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A (very) close-knit circle Russia’s Circle of Kindness Foundation helps critically ill children by purchasing expensive drugs from providers with personal connections to top officials (including Putin himself)

Source: Meduza

The Circle of Kindness Foundation, which helps children with rare illnesses, was created in early 2021 at Vladimir Putin’s own initiative. It’s funded by a two percent tax on the income of Russia’s wealthiest citizens. The organization pays for expensive medications — but competition is rare at the auctions where these drugs are procured. One of the foundation’s main suppliers is a company called Irvin — and it’s connected to both the foundation’s head and to the family of Alexey Dyumin, Putin’s former bodyguard. In addition, the husband of the woman responsible for purchasing medications on behalf of the Circle of Kindness works for the owner of the company that supplies the foundation with Zolgensma — the most expensive drug in the world. Meduza correspondents Svetlana Reiter and Maria Zholobova break down how the Circle of Kindness Foundation’s procurement system works and why its board of trustees (which includes well-known actors and philanthropists) believes it lacks transparency.

‘Put down the baby, go have another one’

The baby doesn’t lift his head, roll over, or try to sit up. His mother holds him in her arms — but he just droops like a deflated balloon. If he doesn’t start treatment soon, within two years his ribcage will become deformed, he’ll no longer be able to swallow, and eventually he’ll stop breathing.

He has the most severe form of spinal muscular atrophy (SMA). In children with less extreme forms of SMA, symptoms appear later on and progress more slowly, but even they have trouble breathing without treatment, though their cognitive skills aren’t affected.

According to Olga Germanenko, head of the SMA Families Foundation, 10 years ago, almost nothing was known about the disease. “You’d go to the doctor and he’d immediately tell you, ‘Put the baby down, don’t touch him, have another one. Goodbye’,” said Germanenko.

Her own daughter, Alina, has SMA. Alina is 13 years old.

“I have a pretty tough daughter — she’s on a ventilator. I wish I’d have had her a bit later, of course,” said Olga.

“Later” means after medicine that can slow the development of SMA came onto the market: nusinersen (marketed as Spinraza), risdiplam (marketed as Evrysdi), and onasemnogene abeparvovec (marketed as Zolgensma).

In some cases, a single injection of the revolutionary gene therapy treatment Zolgensma can stop disease progression completely, but only in very young children, so it doesn’t always get prescribed. At a price of 160 million rubles ($2.17 million), it’s the most expensive medicine in the world.

The Circle of Kindness Foundation, as per Health Ministry recommendations, only provides the medication to patients younger than six months. This excludes a lot of children, many of whose parents reach out to private charity organizations. For example, the personal foundation of Novolipetsk Steel owner Vladimir Lisin (number three on Forbes’ list of Russian billionaires) recently purchased Zolgensma for an 18-month-old child.

Both Spinraza and Evrysdi slow the development of SMA and allow patients with the condition to move and breathe properly, but only as long as they continue taking the medication. In Russia, the retail price for one vial of Evrysdi is about 800,000 rubles ($10,850) and will last a child who weighs 20 kg (44 lbs) 12 days. That adds up to 30 vials a year at a price of at least 24 million rubles ($326,000). The fixed selling price recorded for Spinraza on Russia’s list of vital and essential medicines (VED) is 5.1 million rubles ($69,000); it requires six injections in the first year, and then three injections a year for the rest of the patient’s life.

According to multiple parents of children with SMA, regional health ministries in Russia are not willing to pay such high prices — despite being required to by law. Patients’ representatives often take them to court and regularly win, but even after that, they’re rarely given the money they need to buy the medication.

“What options do parents have in that situation? Selling your apartment will get you five million. If your relatives sell their apartment, that’s eight million. But beyond that — everyone’s out of resources, you’ve sold everything you can sell,” said Roizman Foundation founder and former Yekaterinburg mayor Evgeny Roizman, who has extensive experience helping parents of children with SMA. 

