Identifier
Created
Classification
Origin
07MINSK297
2007-04-06 14:47:00
UNCLASSIFIED
Embassy Minsk
Cable title:
BELARUS POPULATION IN SIGNIFICANT DECLINE
how-toVZCZCXRO7281 PP RUEHAG RUEHAST RUEHDA RUEHDBU RUEHDF RUEHFL RUEHIK RUEHKW RUEHLA RUEHLN RUEHLZ RUEHPOD RUEHROV RUEHSR RUEHVK RUEHYG DE RUEHSK #0297/01 0961447 ZNR UUUUU ZZH P 061447Z APR 07 ZDK FM AMEMBASSY MINSK TO RUEHC/SECSTATE WASHDC PRIORITY 5881 INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE PRIORITY RUEHBS/USEU BRUSSELS PRIORITY RUEHVEN/USMISSION USOSCE PRIORITY 1503 RUFGAID/USEUCOMAIDES VAIHINGEN GE PRIORITY RUFOADA/JAC MOLESWORTH RAF MOLESWORTH UK PRIORITY
UNCLAS SECTION 01 OF 03 MINSK 000297
SIPDIS
SIPDIS
E.O. 12958: N/A
TAGS: PGOV PHUM BO
SUBJECT: BELARUS POPULATION IN SIGNIFICANT DECLINE
REF: A. 06 MINSK 152
B. MINSK 219
Summary
-------
UNCLAS SECTION 01 OF 03 MINSK 000297
SIPDIS
SIPDIS
E.O. 12958: N/A
TAGS: PGOV PHUM BO
SUBJECT: BELARUS POPULATION IN SIGNIFICANT DECLINE
REF: A. 06 MINSK 152
B. MINSK 219
Summary
--------------
1. (SBU) According to Belarusian and U.N. statistics the
population of Belarus continues to decline at a rate of
roughly 0.4 percent annually. If this trend continues,
Belarus' population will be reduced by a third, to 6.6
million, by 2050. The low birthrate, 1.21 percent in 2006,
remains the single largest contributing factor to this trend.
Additionally, the inefficient healthcare system has failed
to bring mortality in line with levels normal for developed
countries. On March 26, the GOB issued its "Demographic
Security Program", which calls for the government to spend
roughly USD 313 million between 2007 and 2010 on programs
that aim to decrease mortality and increase fertility. Some
UN experts doubt that the population decline can be reversed,
and believe too that intensified GOB efforts can only delay
the inevitable. End summary.
--------------
Population Could Drop by One-Third
--------------
2. (SBU) A general indicator of society's health is the
Probable Life Expectancy at Birth (PLEB). During the 1990s,
the PLEB in Belarus decreased for women by 2.1 years and for
men by nearly 6 years. In comparison to developed countries,
this indicator remains 5-6 years lower for women and 12-14
years lower for men. Coinciding with a period of severe
economic instability, Belarus' population peaked in 1993 at
10.24 million. From 1990 to 2006 the population declined at
a rate of approximately 0.4 percent annually. If this trend
continues at the current rate, by 2050 Belarus will have
roughly 6.6 million citizens, or one-third fewer citizens
than it has currently.
--------------
Factors Behind the Trend
--------------
Relatively High Mortality
--------------
3. (SBU) From 1991 to 2005 the mortality rate grew 18.7
percent for women and 41 percent for men. According to
Natalya Galkevich, a chief pediatrician in the Ministry of
Health, the child mortality rate in rural areas remains
double that in cities. In 2005, Belarus averaged 12 child
deaths per 1000 children under age five, versus 7 in the U.S.
Children under age five account for 60 percent of all deaths
among Belarus' children. Accidents, poisonings, congenital
disorders and prenatal conditions cause 70 percent of all
deaths among children under 15. The maternal mortality rate
in Belarus peaked in 2000 at 24.2 per 100,000 live births
(ref A). In 2005 the rate was down to 15.5. Cardiovascular
disease, intoxication, and traumas have become the most
common causes of death among working-age Belarusians.
Injuries cause 163 deaths per 100,000 per year in Belarus,
versus 45 in the EU. In 2006 over 15,000 people died from
accident-related trauma, making this the third highest cause
of death. Alcohol-related
mortality grows yearly, having nearly doubled since 1990,
and in the last decade drug use has tripled.
