Central Asia must reform its health policies

Deaths are increasing due to taking drugs without controls, or because they are expired or of dubious quality. The deaths could be much higher than the official figures. Pharmacies out of control: they sell everything without a prescription, in several cases even narcotics.

Moscow (AsiaNews) - The pharmaceutical industry in Central Asia is in urgent need of reform, as many media outlets have been reporting for some time. Over the past two months in Samarkand, Uzbekistan, more than 20 children who used Indian-made 'Dok-1 Max' cough syrups and lozenges have died. The probable cause of the deaths is kidney failure.

Deaths caused by this preparation had already surfaced in reports from West Africa since last October, with warnings from the World Health Organisation (WHO) against this medicine. In spite of this, Dok-1 Max and other dubious preparations remained available in Uzbekistan until the end of December, and many believe that deaths due to their intake are far higher than the official figures.

A popular Uzbek blogger, Nikita Makarenko, sought answers on these matters from health officials in his country. He asked why WHO warnings were ignored, even though the weaknesses of the local health system are not a new and surprising fact.

In 2021 in the city of Angren a girl died from 'Tseftrjakson', an antibiotic against infections. The preparation was supposed to be administered under the supervision of doctors, but the girl had received it from a relative without any preparation, and three other people died that year from the same cause.

The Uzbek government does not provide statistical data on such cases. Several observers are convinced, however, that there are other cases of deaths of children and adults linked to taking medicines and antibiotics without due verification.

Tseftrjakson is still available in Uzbek pharmacies, and these cases denote a trend in the pharmaceutical industry in Uzbekistan and all Central Asian countries, as an investigation by The Diplomat also states. The report points out that the healthcare sector in Central Asia is in need of heavy investment, with poorly qualified staff and outdated equipment.

Treatment in hospitals and private clinics is also very expensive, and most people try to get by with home remedies. Public and private pharmacies often work unsupervised: in Uzbekistan there are almost 1,000 pharmacies where one can buy any medicine without a prescription, and non-prescription antibiotics are available in almost all pharmacies in Kazakhstan, Kyrgyzstan, Tajikistan and Turkmenistan.

In 2019, the Turkmen government banned the sale of antibiotics in private pharmacies, but the lack of information makes it impossible to verify how far this directive is enforced. Uzbekistan has also tried to limit the uncontrolled spread of antibiotics, but without success, given the numerous deaths since 2021. The accessibility of medicines in Uzbek pharmacies and parapharmacies is so well established that it is included as one of the benefits in tourist travel advertisements.

This spread of such controversial preparations not only makes the population more threatened in terms of health, but even spreads addiction to narcotics, as The Diplomat points out.

In Kazakhstan, the authorities have fined about 200 pharmacies for selling narcotics, which have been prohibited in the country for years, but this has not stopped (clandestine) trafficking. A similar situation occurs in Uzbekistan and Turkmenistan. Tramadol is widely used among students in these countries, as it is considered an easy and cheap way to overcome all kinds of stress.

Another risk factor is the spread of counterfeit or expired medicines, which are bought at heavily discounted prices for chronic diseases, such as diabetes. It is estimated that between 10 and 12% of the preparations on sale belong to these categories, and entire factories and warehouses of counterfeit medicines have been found in Uzbekistan.

After the devastating effects of Covid-19, profound reforms are needed in this region, where control over the health sector has been lost. So far, 'cosmetic' measures are being taken, with demonstrative closures of some pharmacies and resounding calls for 'European standards', which, however, penalise smaller retailers.

• central asia
• deaths
• health
• economy
• reforms
• drugs