Introduction. Ensuring the national interests of the Russian Federation in the World Ocean presupposes the development of medical and sanitary support for maritime activities, which currently requires integrated approaches in implementing the requirements for the preservation of the health of employees of the Russian fleet established by international legal acts on health and medical care in maritime navigation, of which the Russian Federation is a participant. In this regard, harmonization of legislation and improvement of measures related to the organization and functioning of seafarers' health protection centers are of particular importance.
 The study aims to conduct comprehensive legal monitoring of national regulatory and methodological documents regulating the activities of seafarers' health protection centers in comparison with international standards.
 Materials and methods. The authors have studied and analyzed scientific publications for the period from 1980 to 2023 defining the problems of medical and sanitary provision of water transport workers, methodological approaches of the World Health Organization, the International Labor Organization, the International Maritime Organization in this area, as well as current international and Russian regulatory legal acts, information from official websites of executive authorities and organizations.
 Results. The study found that today the system of seafarers' health protection, which previously existed in our country, has suffered significantly, and its restoration requires an integrated approach and centralization of medical support for maritime activities in accordance with the Maritime Doctrine of the Russian Federation and the Concept of Development of the Russian Federation Marine medicine. To this end, in the structure of organizations subordinate to the FMBA of Russia, in large port cities, head and regional centers for the protection of seafarers' health were established, carrying out accounting and analytical, organizational and methodological, regulatory, therapeutic and preventive, expert, scientific and educational activities. An important direction in the work of these centers is the implementation of preventive measures and the identification of occupational and work-related diseases. For the successful development of a unified system of medical and sanitary support for employees of the marine and river fleet, it is advisable to assign the functions of regulatory regulation in this area to the FMBA of Russia.
 Conclusion. The restoration of a full-fledged domestic system of providing medical care to water transport workers is possible through the creation and regulatory consolidation of the activities of seafarers' health protection centers in the structure of the FMBA organizations of Russia, which is an essential condition for achieving compliance of the national maritime policy with international requirements in the field of health and safety of navigation while maintaining its strategic goals and interests in the field of maritime and river navigation.
 Ethics. The study was conducted in compliance with Ethical standards. This study did not require the conclusion of the Ethics committee.
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