Underutilization of Resources
--------------
4. (SBU) The United Nations Population Fund (UNFPA) Program
Coordinator for Belarus, Tatyana Naplichnik, expressed to
Poloff that Belarus spends sufficient funds on health care
(roughly 4 percent of GDP). However, the healthcare system
has not been updated since Soviet times and significant waste
and misallocation continue. For example, Belarus lacks
sufficient outpatient services. This forces nearly everyone
to use hospitals, even for the slightest procedure, thereby
increasing costs. Furthermore, the average hospital stay in
Belarus remains 11.5 days, versus four days in the U.S.
Belarus also continues to maintain double the European
average of hospital beds. Despite the Gomel region's claim
that it lacks 600 doctors, Naplichnik noted that Belarus'
doctor to patient ratio currently remains one of the world's
highest at 1:250, versus 1:341 in the U.S. Naplichnik added
that nurses are not used to their full potential. Currently,
they fill out paperwork, take patients' temperature, and do
little else.
MINSK 00000297 002 OF 003
Poor Medical Care: Over-Age Doctors, Out-of-Date Equipment
-------------- --------------
5. (SBU) The Belarusian Union of Healthcare Workers has
voiced concern over the low wages, roughly USD 171 per month,
which general practitioners at district clinics earn. The
Union was also alarmed over the high proportion of doctors
who continue working after reaching retirement age. Such
doctors account for 16-18 percent of the medical staff in the
provinces and 45 percent at some clinics in Minsk.
Furthermore, only one in four medical school graduates
assigned to jobs in rural areas was provided housing last
year (ref B). The Union fears that low wages and poor
benefits may affect doctor's motivation and skill level.
According to the health ministry, a total of USD 119 million
worth of equipment was purchased last year. Despite this,
reportedly 80 percent of hospital equipment has been in
service for at least ten years. Modern equipment is often
unavailable or simply non-existent.
--------------
GOB Plans to Address the Problem
--------------
"2007-2010 Program of Demographic Security"
--------------
6. (SBU) The GOB plans to allocate USD 313 million for its
demographic security program. The program aims to boost the
birthrate, strengthen the family, promote healthy lifestyles,
improve health services, increase life expectancy, and
"optimize" migration. However, Naplichnik commented that the
GOB has set unrealistic goals. The UNFPA estimates that the
Belarusian birthrate, currently at 1.2 percent, will never
again reach the replacement level of 2.1 percent. However, a
rate of 1.5 percent would be sufficient, in combination with
a decreased mortality rate resulting from improved health
services, to significantly slow the rate of population
decline. Therefore, the UNFPA recommends that the GOB
concentrate efforts on demographic statistics it can more
easily influence, such as reducing the number of deaths
related to accidents, intoxication and cardiovascular
disease.
Increasing the Birthrate and Creating Affordable Housing
-------------- --------------
7. (SBU) The fertility rate in Belarus, as a result of WWII,
the war in Afghanistan, and Soviet fertility programs,
remains in a state of flux. Approximately every 20 years the
fertility rate increases significantly for a few years as
another generation of women reaches childbearing age. The
temporary effect of this cycle has manifested itself in
Belarus in the form of an increased birth rate the last few
years, up 6.5 percent in 2006. Thus, the UN, acting as a GOB
implementing agency, plans to target its funds on families
with three or more children. By targeting families, and not
each child, the UN assistance could help increase the
fertility rate and decrease the rate of flux.
8. (SBU) According to the UNFPA, which continues to work
closely with the GOB on this issue, the GOB plans to make
housing more affordable for larger families. They also plan
to offer to pay half of low interest (five-percent)
forty-year mortgages to families with three or more children.
A presidential edict on April 3 increased the income tax
exemption for families with three or more children under 18.
However, in reality this means that a family of five may only
earn approximately USD 200 per month before it must begin
paying income taxes.
Comment
--------------
9. (SBU) While the majority of official pronouncements and
state media press releases continue to paint a picture of
economic stability and a largely satisfied society, the
sobering demographic statistics indicate that this may be
more of a dream than reality. Despite all of Lukashenko's
efforts to maintain a welfare state and reassure and
reconcile societal fears about the future, the fertility rate
remains well below replacement level, which may indicate that
under the surface society remains uncertain about the future.
