Under the headline "A Sickness of the Soul" the Economist reports on Russia's dire demographic crisis, the sign of a fundamentally failed society, failed at the level of biology.

OLGA wants her first baby, just delivered in the Siberian city of Irkutsk, to have two siblings. Whether he will get them depends on whether she and her husband can afford them. Yes, she says, President Vladimir Putin's new plan to boost child support, and pay a lump sum for second babies, might help.

Mr Putin's aim is to boost Russia's birth rate, which plummeted after the late Soviet period and has stabilised well below replacement level. His ultimate goal is to arrest and reverse Russia's headlong population decline. Despite a large influx of ethnic Russians from elsewhere, the population has fallen by 6m since the Soviet Union collapsed, to 143m. It is falling still, by around 700,000 a year. There may be fewer than 100m Russians left by 2050.

Olga's interest notwithstanding, Mr Putin's plan is unlikely to halt the slide. That is partly because the trend is an old and accelerating one. Money worries do not entirely explain it: some of the poorest groups in Russia (most of them Muslim) are the most fertile. In a way, wealth is even a contributor: Western lifestyles and expectations have spread into Russia and, by European standards, the birth rate is low but not outlandishly so. Anatoly Vishnevsky, of the Russian Academy of Sciences, points out that, elsewhere, maternity bribes have produced a short-term baby rush but little long-term effect.

But the bigger reason for scepticism is that Russia's truly startling demographic problem is its amazing death rate, which has leapt as fertility has crashed, and is now more than twice western Europe's. Most of the leap is accounted for by working-age men. At less than 59, male life expectancy has collapsed in a way otherwise found only in sub-Saharan Africa. It is around five years lower than it was 40 years ago, and 13 years lower than that of Russian women—one of the biggest gaps in the world. Male life expectancy in Irkutsk (not the country's lowest) is just 53.

Russia leads the world, in fact, in a staggering range of scourges and vices. Nicholas Eberstadt, of the American Enterprise Institute, speculates that the heart-disease rate may be the highest anywhere, ever. Russians' propensity to die violently is probably unprecedented in industrialised societies at peace. The suicide rate is more than five times Britain's. With fewer cars, Russians are four times more likely to die in traffic accidents than Britons. Murder is 20 times more common than in western Europe. And so on.

There is an obvious culprit: booze, especially the Russian taste for strong spirits, sometimes not fit for human consumption and often moonshine. Heart disease and violence, the two biggest factors in the mortality surge, are strongly alcohol-related. Alcohol poisoning itself killed 36,000 Russians last year; in America, it kills a few hundred. Mikhail Gorbachev's efforts in the late 1980s to rein in alcohol consumption briefly improved life expectancy. In Irkutsk Igor Bolugin runs a club for children of alcoholics, sometimes taking them to Lake Baikal (see article). Many are themselves drinkers from around 13; in the villages, says Mr Bolugin, the drinking starts much younger.

But the obvious culprit is only part of a complicated, self-destructive syndrome. Other factors include smoking (among the highest rates in the world), pollution, including radioactivity, and a grim and corrupt health system. Alcoholism itself is a symptom. Some see the stress and inequality brought on by the Soviet Union's fall as the cause. But a wanton disregard for their own lives set in among Russian men long before that, and has persisted even as the economy has turned round. Sergei Voronov, deputy governor of Irkutsk, blames the local gene pool, derived largely from Soviet-era prisoners.

Whatever its causes, and shocking though it already is, Russia's national sickness is now likely to worsen, because of AIDS. Since the disease arrived so late, the Russians ought to have been ready. Instead, out of prudishness, intolerance and Soviet-style pig-headedness, the response was criminally lackadaisical. This year the federal AIDS budget is around 3.3 billion roubles ($124m) with extra funding coming from abroad: it was a big increase, but it is piffling by international standards.

In Irkutsk, which has Russia's highest HIV-infection rate, it shows. Packs of stray dogs prowl the grounds of the hospital that houses the AIDS clinic. Yulia Rakhina, its boss, maintains that attitudes, not cash, are the main obstacle. Young people do not use condoms, she says; even HIV-positive people are blasé. “It's hard to explain to someone who feels well that they're going to die.” Like all Russians, says Ms Rakhina, they want to live better, but do nothing about it. Only 200 people in Irkutsk (a city of 600,000) are on anti-retroviral drugs.

Nationally, says Vadim Pokrovsky, head of the federal AIDS centre, some 20,000 will get drugs by the end of 2006—up from 4,000 at the start of it, but still low. The best guess for the total number of HIV-infected Russians is around 1m. (Rates of other sexually transmitted diseases are a guide, and syphilis is dozens of times more prevalent in Russia than in western Europe.) AIDS-related deaths are of hard to measure, partly because of Russia's astronomical level of tuberculosis. The number of future infections, says Mr Pokrovsky, will depend on whether the epidemic continues to shift from drug-takers to the general population. Irkutsk's infection rate reflects its big drug problem; but now, says Ms Rakhina, 70% of new female patients contract HIV from sex.

The immediate result of all this is a huge toll of tragic and needless early deaths. But its health and demographic malaise will also warp Russia's future. The army is struggling to find as many healthy recruits as Russian generals say they need. The population is ageing and sickening: behind the headline death rates is a secondary plague of incapacity. The workforce is shrinking. Yet, as a racist bombing at a Moscow market last month and a near-pogrom against Caucasians in a northern town this week both suggest, Russians are ill-disposed towards the new immigrants their economy increasingly needs.

Some, including Mr Putin, have gone so far as to prophesy the death of the nation itself. In Irkutsk the big fear is the “yellow peril”. As people quit cities that should never have existed, the population of Siberia and the Russian far east has shrunk faster than the rest of the country's. Those who remain fret about Chinese hordes swarming across the border, intent on annexation. “They work for kopeks and live ten to a room,” complains Alexander Turik, an Irkutsk extremist, also alleging that Chinese men are paid to marry Russian women. Even some Chinese worry: Changa, a long-term trader in the Irkutsk market known as Shanghai, grumbles that recent arrivals are damaging business.

It is an ancient Russian anxiety, though probably an irrational one. Many of the Chinese, like Changa, are shuttle traders rather than colonisers. Still, even if fears of Russia's dismemberment are fanciful, its demographic course will render it a different country, and probably a more ungovernable one. That, plus Russia's incubation of assorted epidemics, ought to be a worry for other countries too. Alas, persuading Russia and the Russians to change their ways has never been easy.