For Russia, Slovakia is becoming a key trading party.
As Medvedev arrived in Bratislava, Russian Energy Minister Sergei Shmatko and Slovak Economics Minister Lubomir Jahnatek unveiled a joint Russian-Slovak proton therapy center to aid cancer patients in the northern Slovak town of Ruzomberok, accorind to RIA Novosti.
But energy is the ultimate game. Russia has it, Slovakia is dependent on it.
It gets nearly all its gas and oil from Russia, and past gas spats between Moscow and Kiev left Bratislava and other Slovak cities and towns cold in the winter.
So desperate were the Slovaks in January 2009 when Moscow's energy taps shut off, they turned on a nuclear reactor that only a year earlier had been shut down over safety concerns that its Soviet-era technology could go kaboom.
The 2009 energy cut-off, impacted Slovak industry hard. Korean car maker, KIA, with a large plant employing 2,700 in northern Slovakia, had to cut back production as a result.
As this European parliament video shows, they weren't alone.
For the Russians, Slovakia offers a strategic location for getting their energy products to European markets. Plus, the Russians understand they have leverage over the Slovaks, given the latter's junky-like dependence on Moscow for energy.
So accommodating are the Slovaks, the country's parliament altered legislation to allow Gazprom to acquire a stake in the Slovak gas-distribution network.
And the Russians are appreciative.
During a visit to Bratislava last November, Prime Minister Vladimir Putin promised to upgrade one of the Soviet-era pipelines, according to Russia Today.
“The extension of the Druzhba oil pipeline may be rather promising. There is a proposal to extend it from Bratislava to the Schwechat refinery near Vienna. But we need further study.”
Here, Putin and Slovak Prime Minister Roberto Fico, discuss their countries' work-in-progress "energy pact."
Slovak state-owned downstream oil company Transpetrol is planning to connect Austria to the Druzhba pipeline -- pumping Russian oil to central Europe -- via a connector passing through the Zitny ostrov (Rye Island) protected area.
The proposal has been slammed by Slovak ecologists, who contend the extension could threaten a crucial water reservoir, as France 24 reports.
"An oil pipeline leading through Zitny ostrov would endanger a unique and irreplaceable drinking-water resource for Bratislava and surrounding regions," Zenon Mikle, spokesman for a company supplying water to the Slovak capital, told AFP.
Transpetrol and Austrian downstream oil giant OMV expect to start building the 62-kilometre (39-mile) pipeline connecting Druzhba and the Trans-Alpine pipeline in 2012.
While all eyes will be on Prague this week and the nuke treaty signing, Brussels and other policy wonks will be watching how much cozier Bratislava and Moscow become.
In central Europe, Russia may not have a better partner on the political front as well, despite the fact Slovakia is a card-carrying member of NATO.
Fico and his Social Democrats SMER party are not exactly star-struck by their Western elite counterparts, unlike much of the region.
The Slovak daily, SME, reports Fico did not meet with German Chancellor Angela Merkel, nor British Prime Minister Gordon Brown when those two titans came into Bratislava. The paper adds Fico will be meeting Obama for the first time at the Prague summit this Thursday, April 8.
Fico had the audacity to blame Georgia for starting the 2008 war with Russia, saying "It is clear who provoked this."
The ornery Fico caused an embarrassing moment at the NATO summit in Bratislava late last year when he stated almost defiantly that Slovakia would never host any part of the American anti-missile system.
Elites from Brussels and Washington dream for the day when Fico leaves office.
In Prague, Social Democrat leader Jiri Paroubek, however, sees Fico as Europe's most successful socialist leader.
As the Czech daily Mlada Fronta posits Medvedev's trip to Bratislava and Obama's to Prague underscore a subtle division of influence in former Czechoslovakia.
The daily says with Paroubek's Social Democrats favored to win upcoming parliamentary elections, that balance could shift a bit more in Moscow's favor.
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