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How Vaccine Refusals Are Affecting Public Health in Kazakhstan

New data from analysts at Ranking.kz highlights a concerning trend: rising anti-vaccination sentiment in Kazakhstan is contributing to the resurgence of infectious diseases that could have been prevented through routine immunization. A Sharp Rise in Preventable Infections According to the National Statistics Bureau, the incidence of several vaccine-preventable diseases has spiked over the past five years. When comparing cases per 100,000 people between 2019 and 2024, whooping cough increased 19-fold, scarlet fever 5.4-fold, viral hepatitis 3.1-fold, and measles nearly doubled. These increases are also reflected in absolute numbers. The resurgence of measles is particularly striking. After a decline following the 2018-19 outbreak, the disease surged again in 2023, with cases jumping from just 4 to 29,700. Health officials described it as the largest outbreak in a decade, attributing the spike to imported infections and their spread among unvaccinated communities. While the situation showed little improvement by the end of 2024, 2025 brought some relief. According to Kazakhstan's chief sanitary doctor, Sarkhat Beisenova, 2,800 cases were recorded in the first ten months of the year. Notably, 80% of those infected were unvaccinated children, mostly due to parental refusal. Why Vaccine Refusals Are Increasing The number of vaccination refusals has been rising steadily in Kazakhstan. According to the Ministry of Health, there were 5,300 recorded refusals in 2017. By 2024, that figure had jumped to 20,700 and approached 20,000 again in 2025. A 2024 UNICEF study revealed that in 60% of cases, parents offered no specific reason for refusing vaccinations, citing only personal beliefs. Religious objections accounted for 12%, distrust of vaccines for another 12%, and 6% admitted they were influenced by negative rumors. Social media continues to fuel fear around “severe vaccine reactions,” “risks of complications,” and widely debunked myths, such as a link between vaccines and autism. In response, Kazakhstan’s National Center for Public Health has launched an informational portal to provide evidence-based explanations of vaccine safety and to refute common misinformation. Herd Immunity: A Collective Responsibility To effectively stop the spread of contagious diseases, a high level of immunization is critical. For measles, 95-97% of the population must be vaccinated; for polio, around 80%. According to the Committee for Sanitary and Epidemiological Control, Kazakhstan’s overall vaccine coverage stood at 95.3% in February 2025. International data supports Kazakhstan’s strong vaccination rates among infants. In 2024, more than 98% of children under one were vaccinated against polio, hepatitis B, whooping cough, diphtheria, and tetanus. Measles and rubella vaccinations reached 93%, and pneumococcus 90%, rates higher than the global, Asian, and European averages. Still, even a small unvaccinated population segment can trigger disease outbreaks. The World Health Organization classifies vaccine hesitancy as one of the top threats to global health. A landmark study by Australian epidemiologist Andrew Shattock, published in The Lancet, modeled a world without vaccines. Over the past 50 years, vaccines have prevented 154 million deaths, 146 million of them children under five. “In 2024, the probability that a child under 10 will live to see their next birthday is...

Healthcare

Kazakhstan Faces Deepening Medical Personnel Shortage Amid Rising Emigration

Kazakhstan continues to grapple with a severe shortage of medical personnel, a crisis intensified by the steady emigration of specialists. According to First Deputy Minister of Health Timur Sultangaziev, there are currently around 9,000 unfilled positions across the country, approximately 4,000 for doctors and over 5,000 for mid-level healthcare workers. Speaking during a session of the Mazhilis, Kazakhstan’s lower house of parliament, Sultangaziev reported that roughly 2,500 medical professionals have left the country over the past five years. “There is an outflow of medical personnel from the healthcare system to foreign countries,” he said. Sultangaziev cited inadequate compensation as the primary factor driving this exodus. In response, the government has allocated an additional $9.6 million this year to raise salaries for public emergency medical service employees. The Health Ministry is currently evaluating a further salary increase estimated at $19.2 million, though a final decision has yet to be made. The parliamentary session also focused on proposed legislation to increase penalties for violence against medical workers. MP Askhat Aimagambetov noted that 280 such incidents have been officially recorded in the past five years, but suggested the real number is much higher. Many medical professionals reportedly choose not to report assaults, fearing retaliation or loss of work hours. The draft bill includes a new article in the Criminal Code, introducing special legal status for “medical workers” and “ambulance drivers", and stipulating harsher penalties for violent offenses. Aimagambetov compared the proposed sanctions to those for attacks on gamekeepers, which carry a maximum sentence of 12 years’ imprisonment. “If a hooligan breaks the finger of an ordinary citizen, it’s moderate harm. If he breaks a surgeon’s finger, it’s a disaster. Thousands of operations may be cancelled because of one broken finger,” Aimagambetov said, emphasizing the vulnerability of ambulance staff, who must respond to emergency calls without regard to risk. The final version of the bill outlines penalties including fines, correctional or community service, or up to three years’ restriction or deprivation of liberty for non-life-threatening violence. In cases involving aggravating circumstances, the punishment increases to 3-7 years. Life-threatening or severe injuries could result in 5-10 years’ imprisonment, or 7-12 years under aggravating conditions. As previously reported by The Times of Central Asia, Kazakhstan has already begun implementing additional protective measures for medical personnel. In the summer, authorities announced plans to equip ambulance staff with body cameras in response to the rising number of assaults on healthcare workers.

