Putin at the Future Technologies Forum

Putin touring the exhibitions on the sidelines of the Future Technologies Forum.

On the 14th, Vladimir Putin took part in the plenary session of the Second Forum of the Future Modern Medical Technologies: “Tomorrow's Challenges – Ahead of Time.” This year’s edition was held at Moscow’s Worl Trade Center and focused attention on the development of modern medicine, nuclear medicine, creation of new medicines, and the use of innovations in disease treatment.

As you see in the top photo, there are several speakers on the dais who will follow Putin’s opening remarks, and there will be a good deal of Q&A. Back in July 2023 soon after I began the Gym, I reported on the initial session of this Forum, which was devoted to quantum computing, as it marked the beginning of Putin’s declared Decade of Science and Technology in the Russian Federation. Readers will have noted by now that Russia conducts a large number of these events in which the president directly participates—far more than any other nation. And despite the focus on Russia, these events are always international, and they are always well attended. I was hoping the transcript of Putin’s meeting with scientists associated with this event would be expanded and we could learn what was discussed. Unfortunately, it doesn’t appear that will occur, and of course today’s events will somewhat displace that event.

On to the discussion with all emphasis mine as usual:

Vladimir Putin: Dear friends, good afternoon!

I am glad to welcome Russian and our foreign guests: scientists, doctors, business representatives, and all participants of the Future Technologies Forum. We have created this platform for discussing promising solutions that are just being born, are being tested, are sometimes ahead of their time, but will soon radically change, should change and will definitely change people's lives.

Among such rapidly developing areas are cutting – edge developments in the field of medicine, to which the current forum is dedicated. I would like to use its platform to share a holistic vision of the development of the entire national healthcare system. Answer the question of what principles and approaches we will build our work on, and what tasks we are going to focus on. And of course, how we will – with your help, of course, colleagues – create and implement the most advanced solutions in the daily activities of medical organizations.

I would like to emphasize that the national program to combat cancer, which we launched in 2019, has become a visible priority for cooperation between the medical community, science, the state, and the regions.

Over five years, more than 500 outpatient cancer care centers have been established across the country. Recently I got acquainted with the work of modern cancer centers in Kaliningrad and Tula. What is most important here is that people who live there, especially in Kaliningrad, which is, as you know, an enclave part of Russia. It is in their own locality, in their own city, in their own region that they have the opportunity to receive the medical care they need right now. At the same time, high standards of diagnostics, therapy, and rehabilitation are set throughout the country.

As a result, now more than half of oncological diseases are detected at the initial stage, when the prognosis of treatment is as favorable as possible. The volume of chemotherapy has increased by 60 percent, and radiation therapy has increased by more than 25 percent. Proton therapy has been carried out since 2020. About the achievements of our science, pharmaceuticals, nuclear medicine – I will definitely return to this and say a few words, of course, about each of these areas separately.

What I think is extremely important: the created groundwork already allows us to reduce the death rate from cancer. But we certainly need to step up our efforts in this crucial area and continue the work we have begun. At the same time, I would like to draw the attention of my colleagues both in the Government and in the regions of the Russian Federation: all our measures must be provided with the necessary amount of funding.

It is equally important to increase the effectiveness of our actions in the fight against cardiological, autoimmune and viral diseases. In particular, the incidence of hepatitis C should be reduced to a minimum by the end of the decade. This is exactly what our special program, which we started implementing last year, is aimed at.

Further. In recent years, primary health care has been significantly strengthened. New polyclinics and district hospitals were built and equipped. Paramedic and midwifery centers and outpatient clinics are being opened in small towns and rural areas.

For very small localities, mobile medical complexes with the necessary diagnostic equipment are organized. Telemedicine increases the availability of high-quality medical care in small towns, villages, towns and in hard-to-reach areas.

Colleagues from the regions and citizens are constantly asking, of course, including, if you have noticed, Direct Line, what will happen next with the project to modernize the primary health care system. The answer is obvious: we will definitely continue this work.

At the same time, special attention should certainly be paid to the provision of emergency medical care, when saving a person's life, minutes count. Everywhere-in large and small cities, in rural areas and in remote areas-all parts of the emergency care system must work clearly and without failures.

It is necessary to radically modernize the emergency departments of hospitals, equip them with modern, including resuscitation equipment, and, of course, it will be necessary to launch special training programs for medical workers in emergency departments and ambulance crews.

An important issue is modern logistics, especially in remote, hard-to-reach areas. I would like to note that since 2019, we have begun to seriously rebuild the air ambulance system. We will certainly move further in this direction: to produce and purchase new equipment (of course, these are still the first steps, but the situation is still developing, and we will continue to work in this direction), as well as to build additional helicopter pads, primarily at medical organizations, and develop other necessary infrastructure. The task is to further expand the geography of air ambulance operations and increase the number of sorties. Since 2019, air ambulance has made approximately 57 thousand sorties.

Now, of course, we need to talk about personnel, which I will do with pleasure, about the decisions taken that are designed to increase the salaries of medical workers, primarily primary care. We discussed this issue in the Government late last night with our colleagues, and this is what we came up with.

Starting from the current year, 2024, tariffs for providing medical care in cities and in rural areas will be equalized. In other words, the level of financial support for FAPs, outpatient clinics, and other primary care organizations in small localities will significantly increase. In this regard, I would like to draw the attention of the heads of regions to the fact that these funds should primarily be used for salaries of medical workers in rural areas.

Further. Last year, we introduced monthly payments for primary care healthcare workers. And here is what we agreed with the Government last night: I propose to increase their size for specialists who work in small towns, regional centers and villages starting from March 1 of this year. At the same time, special attention should be paid to the support of doctors in the most popular areas, as well as employees of district and district hospitals.

In cities where from 50 thousand to 100 thousand people live, doctors will receive an additional 29 thousand rubles [~$325] in addition to the basic salary, and the average medical staff-13 thousand rubles [~$145]. In localities where fewer than 50 thousand people live, such special payments will be significantly higher. Namely, doctors will receive 50 thousand rubles a month [~$560] in addition to their salaries, and middle – level medical workers will receive 30 [~$335] thousand rubles.

It is clear that the implementation of such solutions will require time to prepare the regulatory framework. I ask the Government to complete this work as soon as possible. So that starting from April 1, medical workers will start receiving increased payments for March, retroactively.

And one more decision that concerns all medical professionals. Starting from April 1, the regions should raise the salary part of their salaries to 50 percent, while retaining additional payments. We always say that the fixed part should be provided, of course. And additional payments are also important. But medical workers are interested, of course, in the fact that the main part, the salary was higher. In turn, the Government should prepare similar decisions for medical employees of federal organizations working in the system of compulsory health insurance.

And now, taking this opportunity, I would like to thank you, dear friends and colleagues, for your dedicated work. I would like to thank everyone: doctors, paramedics, middle and junior staff of federal medical organizations, hospitals, polyclinics, outpatient clinics, paramedic and obstetric stations, ambulance crews.

You are the foundation of our entire healthcare system. And whatever we say about artificial intelligence (Sergey Semyonovich brought me up to date today, it's all very interesting, promising and necessary), whatever we say about it, about robots, it's important, they are certainly loyal, reliable human assistants, how we will implement such technologies, we will talk more now, but they will never replace the sensitivity and participation of medical professionals in the fate of a person.

