CENTRAL ASIA Central Asia must reform its health policies

There are more and more cases of deaths from taking medicines without medical supervision, because they are expired or of dubious quality. The actual number could be much higher than the official figures. There is no control over pharmacies: they sell anything without a prescription, in some cases even narcotics.

Moscow () – The pharmaceutical industry in Central Asia needs urgent reforms, as many media outlets have been saying for a long time. In the past two months, more than 20 children have died in Samarkand, Uzbekistan, after consuming Indian-made “Dok-1 Max” cough syrups and drops. The probable cause of the deaths is renal failure.

Already in October of last year, reports from West Africa had revealed the deaths caused by this drug, with warnings from the World Health Organization (WHO) against it. Despite this, Dok-1 Max and other preparations of dubious effect continued to be sold in Uzbekistan until the end of December, and many believe that the number of deaths it has caused is much higher than the official figures.

A popular Uzbek blogger, Nikita Makarenko, has sought answers to this issue from his country’s health officials. He asked why the WHO warnings were ignored, even though weaknesses in the local health system are not a new or surprising development. In 2021 in the city of Angren a girl died from taking “Tseftrjakson”, an antibiotic against infections. The drug was supposed to be administered under medical supervision, but the girl had received it from a relative without any professional training, and three other people died that year from the same cause.

The Uzbek government does not provide statistical data on these types of cases. However, several observers are convinced that there are many deaths in children and adults related to the ingestion of medicines and antibiotics without due control.

Tseftrjakson is still on sale in Uzbek pharmacies, and these cases show a trend in the pharmaceutical industry in Uzbekistan and all Central Asian countries, as also confirmed by an investigation by The Diplomat. The report notes that the health sector in Central Asia would need heavy investment and operates with low-skilled staff and outdated equipment.

Care in hospitals and private clinics is very expensive and most people try to get by with home remedies. Public and private pharmacies often operate without any supervision. In Uzbekistan there are almost 1,000 establishments where you can buy any medicine without a prescription, and antibiotics without a prescription 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 to what extent this directive is being applied. Uzbekistan has also tried to limit the uncontrolled spread of antibiotics, but without success, given the many deaths that have occurred since 2021. The accessibility of medicines in Uzbek pharmacies and parapharmacies is something so “normal”, that it is included as one of the benefits in the publicity of the tourist trips.

This diffusion of such controversial preparations not only threatens the health of the population but also encourages addiction to narcotic drugs, as The Diplomat points out.

In Kazakhstan, authorities have fined about 200 pharmacies for selling narcotics, which have been banned in the country for years, but that hasn’t stopped the (illegal) trade. A similar situation occurs in Uzbekistan and Turkmenistan. Tramadol is widely used among students in these countries because it is considered a simple and cheap way to overcome all kinds of stress.

Another risk factor is the sale of counterfeit or expired medicines, which can be purchased at greatly reduced prices for chronic conditions such as diabetes. It is estimated that between 10 and 12% of the preparations sold fall into these categories, and factories and warehouses of counterfeit medicines have been found in Uzbekistan.

After the devastating effects of Covid-19, it is necessary to make deep reforms in this region, where the health sector works without any type of control. So far “cosmetic” measures have been taken, closing some pharmacies and making high-sounding claims to “European standards”, but only penalizing small retailers.