Former head of the anti-doping commission of Rossport, and now head of the medical center of the Continental Hockey League Nikolai Durmanov confirmed in an interview with Chempionat.ru that in the near future he could go to Switzerland to open doping tests for Russian biathletes. At the same time, he refuted the opinion that with a positive sample, A B will also give a positive result.

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Nikolai Dmitrievich Durmanov
Born May 5, 1946 in Moscow. Graduated from the First Moscow Medical Institute. After graduation, he worked in the system of space medicine for many years. Managed biotechnological productions in Russia. Specializes in genetic engineering. He worked in this profile in more than 30 countries of the world. Nikolai Durmanov was a member of UNIDO, the United Nations Industrial Development Organization, for several years.
From 1990 to 1998, he headed the Biomedical Center at UNIDO.
Since 1998 he has been working in the system of the Russian Olympic Committee (ROC).
From 2001 to 2007, the professor headed the anti-doping committee federal agency on physical culture and sports of the Russian Federation.
Since the fall of 2008, he has been the head of the medical center of the Continental Hockey League.

How legitimate is the information that you are flying to Switzerland to represent Russia at the autopsy of the B sample of the doping tests of our biathletes?
- I will give an exhaustive formulation: there is such a possibility.

- You are now working in the KHL. Why did they target you in this case?
- I have dealt with anti-doping issues for many years. On duty, I had to deal with all sorts of incomprehensible stories. With new and supernova dope. In addition, I am well acquainted with the global anti-doping community. Including with colleagues in Lausanne. I am a genetic engineer by training.

- That is, you do not have a corresponding position now?
- No. And I want to emphasize separately: thank God that neither this nor any other doping has anything to do with our hockey. And let's pray for it to continue.

Svetlana Ishmuratova stated that if the A sample is positive, then the B sample will also be positive. Is it really true?
- With all due respect to our great athletes and coaches, who are now commenting on this topic, I must say that this is far from the case with erythropoietin. This does not mean that someone expects someone to smear. No. The main thing now is to find out what really happened. And the function of experts in this case is to find out the real circumstances of the case.

- Is erythropoietin doping itself?
- More doping. Terrible dope! Nightmare dope! We've had enough of him already.

The work will be carried out in the most serious way, and at the same time in the most respectful manner in relation to all. Therefore, talk about a conspiracy, about what they “packed”, what they again guessed for the World Cup, is inappropriate.

- What functions does it perform?
- In normal medicine, millions of people need it. Hundreds of thousands, maybe millions of people are indebted to him: those who live on an artificial kidney. Those who are being treated for cancer. And many others. Well, in sports it is used as a powerful doping. It increases the amount of hemoglobin in the blood. Accordingly, endurance increases and the risk to health increases.

- According to your practice: could such a storm rise from scratch? Could there be a mistake?
- In Russia now there is a national anti-doping organization: RosADA. She tries to build her work on international principles. On the principles approved the international community. RosADA has a huge number of connections with other organizations, very respectful relationships with WADA, a number of major international sports organizations. And these relationships lead to the fact that if we have any information, then it has a very good reason. In addition, any anti-doping laboratory, valuing its reputation, will double-check itself several times before announcing any positive doping result. And in the case of erythropoietin, he will also ask for the opinion of an independent organization.

- But in this case, the information was not from our side.
- This does not exclude the fact that everything was rechecked. In this world, everyone respects each other and they won’t raise a fuss just like that.

The main thing now is to find out what really happened. And the function of experts in this case is to find out the real circumstances of the case.

How weighty is the news that a drug has been diagnosed for the first time in the history of international sports? That he is the last generation.
- Quite possible. Actually, one of the tasks of both our anti-doping services and the biathlon union, as I said, is to find out the real circumstances of the case. If it turns out that this is really doping - well, well ... The work will be carried out in the most serious, and at the same time, in the most respectful manner in relation to everyone. Therefore, talk about a conspiracy, about what they “packed”, what they again guessed for the World Cup, is inappropriate. No one plays these games in these circles. It's really about the problem. And how serious the problem is, we will find out. Whether the athletes are guilty in this story, we will also find out. It's too early to talk about it yet.