In the coming years, we will have to seriously change the principles and approaches to the work of the healthcare system. We need to set up the entire system-from primary care to leading clinics and institutes-to save the health of citizens. It is not the number of services provided, but the person and their health that should be at the center of the entire health system.

It is necessary to use the full potential of advanced digital and medical technologies. This includes data-based management technologies, individual medicines, new medical equipment and methods of treating diseases, selection of vitamins and dietary regimes, and so on – all this should be configured to save, promote health, effectively treat a particular person, as well as remote health monitoring technologies that are already becoming everyday practice.

Prevention and early detection of diseases should come to the fore. To do this, we are constantly expanding the opportunities to regularly undergo medical examinations and preventive examinations, including additional tests and studies. I would like to add that such inspections can also be carried out during working hours, and with the preservation of wages. Last year, for example, more than 90 million people underwent medical examinations and preventive examinations.

Of course, we will continue to support the desire of people at any age to maintain their physical fitness, play sports, and lead an active lifestyle. In this regard, we plan to significantly expand the program of construction of sports and recreation complexes in our cities and localities. And physical education and sports should definitely be made accessible to citizens, and our system of physical education and sports should be spared from excessive commercialization. The Ministry of Sports should work closely on this issue and restore order here. Everything that is done in this area under the auspices of the state and municipalities should be accessible to Russian families. That's what I want to draw your attention to.

Dear friends!

The topics that you are currently considering, which are the subject that you have been working on all your life, are undoubtedly so important for the country as a whole and for each individual person that you probably can't say an extra word here. But I would like to wish you success from the bottom of my heart. Both in our country and abroad, we have always done everything possible to ensure that this single space of knowledge, a single space of activity, which is centered on human health, is shared.

We see that, unfortunately, in modern conditions, this system of general care for human health and humanity as a whole gives certain failures. But let it be on the conscience of those who conduct such a practice in today's life. For our part, we are always open for cooperation. Yes, we know and see that some manufacturers and companies, especially in the pharmaceutical industry, prefer not to work anymore, and they cut ties. But we also know that at the professional level, this interaction between colleagues and specialists persists. And, without any doubt, it will develop. This is practically impossible to prevent. I simply have no doubt that the work will continue at the highest level and will continue to benefit not only the citizens of our country, but also for the benefit of all mankind, without any exaggeration.

Just now, at the exhibition, I was shown the latest developments that are being implemented in our country. Sergey Semyonovich at the X-ray center of Moscow showed what is being done in the capital. I will not list all the institutes, all our companies that work in these areas, but Rosatom is implementing its latest technologies here, the Kurchatov Institute. Oddly enough, companies such as Rosneft, which are not directly related to medicine, nevertheless join in, say, and invest their available free resources in the development of genetic engineering, genetics in general, and so on. A large number of Russian companies under the leadership of the Ministry of Health and the Government of the Russian Federation work for medicine and science, which is somehow connected with it. I have no doubt that this will bring serious and noticeable results for our citizens.

I would also like to add that we are very close to creating so-called cancer vaccines, vaccines against cancer, and new-generation immunomodulatory drugs. And I hope that soon they will be effectively used as methods of individual therapy. Of course, there are many bright discoveries now, and we look forward to such discoveries in the future.

In total, 530 Russian medicines were registered in 2023 alone. Thanks to the developments of leading scientists and medical specialists, the production of many types of domestic equipment for cardiovascular surgery, as well as for resuscitation, rehabilitation, and diagnostics of genetic diseases has begun for the first time.

I would like to repeat that we have significant achievements, but we certainly need to move on, continue this work, and at a qualitatively new level, increase self-sufficiency, become global leaders in key areas of medical technology development, and be prepared for any challenges, including the threat of outbreaks of new global epidemics. To do this, we must have a strong sovereign scientific and technological base and infrastructure, the entire line of substances and components.

I spoke about cooperation with our colleagues abroad. Yes, I am sure that this cooperation will continue, but we must certainly be self-sufficient in the main areas. That is, in fact, we should have "technological keys" to all the decisions that are necessary to save health and increase human life expectancy.

Fundamental and practical science is the basis for fulfilling these tasks. It was developed by outstanding scientists whose names we remember from school: Pavlov, Mechnikov, Vavilov, Koltsov, Engelhardt, Chumakov, Gamaleya. Our research institutes and scientific and practical medical centers are named after them. Maintaining continuity, their teams now work at the intersection of medicine, genetics, biology, chemistry, mathematics, and achieve success in the most advanced areas, such as neuroscience, biomedical technologies and exoprosthetics, cell technologies, and regeneration technologies.

Today we showed it during the discussion, during what my colleagues told me here, below, on the first floor – this is some kind of fantasy. Until quite recently, we could only read about such things in fantastic works of art, but today it is all becoming a reality. All these areas are now only gaining strength, but it is expected that in the near future they will make a real revolution in medicine.

More recently, I have also spoken about expanding support for domestic science, including the need to increase the amount of budget funds allocated annually for the development of innovative medical technologies and products.

It is necessary to pay special attention to medical science and support strong institutions that combine research activities with practical medicine. They should become real centers of knowledge for the entire national healthcare system, work in the full sense of the word on future technologies.

In this regard, I propose to expand the network of national medical research centers and strengthen their interaction with other research institutes. Also, where necessary, it is necessary to update the material and technical base of federal medical and research institutions that provide high-tech assistance to citizens across the country, including in such areas as cardiology, cardiovascular surgery, oncology, and orthopedics.

Finally, another solution that is designed to provide reliable protection of the intellectual rights of leading medical centers and research institutes that create unique technologies. I believe that when transferring intellectual property rights to manufacturers, i.e. commercializing breakthrough scientific solutions, research teams should receive a decent reward, the so-called royalty. The amount of such payments should be calculated according to clear rules and a unified methodology. We talked about this when you proposed the world's first COVID vaccine.

In general, we need to create a modern legal framework for creating and testing and using the most advanced medical technologies. Some legislative decisions have already been taken. This also applies to the use of personalized medicines developed for a specific patient, as well as the development of such a new direction as regenerative medicine.

What I would like to note in conclusion. New discoveries in the field of medicine, methods of prevention, treatment, new drugs and equipment are not valuable in themselves. They are designed to preserve the health of our citizens, be accessible to people, and be widely used in primary health care organizations. It is also important that the tasks we are facing are not narrowly specialized; they require the participation of representatives from various fields of science, economy, and industry, such as chemistry and microelectronics.

The consolidated work of regional ministries and departments, state-owned companies, and, of course, active involvement in the overall tasks of business are also of fundamental importance. I have just mentioned how business is integrated into scientific activities in various fields. But it is absolutely necessary to continue.

Therefore, we work in the format of national projects in key technological areas. Their mechanisms allow you to build the entire technological chain-from the creation of fundamental reserves and applied solutions to production facilities and training of highly qualified personnel.

In this regard, I consider it possible and ask the Government to form and ensure the launch of another national project, ensuring technological sovereignty, on the development of modern technologies for saving health, by the end of this year. It is necessary to determine the sources of financing and the necessary amounts of financial resources for its implementation.

I very much look forward to participating in this big, serious work of our medical and scientific community.

Thank you very much for your attention.

Mr Trubnikov: Mr President, thank you very much for your impressive performance.

Today is the second time our forum is being held, and it has become a very good tradition for you to participate, and believe me, it is very valuable for us – your patronage and your involvement in all substantive issues.

