Thursday, 03 September 2020, 15:29:53
During a briefing at the government's press center, First Vice Minister of Healthcare Marat Shoranov spoke about the main provisions of the Address of the Head state to the people of Kazakhstan of Sep. 1, 2020, "Kazakhstan in a New Reality: Time for Action" in the field of healthcare.
The Head of State in his Address to the people of Kazakhstan identified 11 tasks in the field of healthcare.
The social allowance for material incentives for medical workers who took part in measures to counter the spread of coronavirus infection will be paid by the end of 2020. During the period from March to July, 59.7 billion tenge was paid to specialists as incentives for three risk groups. Additionally, 150 billion tenge will be allocated. The corresponding calculations were sent to the Ministry of Finance.
“The order of the minister on the issue of allowances was signed back in April. Since then, the course and nature of the spread of infection has changed significantly. If at the initial stage of the pandemic we faced more imported cases of coronavirus, then in the middle of summer we faced an internal spread and, accordingly, the number of medical workers involved in directly countering the consequences of COVID-19 was significantly increased,” said the first vice minister of healthcare.
So, if in March 2020, there were about 23 thousand specialists who participated in this work, then in July this number was about 82 thousand medical workers.
Over time, medical organizations of non-departmental health care (hospitals of the Ministry of Defense and other power structures and central government agencies), employees of military medical, forensic medical units were involved in this work. Since July, more than 3.5 thousand mobile brigades have been operating, whose personnel have also been involved in the fight against coronavirus.
The Head of State has set the task to gradually increase the salaries of specialists of the sanitary-epidemiological service and doctors from this year and to double the average salary by 2023.
The bill "On the Republican Budget for 2021-2023" provides for these costs.
The total cost of raising wages for 247 thousand medical workers in 2021 will amount to 223 billion tenge, in 2022 - 362 billion tenge, in 2023 - 557 billion tenge.
The Ministry of Healthcare will submit a set of proposals for the development of the domestic pharmaceutical and medical industry in accordance with international standards in the Ministry of Industry and Innovative Development, taking into account the needs of the population for medicines with proven effectiveness.
“A list of basic drugs will be determined, which will have to be produced within the country by domestic producers,” Shoranov said.
According to him, the share of domestic manufacturers in the procurement of medicines from the Single Distributor is growing every year, which today amounts to 30% of the total volume in monetary terms, it is planned to increase to 80% by 2024.
The Ministry of Health, in order to support and develop pharmaceutical production and reduce import dependence, is supporting domestic manufacturers through the conclusion of long-term contracts for the supply of medicines for up to 10 years.
Today there are 63 long-term contracts concluded with 32 domestic manufacturers for the supply of 3,600 names of medicines and medical devices.
During the pandemic, domestic manufacturers Khimpharm, Nobel, manufacturers of medical devices and others significantly increased production capacity (the production of demanded drugs for the treatment of coronavirus, Azithromycin and Levofloxacin, was increased). The number of manufacturers of medical masks and protective suits increased from 6 to 15, and more than 50 additional types of medicines are planned to be produced.
Also, in order to accelerate the entry of medicines and medical devices into the market of the Republic of Kazakhstan, an accelerated examination is provided for during the state registration of medicines up to 70 calendar days, and for medical devices up to 5 working days.
Currently, the regional akimats have begun the active phase of construction of 12 modular infectious diseases hospitals and the reconstruction of two hospitals with their commissioning in October of this year.
This work is being carried out in preparation for a possible second wave of the pandemic and will provide timely and high-quality assistance to the population. country. Additionally, 2,700 infectious beds will be deployed, equipped with modern equipment. Funding is provided from the Employment Roadmap and local budgets.
By 2025, 20 large modern medical centers will be created in the regions of the country through PPP. These are multidisciplinary hospitals that will provide the entire range of high-tech medical care to the population in accordance with international quality requirements, and will also provide 50% renewal of the bed fund. About 1.5 trillion tenge of investments will be attracted. Also, in accordance with the Code "On public health and the health care system", we are submitting a draft government decree on the creation of a National operator.
By the end of December 2021, two multidisciplinary research centers for infectious diseases will be built in the cities of Almaty and Nur-Sultan, 500 beds each.
This will make it possible to respond in a timely manner to current and probable epidemiological threats, consolidate scientific and technical potential, as well as broadcast the best world practices for observing infectious safety in the regions of the country.
The Head of State has been instructed to radically revise the approaches to the organization of primary health care.
The ministry will develop an appropriate plan to improve the provision of health care in the Republic of Kazakhstan for 2021-2023, including measures to improve the availability of primary health care, primarily to rural residents.
