Footage of the 73-year-old Russian President repeatedly coughing and clearing his throat has renewed the often feverish speculation over his wellbeing

Russia’s 73-year-old President, Vladimir Putin, notoriously curates his public persona to exclude any suggestion of frailty and illness. This weekend, though, a video was accidentally released showing him coughing and croaking, leading to an inevitable resurgence of claims of his having some deep-seated medical problem likely to lead to his imminent demise.

We’ve been here many, many times before.

The first time I encountered this particular product of the ever-active Russian rumour mill was in Moscow, in 2014, when the claim from a since-defrocked academic called Valery Solovey was that Putin had cancer and would be dead within six months at the most.

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Since then, the catalogue of medical catastrophes that have variously been inflicted on him range from leprosy and Parkinson’s to blood cancer and complications from cosmetic surgery. Almost invariably, the prognosis is that he will be dead or incapacitated within the same six-month term.

Indeed, in 2023, Ukraine’s Volodymyr Zelensky even speculated that he was already dead, and the ubiquitous Solovey went further later that year, asserting that Putin had died. His carcass, the story went, had been stuffed into a freezer in one of his palaces, and his place taken by a body double reading lines written by a cabal of senior figures.

Twelve years on from those first rumours, Putin is older and no doubt frailer. We no longer, thank heavens, have to swallow a diet of macho photo opportunities – bare-chested Putin on horseback, Putin demonstrating judo, Putin flying a microlight – but he seems in robust health. There are suggestions of thyroid problems, and we know that he has recurring back problems. Like any world leader of his age, he travels with an entourage of doctors.

Nonetheless, the CIA, for one, has every rumour and video clip scrutinised in minute detail by medical specialists, and their conclusion is that he is in relatively good health.

So why the rumours? There is often a degree of wishful thinking. Besides, in an environment of censorship and disinformation like Russia’s, knowledge is a currency, and everyone is trying to claim they have insider access.

Given just how personalistic the Russian system has become, spreading such rumours can also be part of a campaign of deliberate destabilisation. This is no doubt why the Ukrainians regularly amplify them – and why they seem increasingly to irritate the Kremlin. When I tried to ask a Russian government-adjacent commentator about the latest video, he put the phone down.

After all, any questions over Putin’s health implicitly question the health of his whole system. It is a mark of this sensitivity that, while last year Putin claimed that he was “always” thinking about the question of succession, it has become a taboo subject. No one dares publicly to speculate about it, let alone suggest that they would be willing to step into his shoes.

Putin is avoiding any hint that he has chosen an heir, not least out of fear that this would make him a “lame duck” president, marginalised by an impatient successor.

It may be that he will someday be forced to do so, especially if illness does begin to call into question his capacity to remain in power. Doing so, however, would put his fate (and his fortune) squarely into the hands of this successor – an act of trust that would not come easily to this notoriously wary man.

If forced to take this step, Putin would presumably pick someone he feels would protect not only himself and his family but also his legacy. Perhaps this would be some veteran of the security apparatus like Alexei Dyumin, one of his bodyguards who was promoted to be first governor of Tula region, and now a presidential aide.

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However, if Putin dies in office, although there is a constitutional process – the prime minister steps in as interim president, with elections to be held within three months – in practice, as when dictator Stalin died in 1953, powerful figures and power blocs will probably gather behind closed doors to hash out a succession. No one individual or institution currently has the power to take over, so this would be an exercise in horse-trading and coalition-building that would be likely to see the presidency pass to the next political generation.

Depending on when this happens, the new president might not be anyone to whom we currently pay much attention. He – and it almost certainly will be a he – may even simply be a figurehead (perhaps former presidential stand-in Dmitry Medvedev) for such a coalition, ironically echoing Solovey’s claims about the alleged Putin double.

Still, with Putin and China’s Xi Jinping having publicly mused on how, with advances in medical technology, people might be able to live for 150 years or even longer, this may yet be premature speculation.