthropy or launched partnership projects with Russian charitable foundations.¹⁶⁸

Despite positive trends towards a recovery in donations in the fall of 2022, today the timeframe for planning the activities of charitable organizations is largely limited. At the start of 2023, with the amount of traditionally received funds decreasing amid the complexities caused by the sanctions, the funds may once again face difficulties.

Still, despite all the obstacles that philanthropists and other contributors have faced this year, they continue to participate in tackling the most important social problems. Charity is becoming not merely targeted and humanitarian aid and is not “patching holes” and urgent fees for operations but brings serious systemic changes and yields a real impact on the quality of people’s lives.

Charitable NPOs and foundations can provide a quick response to an emerging problem, and that also helps the state. Authorities are often shackled by bureaucracy and a cumbersome regulatory framework in tackling with social issues. Seriously ill children, elderly citizens, and refugees, however, have no time to wait. Charitable NPOs can provide immediate assistance, making them real supporters for the state in solving socially relevant problems and providing to save lives and preserve the willingness to move forward among a large number of people.¹⁷³

Assistance to refugees, incurably ill children and adults, homeless animals, and the poor is extended on a constant and prompt basis and demonstrates the empathy of our citizens to each other, their willingness to jointly solve various social problems.

Worth noting is that in recent years the state has shown its interest and has been assisting the development of charity in the country. These intentions are reflected in the Concept for Promoting the Development of Charity until 2025 adopted by the Russian Government in November 2019.¹⁷⁴ In addition, various mechanisms of motivation and involvement in charity are being developed. These include tax deduction for charity, which implies the possibility of getting back 13% of the amount of charitable donations.175 In addition, a mechanism has been developed for donating this tax deduction to the same organization which citizens previously sent funds to. All this makes it possible to attract as many people as possible to the charity area, and gives the nonprofit sector guarantees of support from the state.

The Circle of Kindness Foundation in 2022

A SPECIAL FORM OF GOVERNMENT SUPPORT FOR CHARITY IS DISPLAYED BY THE CIRCLE OF KINDNESS FOUNDATION. ESTABLISHED ON JANUARY 5, 2021 BY DECREE OF THE RUSSIAN PRESIDENT, THE FOUNDATION PROVIDES EXPENSIVE AND HIGH-TECH MEDICINES TO CHILDREN WITH SEVERE LIFE-THREATENING AND CHRONIC DISEASES, INCLUDING RARE (ORPHAN) DISEASES. THIS WAS MADE POSSIBLE DUE TO FEDERAL BUDGET ALLOCATIONS BY INCREASING PERSONAL INCOME TAX BY 2% FOR CITIZENS WHOSE INCOMES EXCEED 5 MILLION RUBLES A YEAR.

Creating the Foundation was a landmark event that in two years changed the context and rules of interaction between the nonprofit sector and the state, and fully transformed the model of helping children with serious and rare diseases.

In 2022, given the changes in the economy, the Foundation faced a number of difficulties in logistics and medication supply from abroad. Additional approvals were required due to changes in the cost of medicines, and a number of foreign suppliers had doubts about further interaction with the Foundation.

All obstacles were overcome in a short timeframe – the prices for medicines today remain below world prices, none of the partners refused to continue working with the Foundation. Given the possible difficulties related to logistics, the Foundation provided for the reserved purchase of medicines for 2023.

Currently, only 40–60 days pass from the moment an application is received to the patient receiving the drug, and, in case of emergency, work is carried out even faster. Among other things, ensuring efficiency is facilitated by the electronic system of interaction operating in the Foundation. Parents can apply for drug assistance through the Public Services Portal (“Gosuslugi”), and the Russian Ministry of Health can control the processing of applications from the regions.

Great importance in the daily work of the Foundation is given to meetings with parents of sick children and interaction with NPOs.

In 2021, the Foundation established the Circle of Friends communication platform, which brings together professional, patient communities, associations of parents, and children with serious illnesses in one space, making it possible to quickly discuss current problems and jointly look for ways to solve them.

Owing to the introduction of a new form of interaction between the Foundation and specialized NPOs in 2022 – the signing of agreements on cooperation and interaction – the burden on NPOs to raise funds for the treatment of children according to the list of nosologies supervised by the Foundation was removed. If nonprofit organizations were previously looking for funds to buy medicines or medical devices on their own, they now have the opportunity to expand their activities to educational projects and leisure programs for children.

Similar agreements were concluded with the Interregional Public Organization “Society of Patients with Hereditary Angioedema”, the All-Russian Society of Orphan Diseases, ANO “House of Rare”, and a number of other NPOs that help children with illnesses.

The Foundation’s Expert Council is constantly working to expand the list of diseases that the Foundation provides its support to, including genetic diseases for which effective drugs have already been developed. In 2022, the list of such nosologies was significantly expanded – by 14 diseases. Now there are 59.¹⁷⁶ The Circle of Kindness has started to purchase special bandages and plasters for “butterfly children”, as well as endoprostheses that can grow with the child’s growth.

On June 1, 2022, the Russian President met with Archpriest Alexander Tkachenko, Chairman of the Board of the Circle of Kindness Foundation. Vladimir Putin approved the idea to expand the Fouundation’s assistance to children aged over 18 so as to continue their treatment. A corresponding instruction was given to the Russian Government. Thanks to the adopted decision, a smooth transition in medicines provision to children who have attained legal age will be ensured.

The practice of accompanying the Foundation-hosted wards has shown that the regions need time to provide funds in the budget for the continuation of treatment. The Foundation is now alerting the region about a specific patient who is moving into the adult category, and monitors his treatment in the future.

Another significant achievement expanding the Foundation activities in 2022 was the delegation of the authority to the Foundation to procure drugs for the wards of the state program “14 high-cost nosologies” (HCN) until they attain the age of eighteen. The stable fund financing makes it possible to provide an additional volume of medication procurement for the new wards of the Foundation that host about 15 thousand in Russia today, preliminary estimates say.

This decision is significant for children who will become the Foundation’s wards and will be able to freely and continuously receive the necessary medicines as well as for adults. Funding for the “14 high-cost nosologies” (HCN) program will remain at the same level, and the possibilities of treating adult patients will expand. This will solve another major problem, i.e. to provide high-quality and uninterrupted assistance to adults, which is difficult for many regions to provide given the lack of finance.¹⁷⁷

In 2022, a separate area of the Foundation activity was the provision of medicines for children with severe, life-threatening diseases in new territories. Work in this direction is further complicated by a number of problems, primarily related to the fact that the application submitted to the Foundation is a complex document that includes a confirmed diagnosis and a drug with a calculated dosage prescribed by a medical commission, and in some cases by the Federal Council. So far, the possibilities of preparing such documents in medical institutions of new subjects remain largely limited.

Despite all the difficulties, the Foundation strives to provide comprehensive assistance whenever possible. During 2022, assistance from the Circle of Kindness Foundation was provided to several children from Donbass with diagnoses of spinal muscular atrophy and cystic fibrosis. The elaboration of optimal mechanisms that would provide small residents of new territories having severe and rare diseases with appropriate medicines will continue in 2023.¹⁷⁸

Another impressive indicator of the Foundation’s performance is the supply of medicines for children with orphan diseases. Today, Russia ranks first in providing medicines to such children. In most other countries where such treatment is available, providing essential drugs requires expensive insurance for parents, which they cannot afford in many cases.¹⁷⁹

Owing to the successful work of the Foundation, the key thing has been achieved today: as soon as a new unique and efficient medicine appears in the world, it immediately becomes available to Russian children.¹⁸⁰