Russian population health status is analyzed during last 25 years and in comparison with European Union countries population health status. The major problems of Russian healthcare system and challenges which will affect its policy next 10 years are outlined. Based on the results of analysis and taking in account the lessons of domestic health reforms the main conclusions are made and key elements of National health Strategy are formulated. The main conclusions are:

1) Russian population health status improvement could be achieved if public health expenditure is at least doubled.

2) Public health investments are promoting economical development with the 200% profitability.

3) In the situation of an economic crisis public health spending increase will improve social and political stability.