Last July, the Future Technologies Forum was dedicated to discussing the development of quantum technologies. At your suggestion, we will discuss the development of future technologies for medicine at the next forum today.

You have already said that even 20 years ago, no one really believed in the possibility of creating artificial organs and tissues, in genetic editing, and today this is already a clinical practice. At the same time, new infections that appear that we did not know about yet, the need for access to new medicines, the need for sparing treatment for the patient – these are serious challenges that give a big boost to the development of medical technologies.

Today you mentioned the exhibition you visited before the plenary session. I am also impressed by the level and scale of developments in Russian science, which is not far behind the world, we really have something to be proud of, a huge number of reasons for pride. And I am, frankly, impressed, of course, by the speed of the emergence of new diseases and infections, as well as the speed of the response of medical science – fundamental and applied – the speed of victory over diseases.

Today, if I may, we would like to talk at the plenary discussion about new technologies that are developing medical science, and about the people who create, implement and allow us to quickly enter our lives.

In June last year, VTsIOM conducted a survey of residents of the country about their expectations and perception of future technologies. So, most of all, our citizens are interested in technologies in healthcare. The most interesting and exciting issues of our people are modern visual and auditory prostheses, modern methods of fighting cancer, 3D printing of tissues and joints. Today's exhibition at the forum demonstrates a large number of unique developments, and I am sure that very soon we will all see them in practical life.

Let me introduce the participants in today's plenary discussion. Academician Alexander Makarov is the Scientific Director of the Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences. Professor Raul Gainetdinov - Director of the Institute of Translational Medicine, Saint Petersburg State University. Academician Akimkin Vasily Gennadievich-Head of the Center for Epidemiology of Rospotrebnadzor. Corresponding Member of the Russian Academy of Sciences Vsevolod V. Belousov, Head of the Center for Brain and Neurotechnology, FMBA of Russia. Ilya Igorevich Eremin, Deputy Head of the Russian Research Center for Surgery named after B. V. Petrovsky, Ministry of Education and Science of the Russian Federation. And Academician Igor E. Khatkov, Head of the A. S. Loginov Moscow Clinical Research and Practice Center. Your humble servant is Grigory Trubnikov, Head of the Joint Institute for Nuclear Research in Dubna.

If I may, if you agree, we would like to touch first of all on the most up – to – date areas of medical science-fundamental and applied-and precisely those areas that are not just well-known, but those areas that depend on and affect the quality of a healthy, long, full-fledged human life.

Genetics and molecular biology, regenerative medicine and nuclear medicine, modern methods of cancer therapy, healthy longevity and neurotechnologies, and, of course, pharma.

I hope that today we will hear and the whole country will hear things to be proud of, and we will talk about the problems that we believe would allow us to move faster and more efficiently.

I suggest starting with epidemiology. This is still remembered, everyone understands it, and this applies to large cohorts of the population.

Vladimir Putin: Just like in football.

G. Trubnikov: Like in football, yes.

This applies to large cohorts of the population. I think it is important to note from this rostrum today that Russia is one of the few countries in the world that has most successfully fought the coronavirus pandemic. Today it is a routine infection, it has entered our lives. But, of course, we must not weaken our attention to the risk of new epidemics. New viruses appear, old ones appear and return, and new infections arise.

Vasily Gennadyevich, you are the head of a center that successfully organizes surveillance of infectious diseases using molecular genetic methods and digital technologies. Please tell us how you are fixing the country's health shield.

Vladimir Akimkin: Dear Vladimir Vladimirovich, Dear colleagues,

The COVID-19 pandemic was a powerful impetus to the development of genetic technologies, and today the term "PCR test"," PCR testing", is well known to any citizen of the Russian Federation.

We must remember the first stages of the pandemic, when the duration of such testing was the maximum, and you, Mr Putin, set the task in 2021 to reduce the time required for such testing as much as possible. Already in 2021, just a few months later, the specialists of our institute created a domestic enzyme base, which made it possible to create T-systems that performed such testing in 30 minutes, which significantly – by four to five times-reduced the time for testing the population and thereby accelerated the time for conducting such testing.

The domestic enzyme base in terms of its parameters was not inferior, and in a number of their positions it surpassed foreign analogues, and at cost it turned out to be 50-70 times cheaper. It is the development of the domestic enzyme base, which continues today within the framework of the "Sanitary Shield of Russia" program, that allows us to speak about the technological independence of the Russian Federation in the field of creating diagnostic drugs for any pathogens, including unknown ones.

As part of the federal program for genetic technologies, we have developed a genome editing system based on the use of CRISPR-Cas technologies. This is one of the modern technologies that allow editing the genome, as well as being the basis for creating high-tech test systems and diagnostic drugs that can be used today not only in the field of infectious diseases, but also for the diagnosis and study of hereditary, oncological, and autoimmune diseases.

It should be emphasized that last year we received all the necessary proteins for editing the genome of domestic production. At the moment, we are going to start producing unique test systems that will exceed the existing ones by ten or more times in sensitivity, can detect single pathogen cells, and can also be used today not only in laboratories, but also at the patient's bedside.

Dear Vladimir Vladimirovich,

The Russian School of Epidemiology has always been proud of its monitoring system, and we have especially managed to take a step forward in the last three years. It should be noted that it is thanks to the technologies of studying the genome in the Russian Federation that for the first time we can talk about the national genome database of infectious disease pathogens, which today already has more than 330 thousand genomes, more than 20 different pathogens, including such pathogens and infections as HIV infection, coronavirus infection, acute respiratory, acute viral, intestinal infections, hepatitis. We are currently actively developing this database.

What does such a database provide? First of all, it is the basis of genomic epidemiological surveillance – the leading scientific direction in the world today, proposed by Russia. It allows us to quickly identify and respond to the epidemiological situation, give us the opportunity to create operational actions, which is very important in the interests of the country, and also be the basis for creating high-tech diagnostic, medicinal and vaccine preparations.

Today, the epidemiological monitoring system is the basis of the country's biosafety, and we continue to actively share this system and experience with other countries.

Thanks

Vladimir Putin: So I understand that the correct diagnosis depends on the quality and timing of the patient's treatment?

Vladimir Akimkin: Of course.

Vladimir Putin: That's why this monitoring system and test systems that detect these pathogens are so important – that's the right word, isn't it? - and determine which infection has affected a person's health.

Vladimir Akimkin: That's right.

Vladimir Putin: Look at what is happening in practice so far. Our test systems are applied, a person has a fever, and he clearly caught some kind of infection, but the test system does not show anything. Why do we need such test systems? I understand that the most nasty, dangerous infections, such as covid, flu, show something else, well, [in relation to] five, six, eight. And how many of them are there, such infections?

V. Akimkin: More than a hundred.

Vladimir Putin: More than a hundred. But they don't show anything else. And how to treat it? Like in the Soviet Army? Now there is no such thing – in the Russian army there is no such thing, but in the Soviet Army – do you know how? Two soldiers arrive: one with a headache, the other with a stomach ache. One tablet in half, one – one half, the other-the second: "Go, drink pills – you will be healthy in a week." This infection passes either in seven days, or in a week – by itself. What to do, what to do?

Vladimir Akimkin: Mr President, first of all, we have a sufficient number of test systems for all infections.

