Kyrgyzstan: Show Me the Money for Health

Kyrgyzstan: Show Me the Money for Health

In recent years, Kyrgyzstan has benefited from a significant increase in international funding to improve health care. Since 2009, Kyrgyzstan has received more than $35 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. In 2011, the German Development Bank pledged an investment of 10.5 million Euros to reduce child mortality and improve health care for pregnant women. And since the Kyrgyz Republic joined the World Bank in 1992, the country has received nearly $1 billion in aid for projects aimed at improving rural infrastructure, including health care systems.

Despite this influx of international funding, many people in Kyrgyzstan are unable to get the lifesaving medicines that they need. And yet, all of the aid grants, from the Global Fund to the World Bank, have included funds specifically for purchasing essential medicines, such as vaccines, antiretroviral medicines to treat people living with HIV, contraceptives, malaria drugs, and leprosy treatment.

If we have the money, then why are thousands of Kyrgyz still waiting for treatment? Unfortunately, the general lack of transparency within government and foreign aid agencies make it difficult to answer that question and identify the barriers that block access to medicines.

That’s why in 2010, three Kyrgyz organizations working on HIV and health issues—the Harm Reduction Network, Partnership Network, and Unity of People Living with HIV—launched a coordinated effort to monitor and analyze the procurement and distribution of medicines purchased with Global Fund grants. Through these efforts, we aimed to increase efficiency and transparency of projects that are implemented by the government’s AIDS center, which was the primary recipient of Global Fund grants.

We set out to track procurement and distribution of antiretroviral drugs and other medicines to treat opportunistic infections, as well as supplies that help reduce HIV infection such as safe injection equipment for people who use drugs. We established a system to analyze whether these processes were transparent, in accordance with Kyrgyz law on public procurement, and in line with Global Fund procedures.

However, we met with resistance from the Ministry of Health, which refused to release copies of tender agreements and other financial documents pertaining to the AIDS center. The government claimed that these records are not available for third parties. So, we joined with other civil society organizations and filed a legal challenge arguing that the government’s actions violated our right to access public information. The Bishkek District Court ruled on January 26, 2012 that the government’s actions were in fact a violation of the right to access information, and ordered the AIDS center to turn over documents pertaining to the purchase of anitretroviral medicines between 2009 and 2011, especially price and quantity lists and distribution reports.

The monitoring and analysis project continues, but this court decision is already a clear victory for transparency and access to information in Kyrgyzstan. Civil society organizations have been energized and we are committed to ensure that government agencies and donors are transparent and efficient.

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Official Kyrgyzstan is known more for what we in the West would call influence-peddling than it is known for abiding by the law. Is that an unfair statement? Assuming it is to some degree accurate, what are the odds that this court ruling will actually have an impact?

Thank you for your interest to our blog. We can say that the decision of judge takes effect after 30 days and only then we could get the documents. But AIDS Center appealed against a decision by District Court, because it was not objective. In response to a complaint from the AIDS Center our lawyer has filed an objection. The Collegium has returned to appeal of AIDS Center, due to the fact that the complaint is signed by a person not entitled to lodge complaints. The case established that the power of Attorney issued by the AIDS Center addressed to the representative does not have the right to appeal against court decisions.

Bravo, the project to improve transparency in the health sector especially in regard to HIV/AIDS is quite timely, and also very much needed in our country i wish you would share lessons learnt,

Verah Nyambok
Anti corruption Coordinator

Dear Verah, thank you. Actually it is a merit of all project participants and organizations comprising into the coalition. We have done and made a lot of effort to obtain these documents. But unfortunately, we have limited access, and we as the civil sector who has the right of access to information have taken such action. The result you can see yourself. But after the decision of judge, we never get the documents, AIDS Centre appealed against a decision by a judge because it was not objective. But the judicial Commission had returned the complaint of AIDS Center.

I am studying health systems in UK. While reading all the articles written by Ministry of Health, international authors, i found out one thing that they talk about how Kyrgyz health care reform was successful and is the good example. However, I would say that in practice this success does not work and people still have to pay out-of pocket money for receiving health services. The main issue of this is not that there is no money for free health care and medications for patients in need, but the problems of TRANSPARENCY and corruption in our government and court system. We do not see the all donors' and tax payers' money spent for actual purpose!

Asel, I agree with you , in practice, everything is exactly as you say.

Dear Ms. Mariam, any updates on the initiative? any progress? thank you for your work!

This is a great blog. I agree, transparency in all medical related fields is key to the general public understanding their health care as well as worldly issues. Thanks for the good read.

Es una verdadera batalla cuando una persiana necesita arreglo, siempre contienen piezas difíciles de ensamblar y la frustración se hace presente, siempre.

Hi, yes, you say right. Despite an influx of international funding for health, many people in Kyrgyzstan are unable to get the lifesaving medicines that they need. Civil society groups have launched a coordinated effort to monitor nd analyze budget spending to identify gaps in health care services.

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