“So it’s 2019. This woman comes in and says she has a daughter, Liza, with SMA. I tell her, ‘Go to the director of our foundation.’ And the director tells her, ‘Sorry, we don’t help with SMA, the cost is prohibitive.’ She passes me on her way out, and I can see how her shoulders are shaking from crying,” Roizman recalled.

“And what did you do?” Meduza’s correspondent asked.

“I can’t just let someone leave our office in tears. So I tell her, ‘Sit down. Write a letter to Donald Trump, President of the United States. Dear Mr. President, save my child. He needs treatment he can only get in America.’ Then I write on social media, ‘So a woman came to me and wrote a letter to Trump, and I’m going to meet with the Consul General to make sure the letter gets to its recipient.’ Five minutes later, all of the media are talking about me,” Roizman explained. “That night, I go on Echo Moskvy and emphasize that the woman can’t get help in Russia so she’s turning to America. And then Vladimir Lizin’s foundation reached out to Olga Zhuravleva, [the journalist] who I’d done the broadcast with. And they immediately said they’d pay the full cost. I told them there was one more girl, Anya. An hour later, Lisin decided to pay for both girls’ treatments.

Other than Lisin, who, according to a representative, paid more than 330 million rubles ($4.4 million), Russian Honey Company owner Igor Altushkin also donated money to the Roizman Foundation to help children with SMA. Every new piece of news about the donations raised a wave of questions: “Why isn’t the government helping? Why are people writing to Trump, a foreign president? These donations are always so painful for the authorities.”

So the authorities found a solution.

Where does the state get the money?

In early 2021, President Vladimir Putin issued an executive order to create the Circle of Kindness Foundation. Its main task was to provide expensive medications for children with rare and severe diseases; to fund this, the government raised the personal income tax of Russians making more than five million rubles ($67,800) annually by two percent.

Presumably, most of the Circle of Kindness’s budget should go towards medications for children with SMA, one of the most widespread and quick-to-progress rare diseases. Among the 1,704 children the fund is supporting, more than 1,000 are SMA patients.

The foundation’s chairman, appointed by Putin, is priest Alexander Tkachenko, founder of the first Children’s Hospice in St. Petersburg. Its board of trustees, which plays a supervisory role, includes 15 medical professionals and philanthropists, including well-known actors Konstantin Khabensky, Chulpan Khamatova, Ksenia Rappoport, and Vera Foundation founder Nyuta Federmesser.

The Circle of Kindness also has a permanent board of experts, which must be approved by the Health Ministry. It includes the ministry’s main contract specialists as well as representatives from academic organizations, patient associations, and charity foundations. The board determines what diseases the foundation will treat, keeps an inventory of purchased drugs and medical supplies, and reviews patients’ applications for medical care.

Nobel laureate and Novaya Gazeta editor-in-chief Dmitry Muratov, who writes frequently about SMA patients, praised the Circle of Kindness: he admires its “tough but incredibly empathetic” employees, as well as the people on its board of trustees and expert board, who he says have “true grit.” According to Muratov, they work diligently to make sure medicine gets to those who need it, and they “don’t let [regional agencies] off the hook.” After all, it’s local officials who are responsible for both notifying the fund of children who need help and, later, making sure the children receive their medications.

Each purchase of medication must be approved by the Circle of Kindness’s expert council. “Each of the patients is announced to us by name — here’s when their assistance period starts, here’s the approved dosage for this patient for this period. And we must vote unanimously for each child — until the end of the year and for the first quarter of the next year, because we make sure to have a surplus of medications. We spent an hour and a half discussing diseases and medications, then the Circle of Kindness’s employees spent another hour and a half reading out the children’s names and their dosages, so in an hour and a half we approve about 20 children,” an expert council member told Meduza.

