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Kazakhstan is leading light for free hepatitis testing and treatment in Central Asia [1]

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Date: 2023-09

Aizhan Amanzholova*, 47, was diagnosed with liver cirrhosis due to hepatitis C in 2012. She was very ill, and often in hospital, but in 2019 was able to start free antiviral therapy and receive care and treatment in her hometown of Karaganda. Today, with annual screening and support, she is healthier and no longer needs hospitalisation.

“We used to have a lot of patients with advanced liver diseases and cirrhosis. Liver transplantation was not available nationally at the time. Then in 2010, Kazakhstan added viral hepatitis to the list of social significant diseases, and by law, this meant offering testing and treatment free of charge to everyone. Right now, irrespective of the stage of disease, everyone can get free treatment. It was good political leadership by the Ministry of Health,” said Kulpash Kaliaskarova, Professor of National Research Oncology Center and Chief Hepatologist to the Ministry of Health, Republic of Kazakhstan.

Hepatitis is an inflammation of the liver with causes including viruses and other infections, alcohol and certain drugs. It leads to a range of health problems, some of which can be fatal. Globally, 90% of people living with viral hepatitis do not know they have it, and each day 3 000 people die of the disease. WHO’s global hepatitis strategy, endorsed by WHO Member States, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.

Free testing and treatment

Having implemented the National Roadmap for the prevention, diagnosis, treatment, and prevention of viral hepatitis in 2017, Kazakhstan is currently one of the few countries in Central Asia that provides completely free testing and treatment for hepatitis B and C. There are no out-of-pocket costs, and no need for health insurance.

“The Ministry of Health is committed to achieving health for all. Ensuring free-of-charge testing and treatment for viral hepatitis for all patients is a solid step in that direction. We have no waiting lists for antiviral treatment for hepatitis, and are exploring a broader nationwide approach to screening to accelerate case finding,” said Gulnara Maxutova, Head of Medical Care for Socially Significant Diseases at the Ministry of Health of the Republic of Kazakhstan.

Ensuring access through primary health care services

Kazakhstan reacted positively to the WHO 2022 recommendation to improve access to hepatitis C care and promote person-centred care. Across the country, treatment is offered through primary health care centres and polyclinics (i.e., facilities covering a variety of diseases), so people can easily access it through their local doctor. A universal screening programme has just been piloted in the capital Astana’s polyclinics to test 10 000 patients over the age of 18, for hepatitis B and C. When the results are in, the programme is expected to roll out nationwide.

Prevalence and partnerships

The Ministry of Health’s official figures show a population-wide prevalence of hepatitis C of up to 3.1%. In 2022, 27 835 patients with hepatitis B and 30 862 patients with hepatitis C were registered.

Hepatitis tends to affect people between 30-60 years. No particular social or economic group is most affected. Some cases of mother-to-child transmission of hepatitis exist; however, across Kazakhstan all children receive a hepatitis B vaccine as part of the universal vaccination programme.

The Ministry of Health finds it important to communicate and cooperate with civil society organisations and patient advocacy groups, to find common solutions to improve the welfare of patients.

“Kazakhstan is rapidly raising the momentum on testing and treatment for viral hepatitis. The Ministry of Health, in cooperation with WHO and other stakeholders, has taken political and strategic decisions and implemented strong technical approaches based on WHO evidence-based guidance to ensure that everyone across the country can access the hepatitis services they need,” said Dr Skender Syla, WHO Representative to Kazakhstan.

*Name changed to protect identity.

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[1] Url: https://www.who.int/news-room/feature-stories/detail/kazakhstan-is-leading-light-for-free-hepatitis-testing-and-treatment-in-central-asia

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