In 2012, as part of his “May Executive Orders,” Vladimir Putin gave his government six years to reduce the number of Russians killed by circulatory-system diseases, neoplasms, and tuberculosis. In September 2017, state officials stood and saluted, announcing that Putin’s decree had been implemented.

According to the newspaper Vedomosti and researchers at the Russian Presidential Academy of National Economy and Public Administration, however, Russia’s health authorities seem to have lowered the mortality rates on ailments mentioned in Putin’s executive orders by attributing deaths to other causes.

Where has this been happening?

The most radical declines in deaths from circulatory-system diseases were recorded in Mordovia, Ingushetia, Amur, Tambov, Vladimir, Nizhny Novgorod, and Mari El. In these same regions, the number of deaths caused by mental disorders, illnesses of the endocrine, genitourinary, and nervous systems, and other diseases nearly doubled. In all these regions except Ingushetia, deaths attributed to these factors have been above Russia’s averages in recent years.

How did this happen?

According to Larisa Popovich, the director of the Institute of Public Health Economics at the Higher School of Economics, sometimes on death certificates doctors can attribute a patient’s cause of death to proximate causes, instead of direct causes. For example, if a person dies from an embolism while suffering from an endocrine disorder, physicians can choose either condition as the cause of death.

Since December, staff at some universities and hospitals throughout Russia have reportedly been receiving unusually high salaries — sometimes five times higher than normal. Moscow’s Economic Policy Department told the magazine RBC that the bigger paychecks are part of Putin’s “May Executive Orders” from 2012, though it wouldn’t explain why the pay raises are only happening now, more than five years later, just a few months before the next presidential election.

The Kremlin, by the way, is reportedly preparing another set of “May orders” for 2018.