“We will reconsider the approaches to ensuring the functioning of feldsher-obstetric points and medical outpatient clinics and will take measures to strengthen their material and technical base and staffing. A comprehensive audit will be carried out, proposals will be made for the construction of new and repair of already existing feldsher-obstetric stations, medical outpatient clinics,” Shoranov noted.
One of the mechanisms for improving the availability of medical care will be the further development of transport medicine for remote regions.
100 mobile medical complexes based on buses for rural settlements will be purchased. Taking into account the available PMK park, the needs of regional hospitals will be covered by 100%.
“These mobile complexes will be equipped with modern medical equipment, including ultrasound equipment, ECG, laboratory analyzers, viewing areas for gynecological examinations, a digital X-ray machine and much more. Since October, these PMKs will be supplied and operated in remote regions of our country,” Shoranov noted.
Also in 2020, the ambulance service is planned to be equipped with modern ambulance vehicles of domestic production through JSC DBK-Leasing. A total of 1,167 pieces will be delivered.
The Ministry of Healthcare, together with the Local Executive Office, will conduct a comprehensive audit of the equipment and infrastructure of medical organizations. Based on the results of the audit, proposals will be submitted to the Government and a budget application will be formed. We will place a special emphasis on rural health care (on determining the need for the construction and repair of feldsher-obstetric stations and medical outpatient clinics).
A long-term forecast (for 10 years) will be developed regarding personnel policy in the field of health, as well as a large number of training of scarce medical specialists, such as an epidemiologist, an infectious disease specialist, an intensive care specialist, a pulmonologist, a cardiologist, will be provided.
Within the framework of the "Ansagan Sabi" program, from 2021 the quota for IVF will increase by 7 times.
Taking into account the instructions of the Head of State, within the framework of reducing the number of target indicators and indicators of state programs, the Ministry made appropriate proposals for amending the State Program for the Development of Healthcare of the Republic of Kazakhstan for 2020-2025.
On purchase of Russian coronavirus vaccine
Shoranov spoke in more detail about the procedure for the acquisition of the Russian vaccine against COVID-19.
“Negotiations were held between the Russian direct investment fund and Kazakhstan's SK-Pharmacy LLP, an agreement of understanding was signed, which guarantees the allocation of the required amount of vaccines for Kazakhstan in order to prevent the spread of the Russian-made Sputnik V coronavirus infection. But at the same time, the agreement does not provide for any obligations, in addition to the guaranteed volume, in the event that Kazakhstan buys this vaccine,” explained the first vice minister of healthcare.
He stressed that at this stage the cost of the vaccine has not been determined.
"The Russian side expressed the position that the vaccine can enter the market no earlier than January 2021, but the final dates for the release of the vaccine and its preliminary cost will be determined only after passing all the stages of clinical trials in which the vaccine is currently located," he said.
As for the number of vaccines, the Ministry of Healthcare has determined a preliminary need for the purchase of immunization of Kazakhstanis against coronavirus in the amount of more than 2 million doses, a list of vulnerable groups of the population has been determined: children, adults registered with dispensaries, pregnant women, pensioners, healthcare and education workers.
In general, work in this direction continues, at the same time negotiations are underway on the Covax Facility through the global alliance for vaccination and immunization, as well as negotiations on a joint clinical trial of the Sinovac vaccine manufactured in China, but this issue is at the stage of development.
Shoranov also named the alleged differences between the Russian vaccine and Kazakhstani developments.
“The Russian-made Sputnik V vaccine is a preparation in the form of live vector virus-vaccines based on two serotypes against adenoviruses. And this vaccine has certain contraindications. Along with chronic infectious and respiratory diseases, this vaccine is contraindicated in pregnant women, during breastfeeding, as well as in persons under the age of 18 and over 60. Thus, these contraindications, unlike our domestic vaccines, significantly limit the vaccination of the most vulnerable groups of the population of our country. And in terms of the risk of complications from CVI, these vaccines are not allowed to be used for risk groups,” said the first vice minister.
Shoranov told how volunteers can take part in the trial of the Kazakhstani vaccine against coronavirus.
According to him, conducting clinical trials is a rather laborious and complex process that requires obtaining various permits in the country where this study will be conducted. First, it is necessary to pass a bioethical commission, as well as obtain a registration certificate at the Center for Expertise of Medicines. However, since all research is conducted in accordance with the principles of bioethics, an appropriate informed consent must be signed between the volunteer, the medical organization and the sponsor of the study. At the same time, the sponsor of the study guarantees, in accordance with the insurance legislation, the risks associated with possible side effects that may arise from participation in this study.