And of course, if we go to a doctor, they must be a qualified specialist and, accordingly, make a diagnosis based on the symptoms, and then prescribe additional tests within the framework of using various test systems and laboratory tests.

Vladimir Putin: The answer is very streamlined.

We need to improve these test systems. If there are these infections, how many did you say? A hundred?

V. Akimkin: More than a hundred.

Vladimir Putin: More than a hundred. Well, it is necessary to work in this direction in order to help the attending doctor, especially in the primary health care system in a remote area or somewhere in the village. [The patient] came in and asked for a test system, and they looked at it and said, " Yeah, that's it, right away. Not like in the Soviet Army – a pill in half, but specifically something for a specific person. Really? There is a lot to work on.

Thanks

G. Trubnikov: Thank you, Vasily Gennadyevich. Thank you, Vladimir Vladimirovich.

But it seems to me that in your speech, in your speech, you said that a person should be at the center of any medical technology, medical science. From the point of view of these test systems, there are probably universal solutions, and there should be some personalization. And it is obvious that everything should work quickly, because-you mentioned this, and I reacted to some words of your speech in this way-the speed and spread of diseases, the speed of their changes and the speed of mutations should definitely keep up with the speed of developing new drugs and their implementation.

Vladimir Putin: And from the speed of infection spread-that's what. Tatiana Alekseyevna and I used to swear! I say, " Listen, while your test system tells you whether a person is sick or not, he will infect a hundred people around him." – We're going to speed it up, we're going to speed it up." Sped up. Well, thank you. But we need it to work all the time.

Mr. Trubnikov: I must say that I think we have set a good example to the whole world of how to organize this work, and the country really has something to be proud of.

Vladimir Putin: It's true. We did better than in other places. It's true, for sure. We did better than in other countries of the world, but maybe even better.

Grigory Trubnikov: I am sure that the medical community will do its best after such a call from the head of state. Sure.

If you'll excuse me, we'll move on.

Vasily Gennadyevich rightly said that the coronavirus infection has pushed the development of genetic technologies in the country as a whole – and not only in the field of biosafety. We really have real achievements in this area. Mr President, you have mentioned this, and you regularly say that the federal program for the development of genetic technologies shows very good results.

Alexander Makarov actually coordinates the development of genetic technologies in medicine within the framework of this well-known federal program. Alexander Alexandrovich, please share your achievements.

Alexander Makarov: Thank you.

Dear Vladimir Vladimirovich, Dear colleagues,

The last time we told you about our achievements under this program, Mr Putin, was two years ago – quite a long time ago. But during this period, we were able to make quite a lot of progress in the concrete implementation of science in concrete, real medicine.

First, I will tell you about a truly unique development made in collaboration with the company" Biocad". And I must immediately praise this company: we are very lucky to have an industrial partner, because this company is highly competent and very interested in the real implementation of what can be implemented as quickly as possible. That is, it really brings it to the market – as it is now being implemented as part of the creation of the world's first monoclonal antibody against an autoimmune disease – Ankylosing spondylitis. This disease is generally terrible, the body goes crazy and begins to destroy its own cells, the person is twisted, cannot…

Vladimir Putin: Does it affect your joints?

A. Makarov: Joints, yes, the spine becomes not flexible, there is pain in the joints, it is difficult to move, the musculoskeletal system suffers a lot. That is, the disease is terrible, a person can live with such a disease, of course, but in a very serious condition. A person literally cringes at the end already… Awful.

The monoclonal antibody destroys a special group of T cells that cause the disease, but does not interfere with the immune system as such. Under the influence of the drug, it is possible not only to stop the disease, but also to reverse the disease – regeneration. A specific example of such regeneration, a specific example of remission that has already been going on for four years, is described in the highly authoritative Western journal Nature Medicine.

Four years ago, a person who had this disease and who was no longer helped by anything – joint replacement, continuous anti-cytokine therapy-was given this antibody. The effect is amazing: like living water in a fairy tale. He, so to speak, came to life, the pain stopped, began to engage in therapeutic gymnastics and, in general, is already living a full life. At the same time, this is the first example of such a long-term remission in the world. Since I always say "first in the world", then, believe me, all our other achievements that I will talk about are also made for the first time in the world, so that I do not repeat myself.

The third phase of clinical trials of this antibody is now being completed. Approximately one thousand patients were treated with this antibody. The result is good: pain disappears, mobility appears, you can even play sports, and, as I have heard, some even play basketball, which requires some effort.

So this is really a new platform. This monoclonal antibody acts on only two to three percent of the cells in the immune system, meaning it's a targeted hit aimed at exactly what needs to be removed, so to speak.

Based on this platform, you can make other medicines for the same kind of diseases. And there is already a concrete example: Together with Biocad, an antibody against diabetes mellitus of the first kind has been created, and the Russian Ministry of Health has already authorized clinical trials of the first phase.

The next development I want to talk about concerns oncolytic viruses. During the pandemic, we were all very afraid of the word "virus": we believed that the virus is something bad and we should fight it. But oncolytic viruses are not pathogenic-they act directly only on cancer cells, and they act directionally, and this action destroys cancer cells.

Since all tumors are different, they depend on the type of disease, on the person, and even inside the tumor, the cells also differ in diversity, then we need to create a panel of these viruses, which we did. More than 30 viruses have been created, and in cases where you need to use one or two viruses, you can use a cocktail of them.

Now – as I understand that we don't have a lot of time – I'll just tell you very briefly about the pre-clinical course, which takes place in two places: at Biocad and the Radiology Center. The results are very good: Some viruses were sent to Biocad, while others were sent to the Radiology Center. Tumors disappear, at Biocad it was breast cancer - the tumor completely disappears, and for the Radiology Center they studied glioblastoma, that is, this is a brain tumor that practically means a very bad diagnosis for the patient. Here the tumor was reduced by four to five times, that is, the experience of using oncolytic viruses is very positive. Now the Radiology Center is preparing patients with solid brain tumors who will be treated with these viruses.

Just two words about antibiotic resistance, which everyone is very interested in, and this is really a big problem, because the creation of new antibiotics is now recognized as economically unprofitable. Antibiotics are created, but resistance to them is formed much faster than the development of antibiotics, that is, bacteria win in this battle, and, in general, a dead end is obtained.

We suggested a slightly different approach, namely, to try to find out what defense mechanisms bacteria have so that they can respond to antibiotics. And they found out that the main protective system is the production of hydrogen sulfide. We have selected the enzymes that are responsible for activating this system, we have selected substances that can stop the action of these enzymes, and together with these substances, if antibiotics are used, there is no longer any resistance. Bacteria perceive the effect of antibiotics – the old ones that exist, that is, nothing new needs to be developed.

That's probably where I'd like to end. There is a lot to tell, but unfortunately, as always, time is limited. I want to say that really genetic technologies have already penetrated our lives, and what will happen next is even impossible to imagine, since the development is very fast, exponential. And it is good that it is going well, because almost everything depends on genetics now-in medicine, in other places, in agriculture, and in the microbiological industry, everything is based on genetics.

Thanks for attention.

Vladimir Putin: Who is your genetics partner? Rosneft?

A. Makarov: No, Biocad . Rosneft itself, it still does not make medicines yet, but Biocad does.

Vladimir Putin: She makes money. All from there. (Laughter.)

Alexander Makarov: I understand that after praising Biocad, I may be…

Vladimir Putin: Where did the viruses come from, from outer space?