“In terms of providing medicine to children with SMA, things really are an order of magnitude better than they were last year [2020]. Back then, only a tiny portion of the children were getting treatment, and now we’re covering 92 percent of the 870 children in our registry,” said Olga Germanenko, another member of the foundation’s expert council. The remaining 8 percent consist of children in critical condition receiving palliative care and several dozen people who still haven’t received their medication.

“All of the children with SMA are being treated with medication — we haven’t refused a single one,” Alexander Tkachenko told Meduza.

What makes the trustees nervous

Many of the board of trustees members don’t attend every single monthly meeting; they’re very busy, so they sometimes send directors or lawyers from their charity organizations in their place. As a result, Chulpan Khamatova is represented in the meeting by Podari Zhizn Foundation director Ekaterina Shergova, Konstantin Khabensky by Konstantin Khabensky Charity Foundation acting director Ekaterina Bartosh, and Nyuta Federmesser by Vera Foundation lawyer Anastasia Zhdanova.

In May 2021, only a few months into the Circle of Kindness’s existence, the board of trustees had a mountain of questions for the foundation, according to Shergova. “The foundation wasn’t patient-oriented enough, it only conducted communication through regional health ministries, and parents were constantly complaining to Chulpan that nobody could explain to them whether the foundation could help their children or not,” said Shergova. Local health ministries often failed to let parents know whether medications had been purchased for their child or if they needed to get in touch with specialists to receive medicine.

The board of trustees is also troubled by the large amounts of money the Circle of Kindness spends on administrative and economic activities, three sources from the board told Meduza.

According to documents obtained by Meduza, the Circle of Kindness doesn’t pay rent for its Moscow-owned office on Maroseyka Street. Nonetheless, the foundation’s budget includes almost 13 million rubles ($177,000) allocated for renovating the building, as well as expenses like car rentals, for which 1.927 million rubles ($26,300) is earmarked annually. The foundation has a staff of 45 people whose salaries come out to over 77 million rubles (roughly $1 million) a year. The expert board is collectively paid about 25 million rubles ($341,000) a year to review patient applications. Altogether, the Circle of Kindness spends 235.7 million rubles ($3.2 million) a year on administrative and economic activities. Compare that to the Podari Zhizn Foundation, which has a staff of almost 100 employees and spent about 133 million rubles ($1.8 million) on administrative and economic activities in 2020.

“We told them, you’re always trying to figure out whether you have enough money to help the children, but meanwhile, you’re not thinking about where you can save. For example, you’re doing this expensive remodel of the building you rent,” said Shergova.

According to her, all of their questions “went into the void.”

It’s written in the board of trustees’ regulations that the directors of charity organizations who represent the board members can attend meetings in the members’ place but cannot vote on their behalf. “We asked to have power of attorney for the artists, but unfortunately it didn’t work out — it’s specifically written in the Circle of Kindness Board of Trustees regulations that board members can only entrust their votes to other members. In other words, Chulpan can entrust her vote to Kostya, and Kostya can entrust his to Chulpan. That means that my presence doesn’t mean anything, and my opinion is just an opinion. There’s no way for us to impact the outcome of the vote,” said Shergova.

“Entrusting non-members with voting rights when there are multi-million-dollar medication purchases at stake is just not possible,” explained Circle of Kindness Chairman Alexander Tkachenko.

In May, the board of trustees laid out their complaints about Circle of Kindness’s management during a meeting with Health Minister Mikhail Murashko, Putin’s First Deputy Chief of Staff Sergey Kiriyenko (the “Kremlin’s curator”), and the head of the Presidential Administration’s Directorate for Social Projects Sergey Novikov. 

“Novikov was sent by the AP [Presidential Administration] to ‘keep an eye’ on the Circle of Kindness. When the foundation was first created, he called us in for a rap on the knuckles and ordered us not to argue,” a source from the board of trustees told Meduza. According to a transcript from the meeting obtained by Meduza, the board members didn’t listen: they talked at length both about the lack of communication and the problems concerning medication purchases. They were specifically frustrated by the foundation’s failure to provide enough information about their purchases, while the purchases approved by the board fell behind schedule. Two people who were at the meeting confirmed the transcript’s authenticity.

