Opportunities in the Health Care Sector of Uzbekistan
August 2006
Prepared by Mr. Jahangir Kakharov,
BISNIS Representative, Tashkent, Uzbekistan
INTERNATIONAL
COPYRIGHT, U.S. & FOREIGN COMMERCIAL SERVICE AND U.S. DEPARTMENT OF STATE,
2006. ALL RIGHTS RESERVED FOR USE OUTSIDE OF THE UNITED STATES.
This report is an
analysis of market opportunities in the health care sector of Uzbekistan. With
its central location in Central Asia, Uzbekistan represents a desirable and
affluent market for U.S. made advanced health care products, services, and
equipment
SUMMARY
This report deals
with market opportunities in the health care sector of Uzbekistan. For the
purposes of this report we focus on three main areas:
- Projects
financed by International Finance Institutions (IFIs) projects in the
health care sector
- Medical
Equipment
- Pharmaceuticals
& Neutraceuticals
Evidence suggests
that the standard of healthcare in Uzbekistan has suffered because of the
emigration of Russian-speaking doctors as well as persistent inefficiencies in
the healthcare sector. According to the Asian Development Bank (ADB), many
official health outcome statistics reported for Uzbekistan may be inconsistent
with those obtained through household surveys. Overall, Uzbekistan reports good
health care coverage but quality is lacking.
Uzbekistan has a
significant number of healthcare projects, which are scheduled to be
implemented through loans from various International Finance Institutions.
These projects are expected to help stimulate a growing market over the next
few years and are funded by the Government of Uzbekistan, the World Bank, ADB
and other multilateral and bilateral institutions.
Uzmedexport, a state company, is one of the main importers of medical
equipment for the public sector and has three subsidiaries, two (Medpribor and
Medcomplekt) of which are engaged in importing medical equipment. Medpribor imports medical equipment and
Medcomplekt imports “turn key” equipment, spare parts for medical equipment, and
disposables. There are also some private clinics and medical services
providers.
Regarding pharmaceuticals, there is a
comprehensive list of approximately 3,500 drug procurements permitted in the
country. An essential drug list was introduced in 1998, and includes 240
of these products. The public
sector supplies 20% of the country’s need. Dori-Dormar (51% state-owned)
imports drugs for the public sector from the newly independent states, and
Uzbekmedexports imports drugs for the public sector from other countries. The
drugs are in central warehouses and are distributed by the state Farmatsija
system through the regional divisions. All vaccines are distributed through
sanitary epidemiological services. Since 1994, 60% of pharmacies have been
privatized, and all drugs for ambulatory care have co-payments, although
in-patient care drugs are subsidized. Ministry of Health subsidizes at least 20
of the most basic drugs on the essential drug list. The licensing committee of
MOH certifies pharmacies, distributors, and manufacturers.
A. MARKET OVERVIEW
1. Healthcare Market Profile
Asian Development Bank RRP for the Woman and
Child Health Development Project notes that the Uzbek health system was
developed under the former Soviet Union, with a strong focus on secondary and
tertiary health care with an extensive network of health care facilities and
specialists. Before 1991, health care policy was developed, managed, and
regulated from Moscow; following independence, this role has shifted to the
Cabinet of Ministers headed by the President. The role of the Uzbek Ministry of
Health (MOH) was limited to implementing the policies developed in Moscow, but
now it includes developing health care legislation and regulation, setting
standards for quality, monitoring quality of care, monitoring the health of the
population, issuing licenses, developing curricula, and coordinating
international aid for health related projects. MOH is responsible for (i)
capital investment for construction and equipment, and pharmaceuticals, (ii)
maternal and child health, (iii) sanitary and epidemiological services, (iv)
human resources and education, and (v) management and supervision of health
services. MOH is also responsible for the administration of health care
facilities catering to government employees and military, while medical
institutions are responsible for management and resources. Regional health
facilities are administered by the regional governors (khokim) appointed
by the President.