A. Makarov: Yes, and in space, too. In space, there are huge problems with the ISS, because it is full of microorganisms, because where a person, and microorganisms, and these microorganisms destroy the structural elements of the station, cause allergies in astronauts, in general, a huge problem. We are now also studying these microorganisms that were delivered to us from the ISS, and we find out that they are becoming even more antibiotic-resistant there, although there is a radiation background a hundred times greater than on Earth, but nevertheless this does not affect them at all – they only become even stronger. Now we are finding out what causes this process and how to deal with it, because this is a real problem.

Vladimir Putin: You can say it's infinite, just as the cosmos is infinite.

Thanks

G. Trubnikov: Thank you, Alexander Alexandrovich.

Indeed, listening to you, you understand that a person is striving for more and wants as many opportunities as possible in a short time.

We believe that neurotechnology should help us in such conditions. It is not for nothing that we say that the potential of our brain is still very, very unknown to us, and at the same time we want, of course, to learn as much as possible about ourselves. In general, it is insanely interesting to find out what is hidden in us. For me, as a person who studies the fundamental properties of matter, studying the brain is like opening up new horizons in the universe.

The Center for Brain and Neurotechnology of the FMBA of Russia has been operating in Russia for several years. It was opened several years ago, and you visited it last year, Mr Putin, and now it is one of the leading centers in the world.

I would like to ask Vsevolod Vadimovich, who heads this center: please tell us how quickly these horizons are opening up for you and what people can expect from your research.

Vladimir Belousov: Thank you.

Dear Vladimir Vladimirovich, Dear colleagues and guests,

Slowly, of course, the secrets of the brain are revealed, but nevertheless we are working on it.

What are neurotechnologies in general and what do we associate them with? Everyone probably knows the word "cyborg" – this is a cybernetic organism. It is usually found in science fiction and carries a negative connotation: we imagine a robot that is controlled by a human brain, or a person who is controlled by some code. But is it true?

In fact, neurotechnologies are already helping us treat diseases that were previously considered incurable. And being a cyborg really means regaining your lost functions. I'll give you three examples.

The first is a stroke. When an area of the brain responsible for a particular function is killed as a result of a blockage of a vessel or vessels. And during my report, there will be from 50 to 100 new cases of stroke in the world.

Let's say that a person's arm has stopped moving as a result of a stroke. It should be understood that the hand in this case is healthy – the brain is sick. And neurotechnologies allow you to retrain neighboring areas of the brain with the area of damage, and they will take over the lost function, they will learn, accordingly, to control the hand – and the patient will return to normal life.

What technologies help us do this? Virtual augmented reality technologies, biofeedback technologies, transcranial magnetic stimulation, brain – computer interface, and much, much more. As a result, the brain will learn to control this hand again. It's much the same as learning a foreign language: at first you don't understand a single word, but at some point you're already fluent.

And the technologies I mentioned are available not only in large federal medical research and clinical centers – but they are now being actively replicated in regional clinics across the country.

The second example is from the field of neurodegenerative diseases. The same hand, but it is not immobilized as in a stroke – it is in a state of trembling, tremor in a patient with Parkinson's disease. They can't drink, eat, or write text on their own. He is forced to take strong medicinal substances, but they do not always help. And in this case, the technology that came to medicine from physics and materials science comes to the rescue – this is focused ultrasound.

A patient with tremor is operated with focused ultrasound, without incisions or anesthesia. During the operation, a small area of the brain responsible for the generation of tremor is switched off precisely, and the patient returns to normal life during the operation. Now in Russia, two clinical centers already own this technique and treat patients, and in 2024 and in 2025, several more clinics will join the treatment process with this technique.

The third example is when the arm is lost as a result of amputation or trauma, here we are talking about neuroprosthetics. Traditional prostheses used to perform a cosmetic function mainly, but thanks to the efforts of domestic developers, bionic prostheses were developed, which were also presented today at the exhibition, and which can already move.

They can perform operations to capture, transfer, and hold items. They are controlled by electrodes that are attached above the level of prosthetics. But it's still far from our real hand. Our hand is controlled by signals from the nervous system, and we always have feedback from sensory neurons that allow us to fine-tune our movements.

We have set ourselves an ambitious goal-to make bionic prostheses with feedback and integrate them directly with the nervous system so that the patient will feel this prosthesis literally as a part of their body and also use it freely. To do this, we combine the resources of several leading scientific clinical centers and high-tech companies, so that the word "cyborg" will soon have a positive sound.

Unfortunately, I can't tell you about all the neurotechnologies in my short report – I can't tell you about synthetic and cellular neurotechnologies, about bioprinting, about gene therapy drugs, about neurostimulation, and so on. But you can already see that neurotechnologies have enormous potential to improve people's lives. All that is needed is a well – coordinated interaction and balance between the technological capabilities of neurotechnologies and timely resolution of emerging ethical issues.

We are confident that a really well-developed state strategy for supporting neurotechnologies will bring together scientists from various disciplines, on the one hand, and high-tech companies to solve applied medical problems, on the other.

Thanks for attention.

Vladimir Putin: You said that when a person's hands are shaking, they can't drink. But a Russian person can. (Laughter.)

V. Belousov: That's for sure.

Vladimir Putin: People's Artist Lebedev showed this very well in his time at the Leningrad BDT. He was pulling up through a towel with his other hand. Well, it's all a joke.

And not a joke-this is what you say: you can teach the brain to control the hand again. But in strokes, the part of the brain that controls the hand is affected. How can you teach the affected part of the brain?

Vladimir Belousov: The fact is that this area of the brain is affected, and it is sometimes lost forever. But after a stroke, the so-called plasticity window opens, when it is the areas of the brain around this tissue that are adjacent, they can be trained to control the hand. I didn't just mention the language by accident.

Vladimir Putin: Can we teach neurons to " run " side by side somewhere?

Vladimir Belousov: Yes, it's just a workaround. That is, we are doing a workaround for the same function.

Vladimir Putin: That's interesting. And of course, it's fantastic that there is feedback: a person begins to feel a bionic prosthesis. It's just unbelievable, I can't believe it.

Vladimir Belousov: It will be done.

Vladimir Putin: But what is no joke-this is to the Government and to Tatyana Alekseevna - you can not in any case reduce social support for people who receive such a prosthesis, referring to the fact that it is like a real hand.

That's right, it's not a joke. In the relevant postulates of the Ministry of Health, it is prescribed that this should be done. I hope that all this has already been withdrawn? Seized, well, thank God. Let's applaud.

G. Trubnikov: Thank you for a very lively discussion. You see, we are already [talking] about the decisions we have made and what we have done.

Indeed, it all looks fantastic – what Vsevolod Vadimovich told us, and this unique Center of our Brain and Neurotechnology…

Vladimir Putin: It's unbelievable.

G. Trubnikov: Yes, absolutely. What our colleagues are doing helps us to deal, I would say, with physiology-the treatment of diseases of the brain and nervous system. These studies are also about preclinics.

At St. Petersburg State University, Professor Gainetdinov's team conducts research in the field of experimental pharmacology of diseases of the nervous system. This is about the intellectual health of the brain, about clarity of mind, clarity of consciousness and, most importantly, about the comfortable well-being of a person.

Raul Radikovich, please share your achievements.

