Aizhan Amanzholova*, 47, was diagnosed with cirrhosis of the liver in 2012 due to hepatitis C. She became very ill and was frequently hospitalized, but in 2019 she was able to start free antiviral treatment and receive care and treatment in her hometown of Karaganda. Today, with annual screenings and support, she is healthier and no longer requires hospitalization.
“We used to have a lot of patients with advanced liver disease and cirrhosis. At that time, there were no liver transplants in the country. In 2010, Kazakhstan included viral hepatitis in the list of socially significant diseases, which by law meant that it was available to everyone Testing and treatment are provided free of charge. Now, everyone can receive free treatment regardless of the stage of the disease. This is good political leadership from the Ministry of Health,” said Kulpash Kaliaskarova, professor and chief hepatologist at the National Cancer Research Center of the Republic of Kazakhstan.
Hepatitis is an inflammation of the liver that can be caused by viruses and other infections, alcohol, and certain drugs. It can cause a range of health problems, some of which can be fatal. Globally, 90% of people with viral hepatitis are unaware they have the disease, and 3,000 people die from the disease every day. The WHO Global Hepatitis Strategy, endorsed by WHO Member States, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.
Free testing and treatment
Kazakhstan implemented a national roadmap for viral hepatitis prevention, diagnosis, treatment and prevention in 2017 and is currently one of the few countries in Central Asia that provides hepatitis B and C testing and treatment completely free of charge. Self-pay, no health insurance required.
“The Department of Health is committed to achieving health for all. Ensuring free viral hepatitis testing and treatment for all patients is a solid step in this direction. We do not have a waiting list for antiviral treatment for hepatitis and are exploring wider national Sexual screening methods to speed up case detection,” said Gulnara Maxutova, head of medical care for major social diseases at the Ministry of Health of the Republic of Kazakhstan.
Ensure access to primary health care services
Kazakhstan has responded positively to the World Health Organization’s 2022 recommendations on improving access to hepatitis C care and promoting person-centred care. Across the country, treatment is provided through primary health care centers and polyclinics (i.e. facilities that cover a wide range of diseases) so people can easily access treatment through local doctors. A universal screening program has just been piloted at polyclinics in the capital, Astana, testing 10,000 patients over the age of 18 for hepatitis B and C. Once the results are in, the program is expected to be rolled out across the country.
Prevalence and partnerships
Official data from the Ministry of Health shows that the prevalence of hepatitis C is as high as 3.1%. In 2022, 27,835 hepatitis B patients and 30,862 hepatitis C patients were registered.
Hepatitis tends to affect people aged 30 to 60 years. No particular social or economic group is most affected. There are some cases of mother-to-child transmission of hepatitis; however, all children across Kazakhstan are vaccinated against hepatitis B as part of a universal vaccination program.
The Ministry of Health considers it important to communicate and collaborate with civil society organizations and patient advocacy groups to find common solutions to improve patient welfare.
“Kazakhstan is rapidly scaling up testing and treatment for viral hepatitis. The Ministry of Health, in collaboration with WHO and other stakeholders, has made political and strategic decisions based on WHO evidence-based guidance and implemented strong A robust technical approach to ensure that everyone across the country has access to the hepatitis services they need.” Syla, WHO Representative in Kazakhstan.
*Names have been changed to protect identity.