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Strategies for Sustainable Development of Healthcare: Modern Challenges and Prospects

SDG 3SDG 17

21 November, 10:00-13:00
Rectorate Hall

Session

Maintaining and improving public health is essential for the sustainable development of any country. However, healthcare systems around the world face serious challenges: from epidemics and pandemics to resource constraints and unequal access to healthcare.

In the CIS countries, as in many other regions, issues relating to SDG 3 (Good Health and Well-Being) and SDG 17 (Partnerships for the Goals) remain pertinent.

The section is devoted to a comprehensive analysis of healthcare system development strategies in the context of the Sustainable Development Goals. The main focus is on the challenges faced by the CIS countries in implementing SDGs 3 and 17, as well as on finding effective solutions to build sustainable healthcare systems.

Figures and Facts

In the CIS countries, as in many other regions, the following issues are especially important:

  • training qualified medical staff;
  • providing citizens with affordable and high-quality medical care;
  • reducing maternal and child mortality rates;
  • increasing life expectancy;
  • preventing and combating infectious and non-communicable diseases, as well as the factors that cause them.

SDG 3

Uneven development of medicine - the disparity in the availability of medical care between urban and rural regions
In Kazakhstan, 70% of doctors work in cities, even though 42% of the population live in rural areas (WHO, 2022).
In Uzbekistan, the number of medical institutions in Tashkent is 3-5 times higher than in the regions (UNICEF, 2021).
Staff shortage – outflow of qualified doctors and nurses, lack of specialists in remote areas.
Kyrgyzstan loses up to 200 doctors annually due to migration (Ministry of Health of the Kyrgyz Republic, 2023).
There are only 5.4 doctors per 10,000 people in Tajikistan (compared to 37 in the EU and a WHO recommendation of 23) (WHO, 2023).
Kazakhstan: 30% of nurses plan to emigrate due to low salaries (Association of Nurses of the Republic of Kazakhstan, 2023).
High incidence of non-communicable diseases (cardiovascular diseases, diabetes, cancer) due to lifestyle and environmental factors.
Diseases of the circulatory system cause more than 50% of deaths in Russia and Belarus (Rosstat, 2023).
Every 4th adult in Armenia suffers from hypertension (WHO, 2022).
Kazakhstan: 63% of all deaths are caused by cardiovascular diseases (Statistics Committee of the Republic of Kazakhstan, 2023).
Uzbekistan: 25,000 new cancer cases are registered each year, 70% of which are detected at late stages (Oncology Centre of Uzbekistan, 2023).
Increase in infectious threats (HIV, tuberculosis, hepatitis), as well as the risk of new pandemics
Kyrgyzstan: 23% of tuberculosis cases are multidrug-resistant (MDR-TB) - one of the worst rates globally (Global Tuberculosis Report, 2023).
Tajikistan: Vaccination coverage (measles, rubella) fell from 97% (2019) to 89% (2023) due to gaps in the health system (WHO).
1.1 million people live with HIV in Russia, (Rospotrebnadzor, 2023), 60,000+ new cases are detected annually.
Insufficient healthcare funding, dependence on imported drugs and medical equipment
In Moldova, healthcare spending accounts for 6.1% of GDP (compared to 9.9% in the EU) (World Bank, 2023).
Tajikistan imports 90% of its drugs (UNCTAD, 2022).
Belarus spends 6.3% of its GDP on healthcare - below the WHO recommendation of 7-10% (Ministry of Health of the Republic of Belarus, 2023).
Uzbekistan: 80% of drugs are imported, which makes them expensive for the population (Ministry of Health of the Republic of Uzbekistan, 2023).
Kyrgyzstan: only 3% of the budget is spent on disease prevention (Ministry of Health of the Kyrgyz Republic, 2023).
High levels of maternal and child mortality in some countries of the region
In Turkmenistan, the maternal mortality rate is 42 per 100,000 live births, compared to 32.7 per 100,000 live births in Tajikistan (3-5 in the EU) (UNICEF, 2023) – one of the highest rates in the region (UNICEF).
15% of children under 5 suffer from malnutrition in Tajikistan (UNICEF, 2022).
Kyrgyzstan: Child mortality (under 5) is 18.2 per 1,000 live births (2022), which is higher than the global average (WHO).
Turkmenistan: Antenatal care coverage is 84%, but it drops to 65% in rural areas (UNFPA, 2023).
Access to healthcare
Azerbaijan: 35% of rural residents do not have access to basic healthcare (World Bank, 2023).
Armenia: 40% of the population postpones visiting a doctor due to financial difficulties (National Security Service of the Republic of Armenia, 2023).
Moldova: 15% of rural hospitals have no running water and sewerage (UNICEF, 2022).

