Exciting news: Today, the United Nations Country Team (UNCT) in Kyrgyzstan established a Youth Advisory Board (YAB). The YAB is composed of 13 young people from different regions in Kyrgyzstan with diverse backgrounds and interests, including representation from various under-represented youth groups. The YAB’s primary mission is to provide valuable insights and guidance the UN in Kyrgyzstan on the integration of youth issues into UN strategies and programs. “As members of the Youth Advisory Board, you will play a critical role in promoting meaningful youth engagement and bridging the gap between the UN and the young population of Kyrgyzstan, advising us on how to make the UN Sustainable Development Cooperation Framework (UNSDCF) 2023-2027 more effective in responding to youth aspirations”, said Antje Grawe, the UN Resident Coordinator in Kyrgyzstan, addressing the members of the YAB. With the establishment of the YAB, the UNCT Kyrgyzstan takes a major step forward in championing youth empowerment and inclusivity.

Ymyt has been struggling with hypertension for over 36 years, which requires her to take medicine twice daily. Half of her monthly pension, which amounts to US$ 35, is spent on her treatment. Until now, Ymyt has had to work as a seller in a local shop as her monthly pension is not enough to meet her basic needs.  For the first time in Kyrgyzstan, prices of medicines are being regulated via a government decree introducing price controls for a number of medicines prescribed at the primary health-care level for the treatment of noncommunicable diseases (NCDs).  This effort, supported by the Universal Health Coverage (UHC) Partnership – WHO's largest initiative on international cooperation for UHC and primary health care – aims to increase the affordability of these medicines, which is critical in addressing the burden of NCDs in the country. Introducing a new price-control mechanism To improve price transparency and to inform the amendments to the price-control regulation, WHO organized several policy dialogues with manufacturers and distributors in Kyrgyzstan. Following these discussions, the revised draft legislation was approved in July 2021.  With the support of WHO and other development partners, a temporary price-control mechanism for selected medicines is currently being piloted across the country. According to a preliminary analysis conducted by national authorities, prices of selected items have decreased by 3–5%. A permanent regulation drafted by the Ministry of Health's working group is currently undergoing public consultation before being formally submitted for approval by the Cabinet of Ministers.  The effects of these first price-regulation measures are modest, and the Government is working on further measures to improve access to medicines and decrease the financial costs to patients. Ensuring effective regulatory practices for medicines  The Ministry of Health is also collaborating with WHO to update its legal framework to ensure people have access to safe, effective, high-quality medicines. Revisions to laws concerning medicines and medical devices have been made, and additional sub-laws and amendments have been developed. As a result, the list of essential medicines subject to price regulation has expanded, and good regulatory practices for medicines and medical devices have been introduced.  The legal basis for implementing a medicines tracking system has also been established, which will enable the creation of an electronic database of medicines to manage stocks, improve pharmacological control and prevent the smuggling of counterfeit drugs. Different approaches to marketing approval for various groups of essential medicines have also been identified. WHO remains committed to assisting Member States in developing policies and guidelines that encourage the responsible selection and use of medical products and medicines, and supporting them in enhancing access to reasonably priced, high-quality essential medicines. To achieve this goal, WHO will continue to organize policy dialogues with health ministries and social health insurance authorities across the WHO European Region.