- When will it be determined whether you are flying to Lausanne?
- I am often asked the question: why do the tests take so long? It seems to many that he took a doping test, dropped it into the device and after half an hour everything is drawn there. But this is a whole network of scientific experiments, rechecking, re-arranging analyzes. I would also like to say this: there are regular problems with some new superdopings. You don't have to look far for examples. For example, third-generation erythropoietin, which crushed the Tour de France. Or a designer steroid: THG, the tetrahydrogestin that has been causing a fever in American athletics for several years. A number of new drugs that appeared in sports, and there was a lot of noise and a lot of litigation about this. So, sadly, but before us is a “normal” element of the sports landscape. Therefore, I would not dramatize the situation. Let's figure it out.

The main biological threat is human ignorance. Mr. Durmanov, as a representative of official science, demonstrates exactly this. He is smart, very smart. Woe from wit - just the same case. To what does he lead the consciousness of the crowd? Catastrophes are inevitable, a food crisis is inevitable, epidemics are inevitable, there is little land, little water, global warming will wash everyone away, GMOs will save us all, and man ... is generally alien to the biosphere. A curtain! We applaud standing.

"It can be assumed that the phenomena, those that we are trying to explain with simple mechanisms of the biosphere, are actually part of a larger picture. In this case, we can agree, if not to the Rothschilds, then to aliens, the parallel existence of the Universe ... to reptilians. I am a technical person I am a designer of biosafety systems, therefore, by an effort of will, I single out a more or less rational platform for myself, while being aware that it is quite possible that I am wrong and it is better to open the Bible."

“We gobbled up the planet, we didn’t leave anything for our grandchildren…”, “people go to the stadium to watch how some of the people in red trample people in blue, while everyone is yelling and drinking something incomprehensible, obviously harmful” “some kind of madness then…”, “any kiosk sells tobacco, which collects half a million lives in our country and our closest neighbors, the same vodka…”, “we adopted Western standards: eat more, consume more, whether it’s emotions or services, no one necessary…”, “everything that a person made with his own hands or with an excavator bucket -50 kg per square meter of the planet’s surface… is incredible! We have remade the Planet... at the same time, the volume of the biosphere, taking into account the depths of the ocean, endless steppes, cattle pastures, is 2 kg per square meter.", "we made an attempt to dominate ... do not give a damn about everyone else, on this Planet", "we manage to maintain the status of the main pest on the Planet, then we will live as we lived ... if not, Nature will reduce us to the amount that it considers rational ... "

Modern science has taken a big step forward in medicine, biology, and genetics. Many things, such as the human genome, for example, have become a solved problem. However, against the backdrop of a huge number of pluses, an equal number of new risks and problems have appeared. And it is not known what will be more as a result.

The seventy-year vacation from diseases is coming to an end. Penicillin, discovered by Alexander Fleming in 1929, became the beginning of the production of a "superweapon" - antibiotics. But, developing science and not realizing the full value of this tool, a person found application for it in all areas of his life, which greatly reduced the period of its usefulness.

Now we are faced with how nature has found an antidote to our antibiotics, superbugs have evolved and mutated under the influence of these drugs, and their "golden age" has come to an end. Pandora's box is open - more than 400 viruses relevant to humans are on the loose (Ebola, Zika and others). What does this threaten us with? What should a person do in order not to return to the days of the "Spanish flu" and yellow fever?

These and other questions will be answered by the guest of Mikhail Kovalchuk - Doctor of Medical Sciences, Professor Nikolai Durmanov.

Durmanov: the crisis of medicine and biological threats

The development of technologies in medicine in the near future will be built according to the reactionary principle. We are still creating new drugs today to fight the ever-evolving viral and bacterial infections.

However, before "nanosubmarines transporting drugs across circulatory system", it may not work out. The bacteriological threat is too serious, and the problem is that our antibiotics will simply cease to work.

N. Durmanov

"In the last few billion years, microbes have been doing nothing but crushing each other with antibiotics or looking for a way to escape this pressure. Accordingly, our naive attempts, having peeped some means of fighting microbes with each other - namely, this is what the first antibiotic looked like - penicillin, this is a means of fighting mold with bacteria - to solve once and for all the problem in the relationship between microbes and humans.The number did not pass.It took only two or three generations in terms of human life, and we see that the system is not working. However, Fleming himself warned about this in 1946, and even earlier Pasteur uttered a wonderful phrase, saying: “You know what, gentlemen? the last word microbes!” This was said before the invention of antibiotics.”