R. Gainetdinov: Dear Vladimir Vladimirovich, Dear colleagues!

We live in an age of rapid development of technology and multiple growth of information surrounding a person, which, of course, affects our nervous system. The level of stress around the world has increased significantly, and we have not missed this cup.

We have not avoided another global trend related to the growth of life expectancy. So, over the past 20 years, life expectancy in Russia has grown from 65 to more than 73 years, and this, of course, is great. This is a great achievement of our Government and the state as a whole.

But at the same time, this led to a cumulative effect of all the factors that I have already mentioned. We are seeing a significant increase in the number of anxiety states, depressive disorders, cognitive disorders and other pathological phenomena that lead to a decrease in human performance and quality of life. As it turned out, the main cause of many of these diseases is a malfunction of key brain regulation systems, including the dopamine and serotonin systems.

Dopamine is a hormone of pleasure, emotional state, attention, but at the same time, movement control is mediated by dopamine. Serotonin, some people call it the happiness hormone, but I like a different definition: it is a hormone of emotional balance. As our great poet of poets once said: "There is no happiness in the world, but there is peace and will." This is the best definition of serotonin, in my opinion, that is available in the classical literature.

Dopamine and serotonin have their own receptors. What is a receptor? It is a molecule on the membrane that carries a chemical signal from outside-dopamine and serotonin, chemical molecules-into the cell, triggering certain sets of biochemical reactions. And it is not surprising that the dopamine system, the serotonin system, and their receptors have become the main target for a huge number of different drugs, for a large number of diseases.

As Vsevolod Vadimovich has already noted, not all medications work for all patients – there are some patients who do not respond to these medications. At the same time, with chronic administration, the effectiveness of many drugs decreases, so it is necessary to develop new generations of drugs with improved characteristics.

I have been studying this field for more than 35 years. At one time, at the beginning of my career, I was lucky enough to work side by side with Nobel laureates, the progenitors of this field, and I learned a lot from them. In particular, as a result of our experiments, we found that it is not necessary to directly affect dopamine receptors, but you can somehow bypass them from the side, influence them with the help of so – called trace amine receptors-these are cousins and neighbors of dopamine receptors. The same can be done with serotonins. That is, instead of activating it, we just fine – tune it a little-fine-tuning the dopamine receptors. The same can be done with the serotonin system. As a result, in practical terms, we come to a completely new pharmacology. Moreover, the effects of this method are softer and more accurate.

More than ten years ago, at the invitation of St. Petersburg State University, we opened a world-class laboratory, where we continue this research. Now we are working in a number of areas on this topic – unfortunately, I don't have time to talk about all these areas. But thanks, among other things, to our discoveries, this topic has now received great interest in many countries of the world, and similar programs are also beginning to develop there.

Here, from the point of view of science, we are one of the world leaders. We already have some developments that are close to clinical trials, and other studies are at the level of basic research. The most advanced direction is that we are already halfway to the cure, but it will still take several years. We are doing our best to accelerate as much as possible in this direction.

The effect of introducing these medicines into the healthcare system should be significant. We expect that this will lead to a significant reduction in, say, anxiety and an improvement in the quality of life of a person. In addition, if we develop these first anti-anxiety antidepressants, it will be a validation of the platform approach-soft regulation of the dopamine and serotonin systems, which will allow us to expand the range of diseases that we can treat.

I am sure that we have everything we need to become a world leader in this area. Among other things, this will allow us to bring our developments to the markets of friendly countries and not only. The most important thing now is to conduct a full-fledged development and launch production in Russia. But we need to hurry: the global competition really pushes us – there are already new developments in different countries. We are ready to do everything for this.

When I say "we", I don't just mean our team. I have many friends, colleagues, and students all over the world. We have always worked with them, and we will continue to work with them in the future. Moreover, some of them are ready to return to Russia and continue their research here, which, of course, will be a boon for our country.

Thank you very much.

Vladimir Putin: You said that similar studies have now been launched in other countries. So you were the first, right?

R. Gainetdinov: We were the first. But, unfortunately, they were the first to catch up.

Vladimir Putin: What do you mean?" You started, and they…

R. Gainetdinov: We are published, we are scientists, this is all available information. For a certain time they didn't believe us, as always: the first one shouted, they don't believe you. After about ten years, they did.

Vladimir Putin: And what, did they overtake you in something?

R. Gainetdinov: In principle, they are already at the third stage of clinical trials. On the second, on the third. But you can try to fight them.

I'm more concerned about our Chinese friends. Just two months ago, three articles appeared, and in journals of the highest level. For example, two articles in Nature, where they just broke in plain text, as they say. They're fast guys, they worry me more.

Vladimir Putin: They also print, they are open. Please, we can translate from Chinese. That's enough for now.

You have given a good classic poem about happiness. Another classic said, I may be wrong, but it sounds like this: "There is no happiness in life, there are only its lightning flashes. Take care of them, cherish them." That means they don't have enough serotonin, right?

R. Gainetdinov: Yes, exactly.

Vladimir Putin: Then you just need to use the drugs that you invent. They used to say: your health is fine-thanks to the exercise. And now we can say: health is in order-thanks to the pills.

R. Gainetdinov: Yes, to some extent.

Vladimir Putin: Thank you very much.

G. Trubnikov: Thank you.

It seems to me that no one has canceled exercise, it should be done regardless of how medicine develops.

Look, my colleagues have actually talked a lot about the synergy of medicine and various other branches of science, which is actually what biotechnologies are. That is, it is the use of living organisms or their products to solve certain problems, including in the field of medicine.

It seems to me that a striking example of biology, medicine and physics is the nuclear medicine that you have already mentioned (you have put such a good emphasis on this). As a physicist, this topic is very close to me, and I am sure that the audience understands perfectly well that nuclear medicine is not only about cancer therapy. And on a much larger scale, nuclear medicine is now creating unique opportunities for us to diagnose all functional human systems. And the ultra-precise positioning and recognition of cancer cells using nuclear medicine, the delivery of new drugs to these cells is much more targeted than a surgeon's scalpel.

I want to give the floor to Igor Yevgenyevich Khatkov here. You are the head of a multidisciplinary center that makes extensive use of various biotechnologies, including for the treatment of cancer patients. Please share your experience.

Igor Khatkov: Thank you very much.

Dear Vladimir Vladimirovich, Dear colleagues,

Here, in the framework of the forum, and today we have heard a lot of reports about the achievements of our fundamental medical science, as Grigory Vladimirovich said, and in radiomedicine, radiopharmaceuticals, and in many, many other aspects, surgery has just been mentioned. In this regard, since I represent clinicians here, I am entrusted with such an honor. I would like to thank our scientists for the products that they allow us to use, and we, as clinicians, are, in fact, on the one hand, end users of these products, and on the other hand, customers. Because we best represent the aspirations of our patients.

But I would just like to describe a few areas of activity that we are engaged in. And I would like to start with surgery. And since we are talking about future technologies, today we can probably say with a fairly serious confidence that surgery is already in the future in terms of technology in many ways. Because we have absolutely amazing technical things that allow us to implement the most ambitious plans for patients. And it is gratifying to say that the most modern high-tech methods of surgical care are available for our patients not only in the capital's clinics, but also in many, many regions. These are leading clinics, such as those in Ufa, Kazan, Tyumen, Krasnodar, and Yakutsk, where you recently opened a cancer clinic. There, cancer patients who have the most complex operations are performed, up to 50 or more, even up to 70 percent of cases for them, operations are performed endoscopically, which corresponds to the indicators of leading clinics in the world.

