Ambassador Krol’s Speech for AmCham Conference: Healthcare Reform: Protecting the Nation’s Health

28 September, 2016


Good Morning.  It is my pleasure to be here today to open this event with Minister Duisenova and Ambassador Steil. As you are all aware, this year marks not only 25 years of Kazakhstan’s independence, but a quarter century of partnership between Kazakhstan and the United States.

The United States has worked with Kazakhstan through a variety of programs to improve the health of the nation and the region. The United States Agency for International Development, Centers for Disease Control and Prevention, State Department, Department of Commerce and Department of Defense have partnered on successful projects with the Government of Kazakhstan that have improved public health and the quality of healthcare provided to the population. Most recently, Kazakhstan became a partner country in the Global Health Security Agenda- advancing the goal of a world safe and secure from infectious disease threats.

Twenty-five years ago, our bilateral cooperation started under the auspices of the Defense Threat Reduction Agency’s program to create a Kazakhstan free of nuclear and chemical weapons. I think we can all agree that this contributed a great deal to Global Health Security.  We can point to many examples, from our work to secure material from the Semipalatinsk nuclear test site to Kazakhstan’s key role in the historic nuclear agreement reached last year with Iran.  While nuclear weapons hold vast destructive power, the threat posed by deadly disease is no less critical.  The recently opened Central Reference Laboratory on the campus of the Kazakh Scientific Center for Quarantine of Zoonotic Diseases is a cornerstone in a collaborative effort to respond quickly and effectively to deadly outbreaks of infectious disease.  It will protect the health of the people of Kazakhstan, of Central Asia, and indeed of the entire world.  In this facility, we see what we can accomplish when the best minds of our great nations work together in the spirit of scientific progress and mutual trust.

Biological pathogens do not observe boundaries, which is why it is imperative that experts from all nations work together to defeat these threats at the source.  That is the work the new reference laboratory makes possible.  Scientists employed in this laboratory will work closely with experts from the international community, including the U.S. Centers for Disease Control and Prevention and the World Health Organization.  As new outbreaks emerge in Kazakhstan or in other parts of Central Asia, the scientists in this center will stand ready to counter them.

Since 1992, USG agencies and programs including USAID, CDC, and PEPFAR have worked closely with the government of Kazakhstan to improve the quality of healthcare provided to the population, by

  1. improving the health care policy and legal framework including support for development and implementation of the Kazakhstan State Health Care Development Program;
  2. introducing internationally-recognized evidence-based standards of practice in a number of priority programs including especially dangerous pathogens (EDPs), TB, HIV, maternal and child health, family planning, cardiovascular disease, and other important non-communicable diseases;
  3. improving the ability of the primary health care sector to provide accessible quality services through structural, financing, and service delivery reforms;
  4. increasing the involvement of the population in their own health and educating the population and communities on health issues;
  5. expanding access to and improving the quality of TB and HIV diagnosis and care, including improving infection prevention and control;
  6. solidifying the gains in health financing reform as the foundation for improving equity, efficiency, and population access to high quality health services through the State Guaranteed Benefit Package; and
  7. supporting the ongoing development and implementation of a robust continuing medical education program for health care providers.

Through our partnerships, we have seen dramatic and encouraging improvements in health care services, access to care, and survival rates in Kazakhstan.   A great example of this is Tuberculosis (TB).  The number of new TB cases has been cut in half and deaths reduced more than four times over the past 10 years.

Kazakhstan has made substantial progress in preventing infections, providing quality testing and treatment, and saving lives.  For example, the U.S. government has partnered with the National TB Program to support the introduction of the first new TB drug in more than 40 years (Bedaquiline) to battle drug-resistant TB. We have also collaborated to introduce technology that rapidly diagnoses multidrug-resistant TB in a few hours instead of many weeks. However, not all drugs are created equal.

Use of counterfeit medicines can easily lead to quick reversals in the health gains Kazakhstan has seen.  Poor quality medications can lead to patient death and on the public health level can lead to resistance (now one of the leading international concerns in health—-when the last line antibiotic stops working, we have no more drug therapies to offer).

This is where our Department of Commerce has partnered with the Government of Kazakhstan to build capacity for the detection and interdiction of counterfeit medications and prosecution of offenses under Kazakhstan’s laws. The Commercial Law Development Program and the U.S. Patent and Trademark Office work with Kazakhstan’s Customs officials and Ministry of Justice on a regular basis- in bilateral and multilateral seminars. Just last week the U.S. Patent and Trademark Office brought judges and officials from the U.S. to meet with their Kazakhstani counterparts to discuss issues relating to intellectual property rights enforcement.  These interactions help facilitate regional trade while protecting public safety.

Protecting a nation’s health requires vigilance and is a shared responsibility that cannot be achieved by a single actor or sector of government. Its success depends upon collaboration among the health, security, environment, agriculture, education, finance, justice…all sectors. The US government congratulates the government for its strong commitment to health reform and is honored to continue its ambitious work with all Ministries in Kazakhstan who have pledged to improve and protect the health and health security of the Kazakhstani people.