According to Durmanov, the already difficult situation in the bacteriological field will only get worse. Thus, cancer patients are completely dependent on antibiotics, and without effective drugs, they will simply die. But already today in many hospitals half of the antibiotics do not work. It will be impossible to carry out a number of operations, for example C-section during childbirth. Even going to the dentist can be dangerous.

In fact, we ourselves as a civilization are digging this hole. After the creation of penicillin, which solved a number of problems at the moment, humanity began to use antibiotics in all areas of its life, for example, when raising livestock. And we use them freely. As a result, we "train the microbiota", creating a testing ground for microorganisms and an additional system for selecting the strongest. What does this lead to today? In addition, we sort through antibiotics in the treatment in an attempt to find one that works.

The most serious threat, according to Durmanov, is "superbugs". When we exclude the antibiotic from the environment, the trained microorganisms regain their competitiveness. Microbes that are resistant to drugs and, moreover, able to compete on equal terms with their counterparts - these are the "superbugs". And they also exchange genetic material among themselves, providing each other with protection sometimes not even from one, but from several drugs.

N. Durmanov

“Many people say: what about from the point of view of the economy? This is the data of Jim O'Neill, the same economist who came up with the abbreviation BRIC. He says: "By 2050, the total cost of antibiotic resistance will be 100 trillion." This is more than the GDP of the entire planet now. The death rate is 10 million lives a year, more than during any war in the history of mankind. And most likely, 40 million. That is, we are facing a phenomenon that, in principle, poses a threat to civilization, to the economy, to social stability."

It would seem if we are talking about such serious losses, it is logical to invest billions of dollars in the creation of new antibiotics. But the lecturer is sure that this is a pointless undertaking. Durmanov recalls that the last truly new antibiotic was developed over 30 years ago. Everything else is just new references to what was invented by nature with minor modifications. And while something is working out, only the time between the introduction of the drug and the formation of resistance is rapidly declining.

From an economic point of view, contrary to popular belief, antibiotics are completely unprofitable. A drug that requires billions of dollars of investment and ten years of research and development is rapidly losing relevance and is too cheap. Subsidies and special programs to force pharmacists to develop new drugs in fact do not lead to tangible results, the lecturer believes.

If we return to the question Agriculture, then flooding with drugs, spraying fields with chemicals - all this will bring less and less benefit in the near future. Already today, instead of 3 times, some Indian farmers are forced to spray their fields 30 times. It will help in some way Information society: Apps will allow you to find the right combination of protections that still work. That is, farmers will, like doctors in intensive care, sort out drugs and look for a worker. This is called stewardship.

N. Durmanov

“These services, these systems for optimizing the use of agrochemistry, and agrochemistry now is about 30% of all costs - this is the future of agriculture. And, most likely, in both medicine and agriculture, for every dollar of the cost of their own drug, there will be 10 dollars. these same stewardship programs. What will they look like? Mobile services, drones, sensors in the fields, remote control using satellites - this is not so important. Important: to use some kind of drug, you need to spend 10 dollars for 1 dollar to understand which drug to use, when and in what mode!

A separate issue without an explicit and unambiguous solution will be "killer drugs" that enter the body, but behave inappropriately. Either they excite the system, but are not removed from it, or they do not act and are not removed, accumulating in the body.

And the person himself exacerbates all these problems due to his psychology. We are not used to listening to doctors. And, for example, antibiotics are often used for viral diseases, from which they, in principle, are not able to cure, as they are adapted to combat bacterial threats. In the era of omics technology, you can't do that. Omix technologies are a whole complex of the most modern technologies, including genomics, transcriptomics, proteomics and metabolomics.

N. Durmanov

"Superactive drugs are entering the arena - targeted drugs, expensive. But the really strong ones will collect their victims. It seems that in 15 years this figure for the United States of America will be a trillion. A trillion! You can extrapolate to us, and the extrapolation is not easy here. There are fewer of us twice, but we are not as disciplined as the Americans. Therefore, we are also expecting monstrous losses in this area, not to mention the fact that the drug is wasted. Although this is politically incorrect."