The country has various public health programs
with many of them introduced in the past decade:
·
Immunization
program with basic coverage against childhood diseases now includes hepatitis.
Tetanus toxoid vaccines are offered for all pregnant women.
·
Integrated
management of childhood illnesses was introduced, although comprehensive
coverage is yet not offered countrywide.
·
A tuberculosis
directly observed therapy program has been introduced, with the tuberculosis
notification rate at 80%, and detection rate at 2%. However, the rates
fluctuate between provinces, and vary drastically over time, suggesting further
investment is required to strengthen the system. This program was fully
implemented in only 2 western oblasts.
·
The drug abuse
and treatment program, which includes a needle exchange, was established in
2001.
·
The country still
needs to focus on many other public health issues. Water and sanitation
coverage is poor. HIV/AIDS national policy is still not developed, although in
1998, the Government introduced the Republican HIV/AIDS Prevention Center in
Tashkent, with branches operating throughout the country.
·
The healthy
lifestyle program was introduced in 1997, with the goal of promoting healthy
nutrition behavior and prevent smoking. The Institute of Health was established
in 1998, and is expected to take on the responsibility of general health
education.
·
MOH is
responsible for sanitary and epidemiological services and has stations in rural
areas. The stations are responsible for health education activities. Reform in
the area is slow and inconsistent.
·
The Family
Planning program is managed by the Maternal and Child Health (MCH) Department
within MOH. Induced abortion is legal within the first 12 weeks of pregnancy.
General revenues are the main source of
financing Government health expenditures. The Government budget is broken down
into four chapters within recurrent expenditures: (i) personnel remuneration
and benefits, (ii) medicine, (iii) operation and maintenance, and (iv) building
repairs. Resources are allocated based on inputs, such as beds, population, and
staff. While, funds for tertiary and specialized facilities are retained at the
national level, districts are responsible for investment and maintenance of
lower-level facilities. All public sectors are on the Government’s payroll. A
physician receives approximately $60–80 per month. Private physicians are
officially permitted to charge user fees. Personnel remuneration as a share of
the budget has increased significantly (from 40% in 1990 to 63% in 2002), while
the salaries of health providers remain among the lowest in the country. In the
health sector, staff-related spending as a proportion of recurrent expenditures
accounts for more than 70% of spending, while in primary level facilities the
proportion is more than 80%. Assessments show that facilities need renovation,
drugs are in short supply, equipment is outdated, and supplies are lacking.
Despite the reform agenda, which aims at
developing primary health care, 76% of the republican budget and 65% of the
local budget go to hospitals (2003). For hospitals, a prospective payment
method is used, based on historical patterns, and reimbursements are not
adjusted for case mix. For outpatient services, a lump-sum payment mechanism is
used for patient visits. However, specialized diagnostic tests, such as
ultrasound, are paid through direct user charges.
Little information is available to show how
much is allocated for public health programs.
Generally, PHC services have no formal fees at
public sector health facilities. However, informal payment for health care is
prevalent in Uzbekistan. One household survey suggested that 11–
30% of those seeking medical consultation paid
for the services. The poor paid more frequently;
70% of those among the lowest income quintile
paid for health care.
Uzbekistan closed many unused hospital beds
over the past decade. The country had 6 hospital beds per 1,000 people in 2000,
as compared with 12 per 1,000 a decade ago. The rates are now closer to that of
Greece and Italy. Since 1989, several hospital beds were closed because of low
bed occupancy rate and the shift to day-care services. Because budgets are
input-based, this rationalization has resulted in hospital budgets decreasing
by almost 50%.
