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Health-care was formerly directly financed by the State, but a health-care insurance system financed by employers was introduced in 1993. The post-Soviet health-care system has suffered from insufficient funding and it is reported that as many as 20 per cent of hospitals lack hot running water and 18 per cent have an inadequate sewerage system. There has been a sharp rise in serious infectious diseases, with the incidence of confirmed cases of tuberculosis rising by 20 per cent between 1994 and 1995. A WHO report in October 1997, on multi-drug resistant tuberculosis, included Russia as one of several “hot zones” in the world where multi-drug resistance among TB patients was significant. In 2007 there was an infant mortality rate of 11 deaths per 1,000 live births, and there was a ratio of 1 doctor to 240 people recorded in 2004. Expenditure on health in 2001 accounted for 0.92 per cent of total expenditure. Early alcohol-related deaths and low birth rates have both contributed to a major demographic trend of negative population growth.
The structure of the armed forces in Russia has changed radically in the post-Soviet period. Immediately after the dissolution of the USSR in 1991, the armed forces were controlled by the military command of the Commonwealth of Independent States (CIS), which inherited the massive Soviet arsenal. In May 1992, however, Russia created its own military structure in response to the formation of separate armies by several CIS states, notably Ukraine. The CIS military command continued to function for another year, although its power was greatly reduced. It was finally abolished in June 1993 and most of its functions transferred to the Russian military command. In 2004, Russia had about 1,037,000 personnel serving in the army (395,000), navy (142,000), and air force (170,000). While military reformers have pressed for a purely professional army, this is still too costly, and therefore men aged 18 or older must serve as conscripts for 18 months in the army or 24 months in the navy or air force. Approximately 330,000 conscripts serve in the Russian armed forces. Defence policy is formulated by the Security Council, an executive body established in May 1992. In 2003, Russia spent US$65,200 million (4.9 per cent of its GDP) on defence. The state of readiness of the Russian armed forces has declined substantially since independence. The defence establishment is beset by a host of problems, including job insecurity, inadequate housing, ageing equipment, and low morale. Despite these problems, the Russian army is engaged in peacekeeping missions in Moldova, Georgia, Tajikistan, and elsewhere; in 1994 it became embroiled in a civil war in the Chechen Republic. Almost all of these military actions are in former Soviet republics, except for air strikes against rebel Tajik forces in Afghanistan. Following the dissolution of the USSR in December 1991 and the establishment of the CIS, member states of the CIS concluded a series of agreements on military cooperation and coordination. Since 1993, however, opposition to the idea of joint CIS forces has grown as the other republics have formed their own national armies and several have sought membership of NATO.
Russia is a member of the United Nations (UN), the Arctic Council (AC), the Black Sea Economic Cooperation Pact (BSECP), the Commonwealth of Independent States (CIS), the Council of Europe (CE), the Council of the Baltic Sea States (CBSS), the Organization for Security and Cooperation in Europe (OSCE), the Partnership for Peace (PFP), Asia-Pacific Economic Cooperation (APEC), the Shanghai Group (SG), the Northern Forum (NF), the International Whaling Commission (IWC), the Group of Eight (G-8), and the Group of Twenty (G-20). In May 2002, the NATO-Russia Council was established to promote closer cooperation. Russia has observer status at meetings of the World Trade Organization (WTO).
In this section, before the revolution of 1917, the term “Russia” refers to the Russian Empire or, more narrowly, to the land of the “Great” Russians—that is, the land of the people known today just as Russians. “Great Russia” was one of the three Slavic lands ruled by the first tsars of the Russian Empire, whose full title was “Grand Prince and Tsar of the Great, the Little, and the White Russians”. Today the “Little” Russians are known as Ukrainians; only the “White” Russians, or Belorussians are still known by their historical name. References after December 25, 1991, relate to the independent Russian Federation. At its greatest extent, in 1914, the Russian Empire included about 22 million sq km (8.5 million sq mi), an estimated one sixth of the land area of the Earth, divided into four general regions: Russia proper, comprising the easternmost part of Europe and including the Grand Duchy of Finland and most of Poland; the Caucasus; all of northern Asia, or Siberia; and Russian Central Asia, divided into the regions of the Steppes, in the south-west, and Russian Turkistan, in the south-east.
During the pre-Christian era the vast territory that became Russia was sparsely inhabited by groups of nomadic peoples, many of which were described by Greek and Roman writers. The largely unknown north, a region of extensive forests, was inhabited by groups later known collectively as Slavs, the ancestors of the modern Russian people. Far more important was the south, where the indeterminate region known as Scythia was occupied by a succession of Asian peoples, including, chronologically, the Cimmerians, Scythians, and Sarmatians. In these early times, Greek traders and colonists established many trading posts and settlements, particularly along the north coast of the Black Sea and in the Crimea.
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