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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 
------- 
 
¶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