Tkachenko claims the trustees expressed no such complaints. He blamed the foundation’s lack of communication on budget constraints and privacy laws.

“There are two laws that apply to us — the law on patient confidentiality and the law on personal data. During the transition period, when our site wasn’t working, members of the board of trustees couldn’t see who we were helping or what we were buying, and that’s because the Health Ministry didn’t transfer money to our foundation until July 1. The artists thought their names were being misused. That’s why the decision was made to allow board members to come to our office and see all of the patient and medication information; they could come themselves, and so could the directors of their foundations,” Tkachenko told Meduza’s correspondent. “And they’ve done so multiple times.”

Several members of the Circle of Kindness Board of Trustees told Meduza that the foundation only provides general information about its purchases, while refusing to explain or discuss its supplier selection process. “We could discuss the procurement and supplier audit reports, that would be helpful, but there hasn’t been anything like that,” a source from the board told Meduza.

How to get into the Circle of Kindness

The Circle of Kindness Foundation’s procurement procedure works as follows.

The foundation purchases medications that aren’t registered in Russia from providers it chooses itself — either manufacturers or distributors. Alexander Tkachenko is proud to report that the foundation “strangles the producers,” getting the biggest possible discounts and buying medicine “for the lowest prices.” According to him, the discounts range from 16 percent to 61 percent.

Tkachenko is confident that the pharmaceutical companies (both Russian and foreign) still make a profit, since the orders are large and the medications are so expensive. However, he declined to reveal how much money the foundation spent on unregistered medications in 2021.

Medications registered in Russia (for SMA patients, this means Evrysdi and Spinraza) are purchased for the Circle of Kindness Foundation by the Health Ministry’s Federal Center for Planning and Organization of Drug Provision for Citizens. This federal government institution (FKU) is led by Elena Maksimkina — a member of the Circle of Kindness’s expert board. A third medication for treating SMA — the gene therapy drug Zolgensma — was registered in Russia on December 8, 2021. The Circle of Kindness used to buy Zolgensma directly from its manufacturer, but it will now be purchased by the Health Ministry’s aforementioned Federal Center for Drug Provision.

Most of the trustees’ questions center around this FKU. “The foundation itself purchases medicine and sends reports fairly quickly, but the FKU is a disaster,” a source from the board of trustees told Meduza. According to him, “not even Tkachenko is able to have any effect on the FKU,” and while board members began asking to see the institution’s reports in the spring of 2021, the FKU didn’t cough up the paperwork until November.

“The government intentionally divided the [purchasing] authorities, and all purchases of registered medications are carried out by the FKU in a transparent process that is in strict compliance with Federal Law 44. Elena Maksimkina serves on the expert board of our foundation, and we’re unable to influence its procurement process, but Maksimkina did work in the Health Ministry, and she has a lot more knowledge about the purchasing process than many others. I completely trust her,” Tkachenko told Meduza.

According to Elena Maksimkina, members of the board of trustees are informed about new contracts on a regular basis. In 2021, she said, the FKU purchased medications for 1,458 patients, 1,039 of whom have SMA, at a cost of 27.28 billion rubles ($372 million).

How the procurement auctions are held

Almost all of the companies who supply medication to the Circle of Kindness Foundation win their contracts without competition. Using documents from the Circle of Kindness website and Russia’s public procurement website, Meduza was able to determine that in most cases, either the Circle of Kindness chooses the only supplier of unregistered drugs according to its criteria, or only one potential supplier participates in the auction and therefore gets the contract at the starting price.