Abdyjapar Safarbekov has lived in Ak-Jar, a rough-hewn settlement known as a novostroika, with his family for more than 17 years. This settlement, consisting of 1900 households with 5600 inhabitants, is located on the outer limits of Bishkek, Kyrgyzstan’s capital, along with 47 other settlements established in 2005.  Like thousands of other Kyrgyz citizens, Abdyjapar considers himself an internal migrant. He moved to the capital mainly for economic reasons, hoping for a better life. Bishkek and Osh are popular destinations for internal migration and internal migrants make up a reported 35% of Bishkek’s population. Most of them live in informal settlements around Bishkek, which means their numbers may even be higher than officially reported.  As Abdyjapar explains, he struggles to access health and social services due to a registration system known as propiska, which requires migrants to register to receive public services such as health care, water, education, and energy. To obtain city registration, internal migrants must receive legal status for their homes and complete additional paperwork, which is a costly and time-consuming process, especially in light of precarious, seasonal or part-time employment.  Vaccination hampered by socioeconomic challenges  Abdyjapar was elected as head of the village last year to solve the socioeconomic difficulties of his community. Among his activities in this role, he actively promotes COVID-19 and routine vaccination among villagers. As he emphasizes, “I believe that vaccination can save lives.”  “COVID-19 vaccine hesitancy has been a real challenge amid all the rumours and disinformation about the vaccine,” continues Abdyjapar. “The reluctance stems partly from myths such as the pandemic being a foreign conspiracy. The hesitancy is also based on cultural and religious beliefs.”  To counter myths and misinformation, Abdyjapar involves religious leaders to deliver sermons, to remove doubts and fears, as part of an awareness campaign. After a detailed conversation with vaccine-deniers about the importance of vaccination for their overall health, villagers usually agree and accept the shot.  Abdyjapar has also helped mobile immunization teams organize vaccination sessions for his community members and encourages people to take advantage of this opportunity to be vaccinated in line with the national immunization schedule and against COVID-19.  Mobile immunization teams help to improve access to immunization With technical assistance from WHO, health authorities in Kyrgyzstan established mobile immunization teams to improve access to immunization services and COVID-19 vaccination during the pandemic for people living in remote, hard-to-reach settlements and for children of internal migrants in large urban settlements such as Ak-Jar.  The mobile immunization teams have been vital in filling gaps in immunization coverage caused by a disruption in the provision of routine immunization services during the pandemic, tailored carefully to the needs of the population.  For example, in the period May–December 2020, the mobile teams vaccinated 155 003 people, including 80 153 children under one year of age, and 18 949 adults with the vaccine against tetanus and diphtheria (Td vaccine).  In 2021, teams involved in 6 rounds of mobile immunization sessions vaccinated an additional 171 161 people, including 158 047 children under 16 years of age. The mobile teams also provide vaccination against COVID-19.  Any disruption of immunization services, even for short periods, can result in an accumulation of susceptible individuals and a higher likelihood of vaccine-preventable disease outbreaks. Such outbreaks may result in severe illness and deaths and an increased burden on health systems already strained by the response to the COVID-19 outbreak.  Monitoring visits to understand local needs Since the start of the pandemic, the WHO Country Office for Kyrgyzstan together with the Republican Center for Immunoprophylaxis has conducted regular monitoring visits across the country to provide technical support to remote areas and district immunologists as well as to public health services for better planning of the work of mobile teams, and for receiving feedback from field workers on their needs.  The monitoring teams have noted, for example, that all required infection prevention and control (IPC) measures have been strictly followed during mobile immunization sessions in the field. In addition, all mobile immunization teams have been equipped with sanitizers, personal protective equipment (PPE), and first aid kits, with funding from Gavi, the Vaccine Alliance, for COVID-19-related activities. Abdyjapar thanks WHO and other partners for organizing the mobile immunization teams. “I am grateful to our health care workers for their hard work and dedication. Many people appreciate your efforts so much and I am very grateful to have selfless people like you working at the frontline,” says Abdyjapar.  