Challenges in Achieving SDG 17

Insufficient international cooperation in medical technology and knowledge exchange
CIS countries receive 5 times fewer grants for health than African countries (Global Fund, 2023).
Turkmenistan did not participate in WHO programmes on antimicrobial resistance until 2022.
Limited participation in global health initiatives due to bureaucratic and political barriers
Less than 1% of medical research in Armenia and Kyrgyzstan is funded from abroad (World Bank, 2023).
Kazakhstan attracted only $120 million in pharmaceutical investment in 2022.
Lack of investment in local health systems from international donorsв
CIS countries receive 5-7 times less funding for health from international donors than African countries (Global Fund, 2023).
In 2022–2023 the following was allocated for the entire CIS region (excluding Russia):
$120 million from the Global Fund (compared to $3.2 billion received by African countries).
$45 million from the World Bank (compared to $1.8 billion for South Asia).
Weak coordination between the CIS countries in the fight against common threats (epidemics, antimicrobial resistance)
Only 30% of the CIS countries exchange data on disease outbreaks (ECDC, 2023).
There is no unified system for purchasing vaccines: Belarus and Russia produce their own, while others depend on imports.
Insufficient development of digital healthcare (telemedicine, electronic medical records) due to the lack of infrastructure and regulation
Less than 10% of hospitals use electronic records in Azerbaijan and Tajikistan (ITU, 2023).
Telemedicine is only available to 5% of the population in Kyrgyzstan (Ministry of Health of the Kyrgyz Republic, 2023).

Despite these challenges, experts and young researchers are ready to share their experience and best practices of their countries in order to achieve the global goal of health and well-being for all.

Discussion Issues

  • Modern challenges to healthcare systems: epidemiological transition and growth of non-communicable diseases, population ageing and related medical and social issues, digital transformation and artificial intelligence in healthcare, financial sustainability of healthcare systems.
  • Strategic approaches to development: problems of organizing primary healthcare, preventive medicine and health risk management, human resources policy, educational strategies, innovative models of organising medical care.
  • International and intersectoral cooperation, interstate initiatives in the CIS region, integration of science, education and practice.
  • Promising technologies and innovations: telemedicine and digital solutions, personalised medicine, biotechnology and pharmaceuticals, smart healthcare management systems.

Programme

  • Welcoming Address of the Session Moderators
    Elena Kaverina (Russia)
    Associate Professor, Department of Public Health, Healthcare and Hygiene, Institute of Medicine, RUDN University
    Bakhyt Kosherova (Kazakhstan)
    Chair of the Board - Rector of Karaganda Medical University, Professor
  • Welcoming Address
    Aleksey Abramov (Russia)
    Director, Institute of Medicine, RUDN University
  • Topic of the report
    Under approval
    Shakhlo Turdikulova (Uzbekistan)
    Vice President of the Academy of Sciences of the Republic of Uzbekistan
  • Topic of the report
    Kazakhstan's Infectious Disease Service: Current Priorities in the Context of Achieving SDG 3
    Bakhyt Kosherova (Kazakhstan)
    Chair of the Board - Rector of Karaganda Medical University, Professor
  • Topic of the report
    Higher Medical Education in the Context of Belarus' Sustainable Development Goals
    Vladimir Pokhozhay (Belarus)
    Vice-Rector of Gomel State Medical University, Associate Professor
  • Topic of the report
    Protecting Public Health in Emergencies – the Mandate of the Red Cross and Red Crescent in the CIS Countries
    Davron Mukhamadiev (Tajikistan, Kazakhstan)
    Head of the Regional Delegation of the International Federation of Red Cross and Red Crescent Societies for the Russian Federation and the Commonwealth of Independent States
  • Topic of the report
    Financing drug guarantees in the CIS, SCO, BRICS: access to innovative drugs by developing mechanisms for financing essential “drugs for all”
    Andrey Ragozin (Russia)
    Vladimir Pokhozhay (Belarus), Vice-Rector of Gomel State Medical University, Associate Professor
  • Topic of the report
    Air Pollution in Central Asian Cities as a Major Threat to Public Health
    Denis Vinnikov (Kazakhstan)
    Head of the Research Laboratory of Health and Environment, Al-Farabi Kazakh National University; Full Professor, Department of Biochemistry named after Academician T. T. Berezov, Institute of Medicine, RUDN University (Russia), Editor of 4 international scientific journals of the first quartile
  • Topic of the report
    Innovative Projects Addressing Real Challenges in the Brazilian Healthcare System: Advancing SDG 3
    Fabricio Pelloso Piurcoski (Brazil)
    Head of the Innovation Department, Member of the Strategic Committee, Integrated University Centre (Centro Universitário Integrado)
  • Topic of the report
    Current Issues of International Cooperation in Healthcare: Modern Challenges and Opportunities
    Murat Shukurov (Turkmenistan)
    Independent Consultant, Expert on Global Health Issues, graduate of the postgraduate programme of the Department of Public Health, Healthcare and Hygiene, Institute of Medicine, RUDN University
  • Topic of the report
    Strategic Approaches to Primary Health Care in the Commonwealth of Independent States
    Gulsim Aimakova (Kazakhstan)
    Head of Physical Therapy and Rehabilitation Services, University Medical Center Corporate Foundation, Heart Center