10. (SBU) It seems that the current regime remains intent
MINSK 00000297 003 OF 003
upon using a well-worn bureaucratic method to solve this
problem, i.e. throw enough money and people at it and it will
get better. Unfortunately for Belarus, the decreasing size
of both the population and the state budget no longer make
this solution viable. For Belarus to have any hope of
slowing its demographic decline, let alone reversing it, the
authorities will have to utilize the resources currently
available more efficiently. In addition, we understand that
the oppressive political situation also limits Belarusians'
interest in raising families, an obstacle the regime is
incapable of addressing.
Moore
SIPDIS
SIPDIS
E.O. 12958: N/A
TAGS: PGOV PHUM BO
SUBJECT: BELARUS POPULATION IN SIGNIFICANT DECLINE
REF: A. 06 MINSK 152
B. MINSK 219
Summary
--------------
1. (SBU) According to Belarusian and U.N. statistics the
population of Belarus continues to decline at a rate of
roughly 0.4 percent annually. If this trend continues,
Belarus' population will be reduced by a third, to 6.6
million, by 2050. The low birthrate, 1.21 percent in 2006,
remains the single largest contributing factor to this trend.
Additionally, the inefficient healthcare system has failed
to bring mortality in line with levels normal for developed
countries. On March 26, the GOB issued its "Demographic
Security Program", which calls for the government to spend
roughly USD 313 million between 2007 and 2010 on programs
that aim to decrease mortality and increase fertility. Some
UN experts doubt that the population decline can be reversed,
and believe too that intensified GOB efforts can only delay
the inevitable. End summary.
--------------
Population Could Drop by One-Third
--------------
2. (SBU) A general indicator of society's health is the
Probable Life Expectancy at Birth (PLEB). During the 1990s,
the PLEB in Belarus decreased for women by 2.1 years and for
men by nearly 6 years. In comparison to developed countries,
this indicator remains 5-6 years lower for women and 12-14
years lower for men. Coinciding with a period of severe
economic instability, Belarus' population peaked in 1993 at
10.24 million. From 1990 to 2006 the population declined at
a rate of approximately 0.4 percent annually. If this trend
continues at the current rate, by 2050 Belarus will have
roughly 6.6 million citizens, or one-third fewer citizens
than it has currently.
--------------
Factors Behind the Trend
--------------
Relatively High Mortality
--------------
3. (SBU) From 1991 to 2005 the mortality rate grew 18.7
percent for women and 41 percent for men. According to
Natalya Galkevich, a chief pediatrician in the Ministry of
Health, the child mortality rate in rural areas remains
double that in cities. In 2005, Belarus averaged 12 child
deaths per 1000 children under age five, versus 7 in the U.S.
Children under age five account for 60 percent of all deaths
among Belarus' children. Accidents, poisonings, congenital
disorders and prenatal conditions cause 70 percent of all
deaths among children under 15. The maternal mortality rate
in Belarus peaked in 2000 at 24.2 per 100,000 live births
(ref A). In 2005 the rate was down to 15.5. Cardiovascular
disease, intoxication, and traumas have become the most
common causes of death among working-age Belarusians.
Injuries cause 163 deaths per 100,000 per year in Belarus,
versus 45 in the EU. In 2006 over 15,000 people died from
accident-related trauma, making this the third highest cause
of death. Alcohol-related
mortality grows yearly, having nearly doubled since 1990,
and in the last decade drug use has tripled.
Underutilization of Resources
--------------
4. (SBU) The United Nations Population Fund (UNFPA) Program
Coordinator for Belarus, Tatyana Naplichnik, expressed to
Poloff that Belarus spends sufficient funds on health care
(roughly 4 percent of GDP). However, the healthcare system
has not been updated since Soviet times and significant waste
and misallocation continue. For example, Belarus lacks
sufficient outpatient services. This forces nearly everyone
to use hospitals, even for the slightest procedure, thereby
increasing costs. Furthermore, the average hospital stay in
Belarus remains 11.5 days, versus four days in the U.S.