Zolgensma

In 2021, for example, the Circle of Kindness purchased 21 doses of the multinational pharmaceutical company Novartis’s medication Zolgensma from its distributor, Skopinfarm, which is part of Alexander Apazov’s Pharmimex group. Because one dose of Zolgensma costs about 160 million rubles ($2.2 million), the cost of the contracts should have been more than three billion rubles ($40.9 million), even with discounts.

A Novartis representative told Meduza that Skopinfarm was chosen to be the Circle of Kindness’s distributor in Russia “in accordance with their standards and procedures.”

When asked why the Circle of Kindness chose to purchase Zolgensma from his company, Apazov told Meduza, “Well, it’s a logical decision, we’ve been around for a long time.”

President of the National Pharmaceutical Chamber, 82-year-old Alexander Apazov began working as a pharmacist in 1962 — and hasn’t left the healthcare sector since. As a result, he’s well-connected; one of his employees, for example, is Elena Maksimkina’s husband, Andrey. From 2014 to 2019, Andrey Maksimkin was general director of Apazov’s company Innopharm, and in 2016, he became head of Apazov’s daughter’s business, Rusinpharma.

In addition to Zolgensma, Apazov’s Pharmimex group won two other Health Ministry auctions to provide the Circle of Kindness with five medications, including Ataluren, a medication for Duchenne muscular dystrophy, for a total of 5.5 billion rubles ($75 million). According to documents from Russia’s public procurement website, there were no competitors (more details can be found at zakupki.gov.ru).

“It’s a typical conflict of interests — state or municipal deals being made despite family or other kinds of close ties between representatives of the customer and contractor,” said Transparency International Russia director Ilya Shumanov; in this case, the conflict of interests comes from the fact that Maksimkina’s husband works for the owner of Pharmimex. According to Shumanov, Maksimkina should have notified her bosses about her personal interest in the situation.

Elena Maksimkina, who is responsible for the Health Ministry’s drug procurements, called Meduza’s questions about the potential conflict of interests “a provocation.” “My husband is a specialist with a pharmaceutical degree — he works and has always worked in the pharmaceutical sector, and he currently happens to work for Rusinpharma. Regardless of any officials’ relatives on its payroll, Pharmimex has been and still is one of the leading public procurement firms by virtue of its competence and expertise — it’s been providing medications to patients with rare diseases for more than 20 years,” she told Meduza.

Spinraza

The foundation’s largest drug provider is the Russian company Pharmstandart, owned by Viktor Kharitonin, longtime friend of Russian Deputy Prime Minister Tatyana Golikova and her husband, former Industry and Trade Minister Viktor Khristenko. Since early 2021, the company has won more than 44 out of 53 auctions to supply Spinraza (manufactured by the American multinational biotech company Biogen) to the Circle of Kindness, for a total of 11.7 billion rubles ($160 million). In more than half of these auctions, Pharmstandart had no competition.

Eight of the remaining Spinraza auctions were won by the lesser-known company Pharmstor for a total of 1.3 billion rubles ($17.7 million), while the one remaining auction was won by former senator Boris Shpigel’s company Biotec. According to data from Russia’s public procurements website, about 20 of the auctions to supply Spinraza to the Circle of Kindness had more than one participant.

According to a representative of the Janssen company, which represents Spinraza’s manufacturer, the American corporation Biogen, Janssen essentially doesn’t participate in Russian public procurement auctions.

Evrysdi

The Circle of Kindness Foundation’s other major provider is the pharmaceutical distributor Irvin, part of the Pharmeko group. The partnership allowed Irvin to increase its public procurements portfolio by almost 40 percent in one year — its total value reached 21.3 billion rubles ($290 million). According to data from Russia’s public procurements website, Irvin won more than 30 auctions held by the Health Ministry’s Federal Center for Planning and Organization of Drug Provision for Citizens to provide the medication Evrysdi (manufactured by Roche) to the Circle of Kindness and signed contracts worth a total of 7.3 billion rubles ($99.4 million). The company didn’t face any competition in any of the auctions it won, although, according to documents from the public procurements site, there are at least nine companies that supply the medication in Russia.