If we still talk about future development, then this is definitely a completely robotic surgery, and this is such a smart robotic surgery with integrated security systems, error prevention systems, and intraoperative navigation systems. And in this regard, since we are gradually acquiring high-quality domestic equipment, we very much hope that we will continue to move forward in this direction very intensively.

I would like to say a few words about the provision of medicines, because this is a real breakthrough. Over the past 10, 15, 20 years, so many innovations have been introduced in the pharmaceutical industry in the world that our approaches to the treatment of a wide variety of diseases – cardiovascular, neurological, endocrinological, rheumatological, autoimmune diseases-have changed dramatically. Of course, oncology is one of the most advanced areas here. In this regard, I am also pleased to say that we have also seen such an explosive growth of pharmaceutical research and, most importantly, products in Russia over the past few years. I can say that, for example, last year more than 30 thousand cancer patients in the country received targeted therapy, that is, this is one of the modern types of cancer therapy, with drugs of domestic production. And such a drug as, for example, prolgolimab, which was created by the aforementioned company BIOCAD, is completely domestic, starting from the substance to the final molecule. About a thousand patients were treated with it last year, which, in fact, meets the needs.

If we talk about further development, then drug therapy will definitely develop in the direction of maximum personification and maximum targeting, that is, when the focus that needs to be affected is precisely determined, and while minimizing any side effects in this regard.

We have some very good developments here, but in order to develop faster, it seems to us that we need to think very carefully about how we can reduce as much as possible the stages of preclinical and clinical research that were mentioned, because this will lead to our rapid development in this direction, because the competition is very high. The period from the moment the drug is conceived, from the moment the molecule is proposed to clinical use is quite long, and any possibility to accelerate the processes of preclinical and clinical research without losing safety, of course, would give us a good advantage.

In conclusion, about nuclear medicine. This is definitely a very actively developing area in healthcare in terms of diagnosis and treatment. And such a direction as teranostics is growing, when at the same time an agent can accumulate in a pathological focus, and help to visualize it, that is, see it, and simultaneously treat it, that is, have some kind of damaging effect, especially in oncological diseases.

The fact that, according to expert estimates, the market for radiopharmaceuticals is growing by about nine percent a year speaks for itself. This is precisely due to the effectiveness that our radiopharmaceuticals have in a variety of situations.

It has become much easier for us to work. Mr President, I would like to thank you, the Government of the Russian Federation, and the Ministry of Health for the law on biomedical cell products, which greatly simplified the production, administration, and use of these drugs and made them as accessible as possible to patients.

We continue to communicate a lot during the forum. Our researchers, those who are engaged in basic medicine, clinicians, manufacturers, and industrial partners display communications that serve as the basis for further development.

Thank you for the fact that we have such opportunities to develop further. We are ready to work hard and actively on this path.

Thanks

Vladimir Putin: Do I understand correctly that we are certainly among the leaders in nuclear medicine and nuclear technologies in medicine?

Igor Khatkov: We were pioneers in the nuclear power industry, and in the 60s we were among the first to develop the first radiopharmaceuticals. Today, we are very actively developing this area. We are setting up radiopharmaceuticals, and we have started factories for the new production of radiopharmaceuticals. Thanks to the law that I mentioned, we can now use more radioisotopes for a wide variety of purposes, so we can call it that. But in order to strengthen this leadership, of course, we need to move forward together, combining the efforts of physical institutions and clinicians, and develop in such communications.

Vladimir Putin: Igor Yevgenyevich, this is, you know, a very delicate and practical question. As a clinician, as a doctor, how do you answer this question: the effectiveness of domestic drugs and imported drugs? You know, yes, that many patients, and I receive such questions, believe that imported drugs are still more effective, they are more suitable. In general, how would you respond as objectively as possible to those who ask these questions? Or is it a purely psychological question-people are used to receiving certain medications. What's in here? What should we do in these areas? But the fact that we need to develop the farm is clear, we are doing so, I did not stop here just now, especially to get into this matter in detail. This is a necessary, useful, and very business-oriented industry, the profit there is decent, it is developing well. We recently discussed all this with some of our colleagues, but we also have huge advantages, and there is something to work on, to put it mildly. But this is the question that I asked, which I receive from citizens.

Igor Khatkov: Mr President, I should probably say that there are original drugs that are produced, and then there are a lot of generics, biosimilars, and they are used all over the world.

I can say that since I have to deal more with oncology, the drugs that we use, their effectiveness and the number of possible side effects are absolutely comparable to those drugs that are original and not made in Russia.

Vladimir Putin: You're like a practitioner, right?

Igor Khatkov: Yes, I speak about this as a practitioner. We discuss this a lot, of course, we have different stories, because there were some drugs that worked worse, some worked better, we need to talk about it as it is. But today, the drugs that are used here, are being brought to the market, work absolutely well in oncological practice and have a minimum of side effects that do not exceed the side effects of Western analogues.

Vladimir Putin: Thank you.

G. Trubnikov: Thank you.

I can't stay on the tail end of the discussion of nuclear and radiation medicine.

Vladimir Vladimirovich, you talked a lot about proton beam therapy in your speech. But the effect of ionizing radiation on the human body is a serious issue, a serious problem - on the body, on tissues, on DNA. And we are very well aware that this is also a determining factor for the implementation of manned flights to deep space. And with genomic technologies for studying the mechanism of cell aging, it is also extremely important to study the effect of ionizing radiation.

Let's now smoothly move on to technologies in medicine that allow us to restore certain human functions that were lost due to illness or in the course of the fight against the disease. Returning to a healthy life after overcoming the disease is the most important goal, the most important story, because it is the restoration of full-fledged working capacity, and this is a direct contribution to the country's economy. Leading scientists from many countries of the world are currently engaged in such research and practical issues.

Ilya Igorevich Eremin, representing the Petrovsky Institute, works closely with the team in this area. You have great success in the field of regenerative medicine and healthy longevity. Please share with us and give hope to many people. Tell us about the most interesting things.

Igor Eremin: Dear Vladimir Vladimirovich, Dear colleagues!

I will start with such a direction as regenerative medicine. This is a global trend in which our scientists and doctors have achieved very significant results. Regenerative medicine includes tissue engineering products and cellular products.

I'll give you an example. With joint diseases, arthrosis, a person experiences discomfort, limited mobility, and pain. And there comes a stage when classical medicine can no longer offer anything but prosthetic surgery, and at this point regenerative medicine technologies are connected in order to restore the lost function.

In our center, in a specialized laboratory, we get a cellular product from the patient's own cells, which we inject into the same patient. Such a product helps to restore cartilage tissue, and the person begins to walk normally again without pain.

We are completing clinical trials this year. We have proved the possibility of recovery without surgery, without subsequent long-term rehabilitation on the example of 110 people, and we plan to widely implement it. Moreover, since April 1 of this year, we have the right to use cellular products.

Dear Vladimir Vladimirovich, you know, the first patient was my father.

In his 60s, the pain in his knee became such that he could not walk more than 100 meters and drive, although he is a professional driver. We offered him our therapy.

Vladimir Putin: Is there cartilage in the knee?