What Prevents Kazakh Women from Using Contraception

Kazakhstani researchers are once again drawing attention to a sensitive yet vital issue: women’s access to contraception and the broader state of reproductive health. Experts at Ranking.kz describe this matter as socially significant, directly affecting public health, quality of life, and the country’s demographic trends. According to the National Statistics Bureau (NSB), the unmet need for contraception among women with partners in Kazakhstan continues to rise. In 2024, the rate reached 18%, up from just 9.8% in 2015. The NSB attributes this unmet need to two main reasons cited by women: 12.5% said they do not want children “at this particular moment”; and 5.5% said they do not plan to become pregnant at all, “as they already have children”. However, analysts argue that the actual reasons are far more complex, encompassing unstable relationships, financial hardship, childfree lifestyle choices, and medical risks. The NSB’s approach, which treats contraception solely as a tool for regulating fertility, largely overlooks its crucial role in preventing sexually transmitted infections. Access to contraception is becoming more limited. In 2024, only 45.2% of women who wished to use contraceptives were able to do so, a decline from 55.7% in 2014. The reasons for use remain narrowly defined: delaying pregnancy or avoiding it entirely. The study also highlights stark regional disparities. Western Kazakhstan presents the most concerning figures. In the Aktobe region, 26.7% of women in partnerships report wanting but being unable to use contraception. The Atyrau region follows closely with 25.6%, then West Kazakhstan at 24%, and Astana at 23%. For comparison, dissatisfaction with access was just 11.7% nationally in 2015. The unmet need is most acute among the youngest women: 20-24 years old - 27.8%; and 15-19 years old - 25.8%. Substantial figures are also seen in older age brackets: 25-29 years old - 25%; 30-34 years old - 21.5%; and 35-39 years old - 16.9%. Globally, the United Nations reports an unmet need for contraception at 15% in 2024. Contributing factors include religious and cultural attitudes, economic barriers, lack of awareness, and restrictions imposed by partners or family members. Despite increasing demand, only 39.7% of Kazakhstani women of reproductive age, around 1.9 million individuals, currently use contraceptives. While this represents the highest number in recent years, the gap between need and access remains significant.

Vaccine Refusals Nearly Quadruple in Kazakhstan Over Eight Years

The number of vaccine refusals in Kazakhstan has surged nearly fourfold over the past eight years, according to Sarkhat Beisenova, Chair of the Sanitary and Epidemiological Control Committee at the Ministry of Health. Speaking at a recent briefing, Beisenova said the rise in vaccine hesitancy reflects a broader global trend that has also taken hold in Kazakhstan. “If we compare with 2017, the number of refusals has increased by a factor of 3.8. At that time, around 5,300 individuals declined vaccination; this year, nearly 20,000 have already been registered. The increase is evident,” she said. Beisenova noted that refusals span all types of vaccinations, except for flu shots, which, she said, no one has refused this year. As part of the country’s guaranteed volume of free medical care, the government purchased 2.1 million doses of the Grippol+ influenza vaccine, enough to cover about 11% of Kazakhstan’s 20.5 million population. So far, 1.9 million people, or 9.4% of the population, have been vaccinated. Free flu vaccination is offered to vulnerable groups, including healthcare workers, children with chronic illnesses, orphans, seniors over 65, people with disabilities, military personnel, pregnant women, and patients with cardiovascular or respiratory conditions. “The World Health Organization forecasts that three strains of influenza, A (H1N1), A (H3N2), and B, will be dominant this season. All are included in the vaccine, which offers protection against severe forms of the disease,” Beisenova emphasized. Since the start of the flu season, Kazakhstan has recorded 84 cases of COVID-19, alongside 150,600 cases of acute respiratory viral infection (ARVI) between October 30 and November 5. Since the beginning of autumn, the total has reached 1.2 million ARVI cases. Laboratories have also confirmed 304 cases of influenza A (H3N2), with 173 occurring in children under the age of 14. This year, the virus began circulating earlier than usual: the first cases appeared in early October, whereas last year’s outbreak began in November. According to Beisenova, this year’s strain is not new but consistent with typical seasonal influenza patterns. Annually, Kazakhstan registers up to 4 million ARVI cases and around 2,000 cases of influenza, the Ministry of Health reported. As previously reported by The Times of Central Asia, this year Kazakhstani citizens have also faced medicine shortages and a sharp rise in drug prices.