“Any company that’s interested is welcome to participate in the auctions, there aren’t any limits,” Maksimkina told Meduza. Pharmeko echoed her message but added that medication distribution requires a lot of resources since many drugs are difficult to transport and store.

A source from Roche explained that the manufacturer doesn’t provide Evrysdi directly to the Circle of Kindness Foundation because it isn’t able to distribute the medication to all of Russia’s regions (despite the fact that Evrysdi should theoretically be easy to distribute: the medication itself consists of powder that patients mix with water and drink. According to its instructions, it doesn’t require any specific temperature, and it doesn’t take up a lot of space).

“Roche chose Irvin-2 (Note: Irvin-2 is a separate company related to Irvin; both entities are run by the same head and belong to the Pharmeko group. In its official response, Roche mentioned Irvin-2, not Irvin, as the company that provides medication to the Circle of Kindness.) as a strategic partner for state risdiplam [Evrysdi] contracts in accordance with the company’s current commercial policy and the goal of increasing this innovative therapy’s availability to patients,” explained a Roche representative, noting that the company reserves the right to work with other suppliers.

Pharmeko’s press service told Meduza that Roche chose Irvin based on the results of an audit of potential partners, and that the companies have been working together since 2005.

Other official distributors for Roche that worked with various state agencies in 2020 and 2021 report that they had no chance to win the Circle of Kindness auctions. “The manufacturer refuses to supply this drug [to us], and only suppliers who either already have the product in stock or who have a confirmed guarantee from the manufacturer can participate in the auctions,” a source from one of the companies told Meduza.

“It came out that Roche chose Irvin as a strategic supplier, so we didn’t even enter the auction — it was obvious that it wouldn’t bring us anything,” another distributor told Meduza. A Roche representative declined to say whether the company has ever refused to supply drugs to distributors.

In any case, Irvin is tough to beat. Sources from a Russian pharmaceutical company and from the Pharmeko leadership told Meduza that Irvin was in talks with Roche to start producing Evrysdi in Russia. Irvin has not officially commented, but a representative of Roche Russia confirmed that the company was considering local production.

Pharmeko and the Circle of Kindness’s partnership isn’t limited to supplying Evrysdi. According to the SPARK-Interfax database, in September 2021, Pharmeko purchased a stake in the Russian representative of the large Swiss company FarmaMondo, which specializes in distributing unregistered medications in Russia. Soon after, the Circle of Kindness chose it as its supplier of the neuroblastoma drug Karziba. The total value of the contract is unknown.

On November 23, the foundation decided to buy a unique medicine from Irvin-2, one of the most expensive in the world: the gene therapy medication Luxturna, made by Novartis, which treats one of the forms of hereditary retinal dystrophy, according to records. One injection of Luksturna is enough to stop the condition, which eventually leads to complete blindness. Treating both eyes costs 850,000 rubles (almost $63 million). This was the first time any patient in Russia had received Luxturna. The Circle of Kindness approved the purchase for six children, according to a spokesperson from the foundation.

Most of Pharmeko’s revenue comes from Irvin and Irvin-2 — in 2020, they had a combined revenue of 48 billion rubles ($654 million) while Pharmeko’s total turnover was 50 billion rubles ($681 million). Both divisions are managed by Mikhail Stepanov — a longtime acquaintance of Alexander Tkachenko, the Circle of Kindness’s chairman.

How is the Circle of Kindness’s chairman connected to Pharmeko?

At the end of 2020, the Cathedral of the Descent of the Holy Spirit on the Apostles opened in St. Petersburg’s Primorsky District. The city’s then-governor Valentina Matviyenko personally allocated space for the cathedral in Dolgoozerny Park — something made abundantly clear in an inscription at the site.

