Vladimir Putin is convinced Russia is surrounded by enemies: mysterious foreign agents lurking in non-government organisations, crusading sexual deviants intent on sapping the nation’s Christian morality and environmentalist-pirates sabotaging its Arctic oil drills.

The war against them may be real, but these enemies are fantasies. This battle is a tragic distraction. Because Russia’s real enemies are growing stronger, more resistant and ever deadlier.

Russia is gripped by an all powerful but grotesquely corrupt bureaucracy. No institution is more criminalised than its police force and prison guards. On the streets, police turn a blind eye to escalating heroin sales for cash kickbacks; in the worst prisons, guards sell it themselves.

Corrupt border posts keep Russia open to gigantic drug flows night and day. In the Siberian prison colonies, needles are shared across barracks, much like after dark in the dingy underpasses leading to Moscow’s overcrowded and imperial railway stations.

Mr Putin has failed to protect Russia. The nation is gripped by a demonic vicious cycle. Heroin is fuelling it faster and faster. The number of needle users in Russia is now more than 1.6m. When Mr Putin first entered the Kremlin in 2000, fewer than 100,000 people in Russia were HIV positive. Today there are at least 1.2m, with estimates that 5 per cent of all young people are now infected.

Driving through the industrial cities of the Urals region into the dying villages of Siberia, you see this catastrophe everywhere. Drugs are bought in broad daylight. Homeless teenage junkies are everywhere. You can easily see why the World Bank estimates that, by 2020, Russia will be losing 20,000 people a month to Aids.

Russia is in great, needless danger. This is a rich country committed to spending $755bn building up its military over the next decade. It may cost Moscow more than £20bn alone to pay for its recent power play to stop Ukraine deepening ties with the EU.

But this will do nothing to stop a new, virulent strain of HIV spreading through Siberia. Nor will it change the fact that by 2020 the number of HIV cases in Russia could surpass 5m. The infected population grew by 12 per cent last year alone.

The country needs a strong leader, one who will fight its real enemies. It needs a leader who will line the roads with posters warning the nation, not a president in denial.

Mr Putin’s war on imaginary enemies makes matters worse. His alliance with the Orthodox Church has shut down sex education in Russian schools. His ban on “homosexual propaganda” has criminalised even discussing gay sex with teenagers. Anti-NGO laws have dealt a heavy blow to the charities fighting HIV.

Russia needs a leader strong enough to break the cycle of corruption, heroin and HIV. A leader strong enough to break the criminalisation of the very agencies supposed to enforce the law – no matter the risks that they may pose to his power. A democratic leader whose praetorian guard will ruthlessly purge the police, not the opposition.

Moscow is one of the richest cities in the world. Its ruling elite is an insulated and wealthy plutocracy disconnected from its empire. Even the bulk of the Russian opposition – hipsters, intellectuals and affluent activists – take no interest in the plagues of the poor.

The underclass feels frightened and resentful. From the endless slab-like Soviet estates ringing the capital to the Arctic mining colonies, both the hipsters and oligarchs that make up the Moscow establishment are despised as callous and indifferent.

Racist vigilantes are filling the void. Heroin suppliers like to work through impoverished central Asian migrants. This means the working class accuse them of spreading drugs and disease. Race riots in Moscow are only the tip of the iceberg. Popular vigilante groups clash and harass migrants nightly. Dozens more riots have broken out in the regions.

In the Urals rust belt Evgeny Roizman, the newly elected anti-Putin mayor of Yekaterinburg, runs a vigilante group that attacks dealers, kidnaps addicts and locks them up in makeshift “cold turkey” camps.

Mr Putin claims not to use the internet. Even in the inner circle, nobody dares mention uncomfortable truths. This leader lives a lonely life of morning swims in the Olympic-sized empty pools beneath his palaces and evening ice hockey games against teams of bodyguards.

Isolated and in denial, the president is in fact little aware of the heroin epidemic and the depths of criminalisation of his bureaucracy. His henchmen are happy to keep him that way. It makes stealing billions from the Russian budget a far easier task.

The writer is the author of ‘Fragile Empire: How Russia Fell In And Out Of Love With Vladimir Putin’

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