Nikolai Durmanov proposes to establish a system in agriculture and medicine according to one principle. In the field of "doctor-patient" communication, the option will no longer work when there is no centralized information system. There should be some data field available to everyone and explaining plain language what can and should be taken for a specific disease, and what should not be taken in any case. Labeling within the Internet of things will also contribute to the exclusion of counterfeit goods.

Omix technologies are already working today, and we can really talk about positive results. So, the drugs developed with their use made it possible to finally defeat hepatitis C. The downside is the exorbitant cost of such drugs. In countries where they would be most relevant, people and the health care system do not have the money to buy them.

N. Durmanov

"Arose alternative medicine before our eyes. It has no doctors. By the way, this is a very interesting phenomenon. This is a spontaneously organized community of patients who immediately found out where you can smuggle drugs, where you can get them, how you can go there, where you can get a visa, how to hide these drugs, because they are shaking here and there at the border, how to use them. to what extent it is possible to apply to official medicine, for example: they go to the laboratory, they want a special apparatus that evaluates the state of the liver. But there are no doctors here. From time to time someone comes here and says: "How great, I'll educate you now." This community exiles the Medic from their membership. Before us is the spontaneously organized "Medicine 3.0", the slogan of "Medicine 3.0" - there is such a famous doctor Eric Topol in America - is the phrase "Now the patient will examine you." That is, the opposite is true. The patient chooses doctors. The patient chooses a treatment system and must understand what it is and measure this matter with their financial capabilities."

Nikolai Durmanov believes that "Medicine 3.0" is a threat and at the same time a chance to build a more up-to-date medical system. A threat - because qualified specialists can be squeezed out of medicine and it itself will be destroyed. A chance - because society begins to pay attention to what is happening and can respond in time to dangerous trends. This is not a substitute for treatment, but a good guiding signal for physicians, indicating what and when to expend energy. Nikolai Durmanov applies the term "metasensorics" to a single informational fabric.

Speaking of "superbugs", we should not forget about the long-forgotten topic of infectious diseases. 70 years ago, humanity decided that they were done with. But it was infections that changed the course of history more than once. It was they who allowed the conquistadors to capture South America, when smallpox decimated most of the indigenous population, made the United States an English-speaking country when Napoleon's expeditionary force was slaughtered by yellow fever during an attempt to suppress an uprising in Haiti. Otherwise, the southern states would have remained French.

Why are the old threats coming back now? Because there are too many people, while they are actively moving around the planet, bringing with them those diseases that have long been forgotten. An example is Ebola. In the near future, we will encounter superviruses - the product of the recombination of existing ones.

N. Durmanov

“When the British brought smallpox vaccine to America, they had to sail for some time, a month, say, or half a month. How to bring it? They caught homeless boys in London and began to vaccinate them one by one, from one to another, from one to another. And at the moment when they swam ashore, they have him, a boy who still has a live vaccine, which became the basis for the vaccination of white settlers. Great. Now there is no such problem. A man from Kinshasa, after two transfers, ends up in St. Petersburg and passport control starts coughing. Hello! Our ventilation system will remarkably reproduce this whole story for the entire Pulkovo airport. So, this is the first problem: there are many of us, we climbed everywhere.

Urbanization is also becoming a problem. Oddly enough, in the modern world, a significant proportion of the urban population are the poor. Moreover, the cities themselves are not adapted for a normal healthy life. Unsanitary conditions, irrational use of antibiotics or lack of them - all this becomes a breeding ground for new types of diseases and a testing ground for virus recombination.

N. Durmanov

"There are now 1,500 of them (viruses), of which 350 are new. Just think, in 40 years there are 350 new viruses, many of them are extremely dangerous. MERS, SARS are SARS, but these are all some kind of wrong names. There are more romantic names like Rocky Mountain Spotted Fever, Kyasanur Forest Disease, Chukungunya, Hanta, Lasta, Dengue, etc. Romance And behind every romantic daytime incubation period and almost guaranteed death.