At a towering 70 meters (229 feet) tall, the Byzantine-style cathedral stands out against the typical Russian high-rises that surround it. Maxim Atayants, who designed the building, was adamant about not adapting it to blend in — something that apparently pleased his client, the rector of the future cathedral, who had already rejected 12 architects. The building was completely funded by donations — “we found some kind people who fully funded it,” Atayants told news outlet The Village.

Circle of Kindness chairman Alexander Tkachenko is currently serving as the cathedral’s rector.

His appointment was first planned in 2007, when the cathedral’s construction was just beginning, according to Tkachenko himself. “At that time, I was a priest at St. Nicholas Cathedral — big, imposing, beautiful, significant, half of St. Petersburg went there, a lot of people were baptized there. When the question was raised of my appointment as the rector of the new parish and I was immediately tasked with creating a new legal entity — a plot was transferred to the church, I turned to the active parishioners at the St. Nicholas Cathedral for help, they became co-founders, so the story of the parish’s creation happened lightning fast,” Tkachenko recounted.

Legally, a parish is supposed to have at least 10 founders, five of whom, according to BBC News Russian, have connections to the pharmaceutical industry — specifically, with one of the largest medical suppliers of the mid-2000s, Imperia-Pharma. According to business media reports, one beneficiary from the company could be Sergey Matviyenko, the son of Valentina Matviyenko, who chose the plot for Tkachenko’s temple.

Among the parish’s founders were Imperia-Pharma founder Omar Gurtskoy and his wife Shorena Goguchia, Imperia-Pharma employee Mikhail Stepanov, and Dmitry Kuzmin and Tatyana Berezovskaya (all three of them have been co-owners of the same company, Rekord-Pharm, at different times). Stepanov went on to found the companies Irvin and Irvin-2 in 2019.

The establishment of the parish was really just a technicality — Gurtskoy helped registered it, so he provided a lawyer to file the documents and brought in his subordinates, according to one of the founders. “If it were possible to build a church just like that, without registering it, we wouldn’t have created a new parish,” the source explained.

According to Tkachenko, six months later, when construction began, all of the founders had left the parish.

“Like a mom and a dad, they gave birth to a legal entity and then left. After these people played their nominative role, I got to work on the church itself, and they remained parishioners at St. Nicholas,” said Tkachenko, who insists that he’s no longer in contact with any of them, and that none of them were involved in the construction of the cathedral or helped the Children’s Hospice in St. Petersburg, which he headed in 2006 (though Meduza was able to find one mention of Imperia-Pharma providing medicine and groceries to the hospice).

At the same time, Tkachenko claims that he’s “not in touch” with Stepanov at the moment. On November 23, a week after meeting with Meduza, Tkachenko signed a contract to purchase Luxturna from Stepanov’s company.

The two men have known each other for almost two decades, according to an acquaintance of Stepanov. “Stepanov was one of the church’s most faithful parishioners, he constantly visited Tkachenko. They stayed close in St. Petersburg, and after Tkachenko opened the hospice, Stepanov continued to give Tkachenko advice. They’re still in touch in Moscow, where they’ve both moved,” he said, although he admitted that they see each other more rarely now.

Pharmeko’s press service insists that Irvin “never provided financial assistance” to the churches where Tkachenko served, and Stepanov wasn’t able to take part in church activities after moving to Moscow; the main factor in the decision to provide any medication to any client, including the Circle of Kindness, was whether the company had the product in stock, the spokespeople added.

“I have no connections to any pharmaceutical companies, I don’t take bribes — don’t try to drag my name in the mud, have a conscience!” Tkachenko told Meduza.

The Lord’s work

Pharmeko’s is currently owned by Vladimir Babiy and Zhanna Sergiyenko. From 2016 to October 2021, former Energy Minister Sergey Shmatko was also a part owner, but he died of COVID-19 in early November. In 2010, Transneft president Nikolai Tokarev’s daughter Maya Bolotova briefly owned a stake in the company.

“The company is deeply religious, and they sometimes walk around with various relics from different saints,” reads a review one employee left with one of the company’s HR contractors.