Evidence suggests
that the standard of healthcare in Uzbekistan has suffered because of the
emigration of Russian-speaking doctors and continued inefficiencies. According
to the Asian Development Bank (ADB), many official health outcome statistics
reported for Uzbekistan might be inconsistent with those obtained through
household surveys. Overall, Uzbekistan reports good health care coverage but
quality is lacking. According to the ADB, causes of poor health coverage
include:
·
outdated policy, protocols, and procedures;
·
poor integration of the health delivery system,
including primary health care (Soviet era emphasized vertical and
hospital-based health care);
·
lack of strategic needs-based human resource
planning, and of continuing education for medical and paramedical staff (the
Soviet era medical system encouraged specialized medical personnel over
generalists, and did not contain institutionalized continuing education
programs);
·
inequitable budgetary support and inappropriate
payment systems (in Soviet times,
health care resources were allocated through general revenues, but since
independence, the resource base had declined drastically, and oblasts (regions)
are expected to cover recurrent costs, with no change in budgeting systems
(they are currently input based), leading to significant inequities);
·
weak initiatives for dissemination of knowledge
and behavioral change (health education was not traditionally part of the
Soviet health system, where health providers did not inform patients of their
health condition or services offered).
In 2004, healthcare
spending amounted to $159 per capita or 5.4% of GDP. Healthcare is publicly
financed and is intended to be free at the point of delivery. However, the
Soviet-era practice of using bribery to obtain faster treatment is now common,
given the lack of resources and the larger population.
Below are some
market highlights:
·
There are 8 322
treatment-and-prophylactics medical organizations in Uzbekistan including 1018
hospitals, 3825 medical out-patient polyclinics, 3479 rural medical and
out-patient polyclinics.
·
Today over 3,500
medicines are registered in Uzbekistan. Among them over 2,000 medicines are
manufactured by foreign pharmaceutical companies, about 1,300 of medicaments
are manufactured by producers from the CIS countries, 250 names of substances
and means for diagnostics are registered, over 300 kinds of medicines are made
in Uzbekistan.
·
Over 80
pharmaceutical companies (foreign representative offices) are operating on the
territory of the Republic of Uzbekistan. The largest suppliers of
pharmaceutical products to Uzbekistan are Russia, Ukraine, Germany, Poland,
France and the USA. There are about 70 manufacturers of medicines and products
for medical purpose in Uzbekistan.
2. Statistical data
Resources of Uzbek
Health Services:
Statistical data
below is based on the World Health Report 2006. All data is for 2003, unless
otherwise indicated.
- Number of
physicians: 71,623
- Density of
physicians per 1000: 2.74
- Nurses: 256,183
- Density of nurses
per 1000: 9,82
- Midwives: 21,270
- Density of midwives
per 1000: 0.82
- Dentists: 3606
- Density of
dentists per 1000: 0.14
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A. RATIOS AND
LEVELS |
1998 |
1999 |
2000 |
2001 |
2002 |
2003 |
2004 |
|
I. Expenditure
ratios |
|
|
|
|
|
|
|
|
Total
expenditure on health (THE) % GDP |
6.7 |
6.0 |
5.7 |
5.7 |
5.6 |
5.5 |
5.4 |
|
General
government expenditure on health (GGHE) % THE |
48.0 |
48.4 |
45.6 |
45.4 |
44.3 |
43.0 |
42.1 |
|
Private
expenditure on health (PvtHE) % THE |
52.0 |
51.6 |
54.4 |
54.6 |
55.7 |
57.0 |
57.9 |
|
GGHE % General
government expenditure |
7.1 |
7.0 |
6.6 |
7.1 |