Pharmaceuticals

Uzbekistan’s Pharmaceutical Market in 2025: Rapid Growth, Foreign Investment, and Localization

Uzbekistan’s pharmaceutical sector is experiencing explosive growth in 2025. According to the analytics firm IQVIA, in September 2025, the market volume reached $204.9 million (wholesale) with 83.1 million packages of medicines sold. This is 36.4% higher in value terms and 24.1% higher in volume than a year earlier, indicating a recovery in consumer demand and a robust post-pandemic market rebound. The total annual market volume (MAT, the twelve months to September 2025) is estimated at $2.14 billion, whereas in 2018 it was about $0.888 billion. Thus, the average annual growth rate over 2018–2025 exceeded 13.4%, with acceleration in 2024–2025. As a result, the country’s pharma market has entered a phase of accelerated development, laying the foundation for further expansion in 2026. Market Structure: Price Segments, Import Dependence, and Prescription Shift to premium segments. The structure of pharmaceutical consumption in Uzbekistan is shifting towards more expensive medications. The share of the cheapest drugs (priced up to $1 per package) is shrinking, whereas the $1–5 and $5–10 segments are growing. At the same time, the niche of drugs priced above $10 is strengthening, reflecting a shift of part of consumer demand toward branded original medicines and complex therapies. This trend indicates qualitative market development: whereas previously inexpensive generics dominated, now an increasing share of revenue comes from innovative and imported products. Imports and local production. Despite localization efforts, the market remains import-dependent – around 90% of sales by value are generated by foreign drugs, with a slight trend toward imports further expanding their share. As of MAT/09/2025, imported medicines have raised their value share from 87% in 2018 to 89%. Nonetheless, in volume terms, the share of local manufacturers has inched up from 40% to 41.2% thanks to the production of affordable generics. Local companies are increasing their presence in the low-price segment by competing on cost. The government is encouraging localization of production, offering incentives (for example, tax and customs benefits in pharmaceutical free economic zones) and reserving 20% of state procurements for domestic companies’ products. These measures have already led a number of foreign companies to begin setting up manufacturing in Uzbekistan. Market Leaders: Companies and Brands Uzbekistan’s pharmaceutical market is highly fragmented – the combined share of even the largest players is relatively small. According to IQVIA for MAT/09/2025, the top three companies by sales value are Slovenia’s KRKA, Turkey’s World Medicine, and Ukraine’s Farmak. These companies together control about 9.9% of the market, which indicates intense competition and a market crowded with numerous brands and manufacturers. Notably, the top ten manufacturers have collectively increased their share since 2018 from 24% to 27%. Among local manufacturers, the Uzbek company Nika Pharm stands out with roughly a 2.5% share, rising from 32nd position in 2018 to 7th in 2025 with a +40.4% increase in sales (in value terms). Nika Pharm has become the most dynamic player in the domestic market and the only local manufacturer in the top ten. Competition at the individual brand level is also intense, with the...

Kazakh Surgeons Use MAKO Robotic System in Tashkent for the First Time

Kazakh surgeons have performed groundbreaking joint replacement procedures in Uzbekistan's capital Tashkent using the MAKO robotic system, an advanced technology in orthopedic surgery. The operations were a centerpiece of the event 'Days of Kazakh Medicine in Uzbekistan'. A surgical team led by traumatologist-orthopedist Timur Baidalin, head of the endoprosthetics department at the Batpenov National Scientific Center for Orthopedics and Traumatology, successfully conducted two joint replacements, one knee and one hip, using the MAKO robotic assistant. The system enables surgeons to plan and execute procedures with exceptional precision and reduced risk of complications. Developed by the U.S. based company Stryker, the MAKO system functions as an intelligent surgical assistant using 3D modeling technology. It creates a virtual replica of the patient’s joint, allowing the surgical team to pre-calculate the optimal implant angle, depth, and trajectory. During the procedure, the surgeon guides the MAKO manipulator, which operates with micromillimeter accuracy. This significantly lowers the risk of tissue damage and extends the lifespan of the implanted prosthesis. “The main advantage of MAKO is the ability to combine the surgeon’s experience with machine precision. This sets a new standard in endoprosthetics,” said Baidalin. For Uzbek specialists, the event served as a hands-on masterclass. In addition to observing the procedures, local doctors operated the system under the supervision of the Kazakh team. “We’ve been anticipating this technology for a long time. Today, we not only saw it in action but experienced the difference. This is a milestone for Uzbek orthopedics, and we’re grateful to our Kazakh colleagues for the opportunity to gain this experience,” said Odil Valiev, head of the adult orthopedics department at Uzbekistan’s Republican Specialized Scientific and Practical Center for Traumatology and Orthopedics. This collaboration follows another recent highlight: in spring 2025, Kazakh specialists from UMC, led by cardiac surgeon Yuri Pii, presented the ALEM device at EXPO 2025 in Osaka. The technology enables the long-term preservation of donor organs and represents another significant advance in regional medical innovation.