Belarus also continues to maintain double the European
average of hospital beds. Despite the Gomel region's claim
that it lacks 600 doctors, Naplichnik noted that Belarus'
doctor to patient ratio currently remains one of the world's
highest at 1:250, versus 1:341 in the U.S. Naplichnik added
that nurses are not used to their full potential. Currently,
they fill out paperwork, take patients' temperature, and do
little else.
MINSK 00000297 002 OF 003
Poor Medical Care: Over-Age Doctors, Out-of-Date Equipment
-------------- --------------
5. (SBU) The Belarusian Union of Healthcare Workers has
voiced concern over the low wages, roughly USD 171 per month,
which general practitioners at district clinics earn. The
Union was also alarmed over the high proportion of doctors
who continue working after reaching retirement age. Such
doctors account for 16-18 percent of the medical staff in the
provinces and 45 percent at some clinics in Minsk.
Furthermore, only one in four medical school graduates
assigned to jobs in rural areas was provided housing last
year (ref B). The Union fears that low wages and poor
benefits may affect doctor's motivation and skill level.
According to the health ministry, a total of USD 119 million
worth of equipment was purchased last year. Despite this,
reportedly 80 percent of hospital equipment has been in
service for at least ten years. Modern equipment is often
unavailable or simply non-existent.
--------------
GOB Plans to Address the Problem
--------------
"2007-2010 Program of Demographic Security"
--------------
6. (SBU) The GOB plans to allocate USD 313 million for its
demographic security program. The program aims to boost the
birthrate, strengthen the family, promote healthy lifestyles,
improve health services, increase life expectancy, and
"optimize" migration. However, Naplichnik commented that the
GOB has set unrealistic goals. The UNFPA estimates that the
Belarusian birthrate, currently at 1.2 percent, will never
again reach the replacement level of 2.1 percent. However, a
rate of 1.5 percent would be sufficient, in combination with
a decreased mortality rate resulting from improved health
services, to significantly slow the rate of population
decline. Therefore, the UNFPA recommends that the GOB
concentrate efforts on demographic statistics it can more
easily influence, such as reducing the number of deaths
related to accidents, intoxication and cardiovascular
disease.
Increasing the Birthrate and Creating Affordable Housing
-------------- --------------
7. (SBU) The fertility rate in Belarus, as a result of WWII,
the war in Afghanistan, and Soviet fertility programs,
remains in a state of flux. Approximately every 20 years the
fertility rate increases significantly for a few years as
another generation of women reaches childbearing age. The
temporary effect of this cycle has manifested itself in
Belarus in the form of an increased birth rate the last few
years, up 6.5 percent in 2006. Thus, the UN, acting as a GOB
implementing agency, plans to target its funds on families
with three or more children. By targeting families, and not
each child, the UN assistance could help increase the
fertility rate and decrease the rate of flux.
8. (SBU) According to the UNFPA, which continues to work
closely with the GOB on this issue, the GOB plans to make
housing more affordable for larger families. They also plan
to offer to pay half of low interest (five-percent)
forty-year mortgages to families with three or more children.
A presidential edict on April 3 increased the income tax
exemption for families with three or more children under 18.
However, in reality this means that a family of five may only
earn approximately USD 200 per month before it must begin
paying income taxes.
Comment
--------------
9. (SBU) While the majority of official pronouncements and
state media press releases continue to paint a picture of
economic stability and a largely satisfied society, the
sobering demographic statistics indicate that this may be
more of a dream than reality. Despite all of Lukashenko's
efforts to maintain a welfare state and reassure and
reconcile societal fears about the future, the fertility rate
remains well below replacement level, which may indicate that
under the surface society remains uncertain about the future.
10. (SBU) It seems that the current regime remains intent
MINSK 00000297 003 OF 003
upon using a well-worn bureaucratic method to solve this
problem, i.e. throw enough money and people at it and it will
get better. Unfortunately for Belarus, the decreasing size
of both the population and the state budget no longer make
this solution viable. For Belarus to have any hope of
slowing its demographic decline, let alone reversing it, the
authorities will have to utilize the resources currently
available more efficiently. In addition, we understand that
the oppressive political situation also limits Belarusians'
interest in raising families, an obstacle the regime is
incapable of addressing.
Moore