Despite the fact that we live in the era of information, when we talk about epidemics, the authorities and relevant departments are sometimes forced to make cynical calculations and hide the true scale of the problems. Otherwise, in addition to superbugs and superviruses, we will also be threatened by panic. After the start of an epidemic that could take the lives of 15 thousand people in one particular city, the state should not trumpet the problem at every turn. Otherwise, people will try to escape from the city, and there will be much more deaths in the stampede, traffic jams, and pogroms.

For this reason, for example, in the United States, a plan of action has long been developed depending on the severity of a biological threat. This applies not only to diseases that spread naturally, but also to biological terrorism. A bucket of anthrax spores can have the effect of a megaton nuclear bomb, and in this case it is worth issuing information in a dosed manner, and at the same time putting corpses in special coffins at stadiums, minimizing the risk of further aggravation of the epidemic.

If we talk about bioterror itself, then it is possible to carry out a devastating terrorist attack with little or no investment, and it is very difficult to prevent it.

N. Durmanov

"A bucket of anthrax spores can be produced at a cheese factory. You can dig up a bacterium from the nearest cattle burial ground, for free, maps of cattle burial sites are in the public domain. And there is even a mark there - anthrax or not anthrax. Grow - no big problems. How to produce a combat uniform aerosol is also not a big problem. That is technically there are no problems at all. As Obama said, "The most interesting thing about bioterrorism is why it hasn't happened yet!" The Americans, and we too, have special systems that are trying to deal with this. Here is the famous American Prism system, according to which any of your text messages, any like on Facebook, any Twitter is analyzed in supermachines to see if you are the same person who wants to send a gene to Malaysia, to Kuala Lumpur, but they go to Islamabad to grow a bucket of this very anthrax in an abandoned factory. All this is. But it looks like we're late. Because besides classical bioterrorism, there is also this one: martyrs infected with smallpox flew to three airports - it is impossible to catch them, because smallpox has a 14-day incubation period. He is healthy, his temperature is normal, but he is contagious!"

In the future, bioterrorism may become something of a hooliganism. Thanks to the fact that the data is on the Internet, it will be possible to conduct experiments, collecting the necessary ingredients and creating weapons. And the tension of forces in an attempt to overcome global threats play into the hands of bioterrorists. This problem, Durmanov argues, does not yet have a solution. Genome editing is our control over the biosphere. Humanity is correcting itself to defeat diseases, primarily those based on problems in individual genes. This can be done in advance, before childbirth.

But in fact, now we see that in countries like India, the identification of genetics allows parents to determine the sex of the child at an early stage, and if it is a girl, they simply have an abortion with a pill. So far, this is a primitive, but the lecturer suggests that genomic editing will become a legal or illegal mechanism for correcting people. And oddly enough, one of the most devastating diseases are mental disorders.

N. Durmanov

"This problem, which is called The city, rapid urbanization, leads to the fact that cities are filled with tens of millions of people, cut off from their usual way of life, from their usual way of thinking, from a certain rhythm, mental, cultural, social. This is an ideal environment for development various diseases - schizophrenia, bipolar disorder, what used to be called manic-depressive psychosis, depressions, especially depressions. Anxiety syndrome - and so on, and so on.

The real numbers are hidden, more difficult to reveal than the losses from epidemics, but Nikolai Durmanov says that even according to a conservative forecast, we are talking about trillions of dollars. 25% of the inhabitants of large European cities and up to half of people in the creative environment can be considered schizophrenics. At least they have certain psychological deviations. These citizens need to be treated because they can be dangerous to society. And besides, they are more vulnerable to other types of diseases. They get sick two to three times more often than mentally healthy people. In order to treat and to identify manic moods, humanity will create new systems for collecting and analyzing information. This is also a threat.

N. Durmanov

“It means that all my knowledge that I will collect on a legal basis, I can use to produce something very exotic. fans to use this most powerful tool... After all, with the same probability with which we collect key information, we can reversely modify the consumer, political, social, gender preferences of the audience - a powerful tool feedback feedback".

Nikolai Durmanov believes that humanity has neither the strength nor the money for everything at once. The only chance to level the damage is to prioritize correctly, and not to “play around”, spending money on technology for the sake of your own amusement.
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