The Russian Federation faces important economic and social challenges. By 1998 national income was little more than half its level in 1990. Life expectancy for men is now about 61 years, compared to 65 years a decade ago. The rate of suicide and self-inflicted injuries is more than three times the OECD average and maternal mortality rates are about five times the OECD average. Infectious diseases have increased in prevalence, but real public spending on health care has fallen by nearly one-third. Spending on many other social programmes has fallen even as a percentage of the smaller GDP, yet much expenditure remains inefficient and ineffective in addressing the serious problem of poverty. More than a quarter of the Russian population is poverty-stricken according to official criteria. Average wages are not much more than half of their real level of the early 1990s, and wage and pension arrears have posed serious problems in the recent past. The informal economy has grown significantly. What can be done to address this crisis? This book provides a detailed analysis of the social problems facing the Russian Federation, and develops proposals for continuing reform to improve the economic fundamentals, including the productivity, while at the same time ensuring that social and labour market policies become more effective in helping the poorest Russians. The book also proposes policy reforms to improve the operation of the labour market, to guarantee a package of essential health care services, to address the wide disparities between different regions of the Russian Federation, and to deal with the human crisis experienced by the very poor.