Point of view: «The efforts of our countries’ healthcare systems should work in a unified manner»

The "Point of view" category

In December 2022, Russian Research Institute of Health (RIH) and the National Institute of Public Health of the Ministry of Health of the Kyrgyz Republic signed a cooperation agreement, which main objective is to improve the quality of public health, science and education, as well as to promote common goals in education, training and practice. We were lucky enough to talk with Acting Director of the National Institute of Public Health, Omor T. Kasymov, learn more about general objectives and goals, and ask about the main changes in the Kyrgyz healthcare system.

- Dear Omor, thank you for agreeing to talk. You have been the director of the R&D Association "Preventive Medicine" for almost 23 years. Just recently, the NGO has obtained the status of the National Institute of Public Health by the decree of the President of the Kyrgyz Republic Sadyr Zhaparov. Please tell us how the institute has changed over the years and how did it manage to achieve such high results?

Research institution headed by me was established on January 1, 1938 according to the resolution of the Central Committee of the CPSU of the Kyrgyz SSR and the Council of People's Commissars. Professor Elbert Boris Yakovlevich, an outstanding microbiologist, was appointed as the first director. He is, in fact, the founder of the whole medical science and education in our country. In 1938 he headed the first research institute of medical microbiology and epidemiology and in the same year (1938) he founded the first scientific and practical journal "Soviet Healthcare of Kyrgyzstan" (nowadays "Healthcare of Kyrgyzstan"). Along with this, in 1939 he headed the Kyrgyz State Medical Institute. For almost 85 years we have been carrying out various scientific and practical research. During the Second World War they provided the entire Red Army system with vaccines and serum, as well as sanitary and epidemiological well-being of the territories and health of Kyrgyz citizens.

In the post-war period, problems of sanitation and hygiene were added to the problems of microbiology and epidemiology, and as a result the Institute became multidisciplinary and was renamed the Kyrgyz Research Institute of Hygiene, Microbiology and Epidemiology. In this form, the Institute existed until about the mid-eighties, and in 2000 it was transformed into the Scientific and Production Association "Preventive Medicine". And now it has been about twenty-three years since I was appointed director's post.

After a rather difficult period, my team and I had to restore many systems of our institute. At the same time, the long-term work of Soviet and Kyrgyz scientists has made it possible to eliminate many infectious diseases, such as poliomyelitis, on the territory of our country. Our country is now free of poliomyelitis and malaria, which is confirmed by the relevant WHO certificates. In recent years, there have been practically no cases of diphtheria in our country. We are also the leading institute that promotes scientific and practical implementation of hepatitis and hepatitis B vaccination programs.

One of the most important events in the history of our institution was the Decree issuance of the Kyrgyz Republic President Zhaparov S.N. dated 07.12.2022 UP № 386 on granting us the status of the National Institute of Public Health. This is a very important appreciation of long-term work of Kyrgyz scientists and, of course, a reward for all our staff.

- RIH and NGO "Preventive Medicine" have recently signed a cooperation agreement. What are the goals of this cooperation today and how it can develop?

Now the National Institute of Public Health, as the legal successor of the NGO "Preventive Medicine" will actively work towards protecting and promoting population health in our countries. Our areas of common interest are diverse and multifunctional, including, for example, rationing the activities of healthcare institutions. This is an urgent issue for the healthcare system of our country, as we have gaps in planning, rationing and remuneration of health professionals. The second important task facing our countries is the elimination of hepatitis. By 2030, all countries should reach this goal, including Russia and Central Asian countries.

It is also necessary to note methodological cooperation in the field of healthcare organization and health promotion of our citizens, both at the population and individual level using program developments of preventive medicine. Recently, a round table on professional burnout of health professionals in CIS countries was held at RIH. We found a lot of points of convergence, giving an opportunity to examine this problem both in our Kyrgyz state and in Russia. For example, in such issues as protection of doctors and health professionals in extreme conditions of infection rapid spread on COVID-19 example.

At the same time, as practice has shown, we should not be disconnected. The efforts of our countries health systems should work in a unified manner. During the pandemic, Russia helped us a lot with diagnostic tests, Sputnik-V vaccine and other logistical assistance. The pandemic showed that countries should unite their efforts when it comes to organizing healthcare and providing medical assistance, because the virus, as it turned out, has no nationality. When isolated, it is difficult for countries to cope with this kind of threat.

Together with RIH, we plan to develop cooperation in the field of training specialists (managers and health care planners) in continuing education system, considering the individual characteristics and experience of our countries. In my opinion we should also focus our efforts on monitoring and analyzing the qualitative indicators of the entire scientific and educational area of the CIS and EAEU countries.

- What changes in the Kyrgyz Republic healthcare system do you consider the most significant in recent years?

Today, it is necessary to understand the effectiveness of our country's healthcare system before and after the pandemic and draw appropriate conclusions. As COVID-19 has shown, the healthcare systems of many countries have not coped well with the extreme conditions that the new coronavirus infection has put us in front of. This means that we must develop preventive measures and have a unified algorithm for responding to infection in emergency situations. In such important areas as laboratory diagnostics, test systems development, provision of personal and collective protective equipment, the healthcare system should always be in a state of full readiness.

The transformations that took place in our country in pre-covid period more or less contributed to fulfillment of the system's main tasks. Efforts were directed at creation of family doctors institute and strengthening primary health care for the population. We are lagging behind the third level of specialized health care, for example, such technological interventions as coronary bypass surgery, endoscopic interventions for various human pathologies. It is important to pay attention to creation of multidisciplinary healthcare organizations, where we could provide a full range of medical services to an individual. Naturally, infectious diseases hospitals should be built according to new architectural and planning requirements. We need to restore such important processes as medical examinations, screening programs to detect hepatitis, HIV infection, oncological, cardiovascular and other non-communicable diseases. I think our countries are very close in implementing such programs and should closely cooperate and help each other to achieve a more effective result.

- How would you rate the digital technologies development in healthcare sector in your country?

We have a number of government programs on digitalization of healthcare system, such as "Target Model of Digital Healthcare Development in the Kyrgyz Republic for 2022-2024". This program supports the online database "Assigned Population"; electronic appointment to a doctor; "Outpatient CIF", "Medstat" and many other documents, which makes life easier for both doctors and patients. We are trying to develop digital skills among health professionals, to ensure personal data confidentiality, as well as cybersecurity. And here we are adopting Russia and other countries’ experience where information systems are more advanced and have more experience. Along with this, a number of health system indicators, such as: birth rate, infant mortality, life expectancy are already stored in electronic format and posted on the portal of the Ministry of Health and on the portal of the National Statistical Committee of the Kyrgyz Republic. The population and all specialists have access to this information.

- Omor, you are a doctor of medical sciences, professor, Winner of the State Prize in Science and Technology, as well as an Honored Scientist of the Kyrgyz Republic, have extensive experience in organization of healthcare and science, a highly professional manager. What advice would you give to young healthcare managers and those who want to be engaged in healthcare sector?

If you go to work in healthcare system, you must understand the level of responsibility you have. This is the profession that gives you an opportunity to realize your potential and achieve success by helping others.

I would advise young managers, first of all, to learn again and again how to develop the field of preventive medicine in healthcare system and implement innovative measures to protect and promote health of our planet citizens. This will help to save resources, as well as pay attention to modern high-tech approaches: digitalization, IT-technologies, implementation of policies aimed at shaping human mental health, etc.