Uzbek Health Sector Faces Spending Cuts

Many state-run medical institutions in Uzbekistan are to have their government funding cut, but it is unclear how they will make up the difference in the absence of a functioning private health sector.

The planned cuts were hidden in a package of “intensified reforms” signed off by President Islam Karimov at the end of November, which also includes an expanded network of clinics in rural areas.

Some hospitals and clinics will have to shift towards fully funding themselves, although the state will retain a controlling stake in them.

A local economist said the government was clearly looking to reduce spending. “It is a consequence of a treasury shortfall,” he added.

Official statistics indicate that government spending on healthcare is equivalent to 15.7 per cent of gross domestic product¸ but the reality is a lot different.

“Much more modest sums than this [figure] are allocated, and the sector is funded on whatever is left over,” a health ministry staffer in Tashkent said.

He said the health provision was in poor shape now, and would get much worse if funding was reduced.

One option for these hospitals could be to start charging fees from 2012, when private health institutions will start being licensed. But the standards needed to win a license, including the availability of cutting-edge technologies, are high. And it is not yet clear whether such licenses will be issued to state institutions so that they can charge patients or set up separate private wards.

Finally, the vagaries of state policy are likely to deter many from making a substantial investment in the future. Private healthcare existed in Uzbekistan until 2009, when it was banned, apart from dentists and cosmetic surgery clinics.

This article was produced as part of IWPR's News Briefing Central Asia output, funded by the National Endowment for Democracy.

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