06ASTANA563, KAZAKHSTANI GOVERNMENT REACTS TO HIV/AIDS SCANDAL

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Reference ID Created Released Classification Origin
06ASTANA563 2006-11-13 09:12 2011-08-30 01:44 UNCLASSIFIED Embassy Astana

VZCZCXRO5984
RR RUEHDBU RUEHLN RUEHVK RUEHYG
DE RUEHTA #0563 3170912
ZNR UUUUU ZZH
R 130912Z NOV 06
FM AMEMBASSY ASTANA
TO RUEHC/SECSTATE WASHDC 7660
INFO RUCNCIS/CIS COLLECTIVE
RUEHPH/CDC ATLANTA
RUEHAK/AMEMBASSY ANKARA 1993
RUEHAST/USOFFICE ALMATY

UNCLAS ASTANA 000563 
 
SIPDIS 
 
STATE FOR S/GAC KRAPPOSELLI 
USAID FOR E&E/DGST PHOLMES, E&E BWALLIN; GH/HIDN/ID CVINCENT 
CDC FOR SBLOUNT, EMCCRAY AND PSIMONE 
TASHKENT FOR EPUTNAM 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: SENV KHIV KZ
SUBJECT: KAZAKHSTANI GOVERNMENT REACTS TO HIV/AIDS SCANDAL 
 
REF: A. ASTANA 353, B. ASTANA 251 
 
1. Summary: The HIV/AIDS scandal in Shymkent continues to receive 
high-level attention.  On October 9, President Nazarbayev instructed 
Umurzak Shukeyev, the new Akim of the Southern Kazakhstan Oblast 
(SKO), to provide all necessary treatment to the 78 children 
infected with HIV as a result of contaminated blood transfusions and 
unsafe injection practices. On October 10, Minister of Health 
Anatoliy Dernovoy announced that the HIV outbreak in SKO has been 
contained.  President Nazarbayev visited Shymkent on October 25, 
where he demanded that those responsible for the outbreak be 
identified and punished.  End summary 
 
2. On October 10 Health Minister Anatoliy Dernovoy announced that 
the HIV/AIDS outbreak in Southern Kazakhstan (SKO) has been 
contained.  Seventy-eight children have been infected due to the 
reuse of disposable medical instruments, improper infection control 
practices in the hospital setting, or through contaminated blood 
transfusions. 
 
3. Minister Dernovoy visited the Southern Kazakhstan Oblast on 
October 15-16.  He stated that the quality of medical services in 
SKO is the worst in the country.  The equipment at the blood donor 
center in Shymkent, the largest city in SKO, is outdated and 
incapable of meeting all necessary safety requirements, said 
Dernovoy.  He added that most hospitals lack basic necessities, from 
hot water to linens.  Dernovoy noted that many medical personnel are 
poorly qualified. 
 
4. The Minister also condemned bribery in the regional hospitals and 
the misuse of budgetary funds.  Patients have to pay for everything 
- medical preparations, blood transfusions and treatment, said 
Dernovoy, and he asked where the twenty billion tenge ($156.6 
million) allocated annually for the oblast had been spent. 
 
5. Dernovoy called for better blood safety in Kazakhstan.  He stated 
that the government has allocated 65 million tenge ($500,000) to 
repair the existing blood center in Shymkent and 120 million tenge 
($940,000) to purchase disposable medical instruments and new 
equipment.  The GOK has also allocated 1.4 billion tenge ($10.9 
million) to build a new blood center in Shymkent. 
 
6. In his introductory meetings as new Akim of the Southern 
Kazakhstan Oblast, Umirzak Shukeyev learned that most hospitals are 
legally categorized as communal facilities, which permits them to 
require payment for services even in cases where free medical 
services are guaranteed by the state.  Shukeyev recommended that all 
children's hospitals and maternity clinics be registered as state 
organizations, thus ensuring that all services will be free. 
(Comment: This reaction reflects an unfortunate shift away from 
USG-supported health finance reforms in Kazakhstan, and disregards 
the fact that informal and under-the-table payments always have 
occurred in the inefficient Soviet system.  End comment.) 
 
7.  In reaction to the HIV outbreak in Shymkent, Kazakhstani 
authorities have examined blood centers throughout the country. 
Activities at blood centers in Zhezkazgan, Temirtau and Balkhash 
were suspended because of equipment degradation.  The Akmola 
Procurator has also recommended the suspension of activities at 
blood centers in Stepnogorsk and Atbasar, after discovering that the 
centers were using outdated equipment, including refrigerators 
manufactured 40 years ago. 
 
8. President Nazarbayev arrived in Shymkent on October 25 to discuss 
the HIV outbreak with oblast officials. Nazarbayev declared that 
urgent measures must be taken to revitalize the health care sector 
of the oblast.  He also urged procurators to quickly complete their 
investigation and to punish those guilty for the HIV outbreak. 
Kazakhstani authorities have already charged 17 doctors with 
negligence and investigators are now attempting to identify who 
recommended and performed the faulty blood transfusions and 
injections. 
 
9. Comment: The USG continues to assist the Ministry of Health with 
the reforms required above and beyond replacing old refrigerators. 
USAID and the U.S. Centers for Disease Control and Prevention 
continue to provide technical assistance in Shymkent and input to 
the draft National Blood Safety Program, which should clarify roles 
and responsibilities of stakeholders, including the quality 
monitoring of blood bank services.  Many of the deeper flaws 
revealed by the Shymkent tragedy, however, will take years of 
continued health sector reforms to address. End comment

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