The anecdote is probably true. One source Meduza spoke with, the head of one of the dioceses of the Russian Orthodox Church, called Pharmeko Board of Directors chairman Vladimir Babiy “deeply religious, polite, and very pleasant to talk to,” while another source from the pharmaceutical industry called him “a typical manager from the 1990s.”

Babiy is chairman of a charity called the Equal of the Apostles Prince Vladimir Foundation, and Zhanna Sergiyenko is its director. It’s something of a subsidiary project to the pharmaceutical company: the foundation is registered to the same address and phone number as Pharmeko. The foundation pays to bring Orthodox relics to Russia: in 2015, they brought the right hand of St. George the Victorious from the Xenophontos monastery on Mount Athos; in 2018, they brought over relics of St. Spyridon of Trimythous, and in 2021, they organized a procession with relics of Alexander Nevsky.

Several sources Meduza spoke to from the pharmaceutical industry, including Irvin employees, claimed that Pharmeko co-owner Zhanna Sergiyenko is the relative of another deeply religious person: Equal of the Apostles Prince Vladimir Foundation vice president and First Deputy Chairman of the Pharmeko Board of Directors Gennady Dyumin. A spokesperson for the company told Meduza that Dyumin and Sergiyenko are not related.

However, Gennady Dyumin and Zhanna Sergiyenko’s mother were born in the same locality — a small village in Kursk region called Chermoshnoye. Dyumin’s birthplace is mentioned in a published biography of him, and Meduza confirmed Sergiyenko’s birthplace with people who know her personally.

Dyumin joined Pharmeko at the initiative of the company’s owners, and his main task is to communicate with “people at the top,” according to a source in the company. That’s why Dyumin has represented Pharmeko meetings with governors to address COVID-19.

Dyumin, a Colonel of the Medical Service, was friends with former Defense Minister Pavel Grachev, was in charge of medication procurement for the Mandryk Military Hospice, and, according to The New York Times, has headed the Defense Ministry’s Main Military Medical Directorate since 2013.

In recent years, however, the media has been less interested in Dyumin’s military career than in his family connections due to the dizzying career of his son, Alexey Dyumin, a member of Vladimir Putin’s inner circle.

Dumin Jr. worked as Putin’s personal bodyguard beginning in 1999, when Putin was appointed acting president. In 2014, Dyumin became Commander of the Special Operations Forces, and according to Kommersant, he led the operation to evacuate deposed Ukrainian President Viktor Yanukovych (although Dyumin later denied any involvement). Dyumin was later named a Hero of Russia, did a stint as Deputy Defense Minister, and finally became governor of Tula region in 2016. In 2018, he was sanctioned by the United States.

Another sign of Pharmeko’s proximity to Dyumin Sr. is that after Dyumin Jr. moved to Tula, the company actively started doing charity work in the region. It helps local schools and orphanages, and even built a roller ski track in the city. “Somehow, we just got attached to the Tula land,” said Vladimir Babiy at the track’s opening ceremony.

But Dyumin Sr. isn’t Babiy’s only colleague capable of solving problems “from the top.” After retiring from medicine, former Equal of the Apostles Prince Vladimir Foundation Director Viktor Kostin spent a number of years serving in various positions in Yaroslavl’s local government.

In 2014, he left the public service to become Pharmeko’s deputy chairman — and became head of the Prince Vladimir Foundation almost simultaneously. Several years later, he left both jobs and returned to politics as deputy chairman of the Yaroslavl regional government, and in 2018 he was appointed chief federal inspector for Moscow in the office of the President’s plenipotentiary for the Central Federal District.

Kostin declined to answer Meduza’s questions, but while preparing this material, one of Meduza’s correspondents received calls from officials close to the plenipotentiary’s office who asked her to write “more kindly” about Pharmeko and the Circle of Kindness’s partnership; after all, they do such good work together.