Well-functioning laboratories are essential for improving health care and public health in Kyrgyzstan. Accurate laboratory results help to diagnose patients at risk of cardiovascular diseases, which currently cause every second death in the country. Laboratory testing for sensitivity to anti-tuberculosis drugs is also needed to find appropriate treatment for patients with multidrug-resistant tuberculosis (MDR-TB), another high-burden disease in Kyrgyzstan.  Today Dr Erkingul Baltabaeva shares her views on why laboratories are also important for protecting public health through detecting and controlling infectious diseases and preventing outbreaks. She has been working as a virologist for many years and joined the Department of Disease Prevention and State Sanitary and Epidemiological Surveillance under the Ministry of Health last year. WHO improves the capacity of health workers and strengthens the role of laboratories Dr Baltabaeva is one of 96 laboratory specialists who had been trained in the diagnosis of COVID-19 infection by WHO. The training involved local polymerase chain reaction (PCR) method experts from the National Tuberculosis Center, AIDS centers, Republican Center for Quarantine and Especially Dangerous Infections, State Centers for Sanitary and Epidemiological Surveillance of Bishkek and the Jalal-Abad, Osh and Issyk-Kul regions, and private laboratories. The training was developed to equip laboratory specialists with basic skills for the diagnosis of COVID-19 infection. Dr Baltabaeva, together with her colleagues, also received face-to-face training in biosafety in laboratory settings and in working with high-threat pathogens and dangerous materials, as well as training in safe collection, transportation, processing, and preparation of samples for further testing. As Dr Baltabaeva states, “I deepened my knowledge and laboratory experience through this training. It covered a lot of practical skills, which was extremely helpful.”  “We’ve been working around the clock during this pandemic to meet testing requirements and accomplish our mission – and we’re still doing it,” she continues. “We realize that COVID-19 will stay with us a long time. At the same time, the knowledge and skills received through the WHO training will stay with us forever. Of course, we will continue to sharpen our knowledge and skills because we always have to be ready for new threats.” Further strengthening capacities in the country Since the start of the COVID-19 pandemic, WHO successfully trained over 500 health workers from intensive care units, the Republican Clinical Infectious Diseases Hospital, primary health-care centres, and 2 military hospitals in the clinical management of COVID-19 patients. The improved capacities of the health workers and the supplies and equipment provided to hospitals and isolation centres helped to ensure the provision of appropriate clinical care for patients and a safe environment at health facilities for all during the COVID-19 pandemic. In addition, WHO continues to provide the Ministry of Health and technical experts with updated evidence, recommendations and WHO guidelines on prevention, laboratory diagnosis and treatment of COVID-19 and other high-threat pathogens. Dr Baltabaeva remembers that early in the COVID-19 pandemic SARS-CoV-2 variants had begun emerging in countries around the world, but laboratories in Kyrgyzstan were not able to determine whether any of them were circulating locally. However, WHO assisted in sending the samples to international WHO reference laboratories for sequencing, which made it difficult to monitor the epidemiological situation in real time. Thanks to WHO and other partners, genomic sequencing capabilities were established in the country, which was a notable public health success. WHO’s Better Labs for Better Health initiative Since 2015 Kyrgyzstan has been implementing WHO’s Better Labs for Better Health initiative. As part of the initiative, WHO leads and coordinates the efforts of national health authorities, donors, and development partners to build national laboratory capacity in different areas, such as policy-making, introducing and implementing national and international quality standards, strengthening laboratory services, and training laboratory specialists. In recent years Kyrgyz health authorities have been establishing national standards for laboratory certification and a quality management system for laboratory research. To prepare national laboratories for accreditation in accordance with the international standard ISO 15189, Kyrgyzstan has introduced a mentoring programme for laboratories. Addressing the need for human resource development, the country has evaluated and updated the national training curriculum for laboratory personnel.  Such a comprehensive and coordinated approach enables Kyrgyzstan to optimally spend limited resources and gradually improve laboratory services with the overarching goal of strengthening the country’s health system and public health. For example, between 2013 and 2018 the number of laboratories accredited in accordance with international standards grew from 11 to 25. And the recently introduced HIV testing guidelines and new diagnostic techniques on TB and MDR-TB have significantly reduced the time needed to identify cases, ensuring early treatment initiation, as well as reducing and controlling further transmission. WHO provides supplies of laboratory kits and personal protective equipment Since the beginning of the COVID-19 pandemic WHO delivered to Kyrgyzstan personal protective equipment and provided PCR test kits for COVID-19 response and laboratory confirmation of positive results. In addition, WHO handed over supplies of laboratory consumables for sample collection and testing. WHO continues to support the Ministry of Health with COVID-19 response trainings for health-care workers, including laboratory, primary health, hospital, and public health specialists.