I. Eremin: Yes, yes, the cartilage tissue is worn out, an unambiguous diagnosis, prosthetics. They offered us our therapy – he agreed, we tried it, and the result exceeded all expectations. After 10 days, the pain was completely gone, after three months he forgot about the restrictions when walking, and after six months he got back behind the wheel. And we now use such cellular products not only for the treatment of joint diseases, but also for a number of other important and serious pathologies.

I would like to note that in Russia we have other developments of other biomedical cell products that are also designed to treat joint diseases without surgery. And given that there are more than 4 million patients with osteoarthritis in the Russian Federation alone, both our and other cellular products will be in high demand.

There are other examples of the use of regenerative technologies: this is wound healing and skin restoration, restoration of the functions of the pancreas, stomach, and spinal cord organs. Currently, animal studies are being conducted to create an artificial eardrum and cornea of the eye. And already in 2025, with the start of clinical trials, it will become clear at what time and how many people with the help of cellular products will be able to restore vision and hearing.

The second area I wanted to focus on, which is also based on the use of regenerative methods, is biomedical technologies for active longevity and prevention of aging.

Everyone knows that to live long, you need to eat right, play sports, and not have bad habits. Today, we, like the whole world, have learned to set the biological age of a person. But how does our cell respond to the impact of harmful factors? Why does it stop dividing normally, causing aging? This is the question that scientists around the world are looking for an answer to.

Why do we do such research? The structure of our center includes the oldest Institute of Morphology, founded in 1960, which has accumulated vast experience in the study of human cells. So we have something to take as an evidence base.

At the same time, the issue of active longevity is multifaceted, and a large number of research teams in our country are engaged in this problem. Every aspect is important here: our genetics, immunity, the number of stem cells, stress tolerance, and the balance between the emotional and mental spheres. Biomedical approaches to creating future technologies for restoring physical activity are currently being developed.

I'll give you an example. Why is there a loss of muscle tissue, fatigue and weakness? In each cell of our body there are special elements – exosomes, with the help of which, we can say, cells "communicate" and interact. As the cell ages, this mechanism is disrupted. Studying the recovery of exosomes is the basis for creating methods for restoring a person's physical activity and strength, and these are the most important components for an active and long life. The key parameter of longevity is determined by the duration of a healthy life.

Dear Vladimir Vladimirovich,

Thanks to the medical science project launched by the Government, we were able to implement regeneration studies, the results of which we will soon apply to the treatment of our citizens. And we would like to see the development of biomedical technologies for active longevity by us and our colleagues also implemented within the framework of this project.

Thanks

Vladimir Putin: Look, scientists used to test new drugs on themselves and their children, and now – on their parents. Well, it doesn't matter, as long as they work for the benefit of the whole country. The most expensive things were touched.

But if we are serious, then, of course, this is a very important area, and we expect great achievements and results from you.

We are 73 years old now.? 74?

Replica: 73 and a half.

Vladimir Putin: 73 and a half. And in Moscow it's decent, I won't even mention it. Only Sergey Semyonovich told me about it today. This includes the results of specialists who are engaged in the type of activity that you have just described.

Thank you very much, good luck.

Igor Eremin: Thank you, thank you.

G. Trubnikov: Thank you. I can't help but react here, too. We have the Year of the Family, and for us both parents and children are the most precious, so the responsibility here is greater. That's why it's probably the right thing to do in life, that we treat older generations and those who follow us with more responsibility.

If you'll excuse me, Mr President, I would like to share two very brief points that were suggested to me by today's discussion. And yesterday was an interesting set of sessions. It seems to me that we are witnessing that medical science is moving towards a personalized trajectory, which means that each object is different, and this is not at all like in physics or chemistry, for example, when we talk about large volumes, about large cohorts of objects that are more or less homogeneous.

You said today that there is a person at the center of medicine, and there are probably no universal solutions around a person in medicine right now. It seems to me that this is just a new paradigm in which we live. And once medicine and medicines and drugs are personalized, it means that technologies should also be personalized. And this means, returning to the question of speeds, it means that technologies must also be introduced and registered faster than the disease flows. It seems to me that this is a good field for energetic and fast work of regulators.

And the second point. Let me also point out that there were a lot of reasons to be proud of our science today. I am simply bursting with pride for our country and for our specialists, for the professional healthcare sector. And your participation in our discussion is like a state award to the entire medical community. And people who forge the glory of their country, of course, deserve recognition by society, preferably during their lifetime.

What would you think if we proposed to organize an annual competition of scientific papers of scientists in medical science in order to mark the most interesting and support the most interesting developments?

I want to say again from this stage that it is a great honor for me to be among such strong people today. I would like to say once again that our country has enormous prospects when we have such specialists and such science.

Vladimir Vladimirovich, thank you very much for being so deeply involved in all the substantive issues. Thank you for your support and patronage.

And if you can, please sum up the results and say some final words to our discussion.

Vladimir Putin: It is not easy to sum up the results. Because after all, everything here is very specialized. You sit there and think about how not to blurt out something unnecessary. And you say to sum up the results. Not an easy task.

But what I can say for sure is that all the areas that were mentioned here, and those that were not mentioned, but which in one way or another relate to the health and life expectancy of our citizens, will certainly be in the focus of the Government's attention. This is an absolutely obvious thing. This is one of the main priorities of the state, and of any state.

But what I would like to point out is: We are happy when we see how Moscow is developing, for example. And a lot of things are being done here. It is a profit center for many companies. The task of the Government is to distribute these profits evenly throughout the country, so that the results of our achievements are enjoyed by as many of our citizens as possible. It is very important. That is why I have spoken quite a lot about primary health care today. We will certainly pay special attention to this.

Of course, it is clear, as well as fundamental and applied science, that one cannot exist without the other. It is clear that research centers and scientific developments certainly need support, and we will certainly do this, we will support everything that has been said here today and has not even been said, but what is of interest to us? huge value and value.

We carefully analyze what is happening in our country and in the world. Of course, we have a lot of unresolved issues, a lot of problems. But still, everything is learned in comparison, and you know, even the achievements of your colleagues in foreign countries – after all, there is expensive paid medicine in some countries, say, overseas. Yes, it is good, the level is good. But there a person on the threshold of a medical institution can die, and no one will take him to the walls of the medical institution, because he does not have insurance. We both know that. And such cases, most importantly, happened. Nothing like this should ever happen in our country.

We have inherited many things from former times, from Soviet times. In my speech, I mentioned the names of our outstanding scientists and doctors. Of course, we should build our work on these moral principles of attention to people. Human-centricity should be at the heart of all our work.

We will certainly continue the practice of such sessions and annual events. Next year we want to dedicate it to new materials, chemistry. This is also related in one way or another to the topics that our colleagues discussed today and that you discussed during your sessions. That is, continuity will be mandatory.

As for a specific proposal – a competition for scientific papers in the field of medicine-of course, we will do it.

Thank you very much. Good luck.

Do I hear some silent applause? My wife works in the medical world and was very impressed by the new treatments as was I. But I’m more impressed by the moral/ethical aspects of Russia’s approach to the whole issue as the last bolded section above attests. Too bad we couldn’t listen to the entire spiel of all those present. Yes, the transcript would be twice as long, but we’d know a lot more. Improving Russia’s healthcare system is a national project that’s well on its way upward in quality of care and infrastructure; but like everywhere else, more practitioners of all types are needed. The shortage of medical workers is global.

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