6.8 |
7.6 |
7.5 |
|
Social
security expenditure on health % GGHE |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Net out-of-pocket spending on health (OOPs) % PvtHE |
97.4 |
96.8 |
96.9 |
97.1 |
95.3 |
95.5 |
95.9 |
|
Private prepaid plans expenditure on health % PvtHE |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
Externally funded expenditure on health % THE |
3.1 |
0.9 |
1.7 |
3.5 |
4.1 |
3.0 |
n/a |
|
II. Per capita
levels |
|
|
|
|
|
|
|
|
THE per capita at exchange rate (US$) |
41 |
42 |
32 |
26 |
21 |
21 |
25 |
|
GGHE per capita at exchange rate (US$) |
20 |
20 |
14 |
12 |
10 |
9 |
10 |
|
THE per capita at international dollar rate |
152 |
143 |
142 |
149 |
155 |
159 |
169 |
|
GGHE per capita at international dollar rate |
73 |
69 |
65 |
68 |
69 |
68 |
71 |
|
B. VALUES UNDERLYING RATIOS AND LEVELS |
1998 |
1999 |
2000 |
2001 |
2002 |
2003 |
2004 |
|
Health System Expenditure & Financing (million NCU) |
|
|
|
|
|
|
|
|
I. Measured
Financing Agents |
|
|
|
|
|
|
|
|
Total
expenditure on health (THE) |
94 426 |
127 671 |
185 434 |
278 707 |
421 936 |
532 200 |
658 718 |
|
.General
government expenditure on health (GGHE) |
45 317 |
61 731 |
84 646 |
126 578 |
186 733 |
228 709 |
277 405 |
|
…of
which Social security expenditure on health |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
.Private
expenditure on health (PvtHE) |
49 109 |
65 940 |
100 788 |
152 129 |
235 203 |
303 492 |
381 314 |
|
… of
which Net out-of-pocket spending on health |
47 839 |
63 860 |
97 668 |
147 759 |
224 079 |
289 923 |
365 685 |
|
...
of which Private prepaid plans expenditure on health |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
|
II. Measured
Financing Sources |
|
|
|
|
|
|
|
|
Externally
funded expenditure on health |
2 947 |
1 134 |
3 201 |
9 872 |
17 359 |
16 212 |
n/a |
|
IV. Macro
Variables |
|
|
|
|
|
|
|
|
Gross
domestic product (GDP) (million NCU) |
1 416 157 |
2 128 660 |
3 255 600 |
4 925 300 |
7 469 300 |
9 664 100 |
12 189 500 |
|
General
government expenditure (million NCU) |
635 855 |
885 522 |
1 279 451 |
1 791 571 |
2 726 295 |
3 006 080 |
3 679 617 |
|
Exchange rate (NCU per US$) |
94.79 |
124.64 |
236.58 |
423.08 |
771.42 |
971.35 |
1019.94 |
|
International dollar rate (NCU per international dollar) |
25.79 |
36.60 |
52.68 |
74.47 |
106.62 |
129.76 |
148.84 |
|
Total population (in
thousands) |
24 034 |
24 375 |
24 724 |
25 083 |
25 452 |
25 828 |
26 209 |
|
Data Sources and
Methods |
|
|
|
|
|
|
|
|
Total
expenditure on health (THE) |
|
||||||
|
General
government expenditure on health (GGHE) |
Source: Public Expenditure Review (PER), World Bank, 2004; www.mf.uz: "Financial Analysis of National Data on Health
Expenditures": Abt Associates memo |
||||||
|
Social
security expenditure on health |
Does not
exist |
||||||
|
Private
expenditure on health (PvtHE) |
Sum of NGOs and OOP expenditures |
||||||
|
Net
out-of-pocket spending on health |
Uzbekistan Living standards assessment (2000-01 Family Budget Survey),
World Bank, May 2003. The 2000-01 Family Budget Survey" (p. 76 of the
source) says private expenditure are between 3-5 percent of GDP. A higher
figure of 5% has been taken. Triangulated with the data from the Abt
associate memo for 1998 where 21 USD per capita are spent on health as OOP
expenditures. |
||||||
|
Private
prepaid plans expenditure on health |
According to HiTs 200, "voluntary health insurance does not yet
play a role in health care financing." |
||||||
|
Externally
funded expenditure on health |
1995-1999 series from the National health expenditure memo, Abt Associates and thereafter OECD grants
commitments are included.2002-2003 are disbursement figures |
||||||
|
Macro Variables |
|
||||||
|
Gross
domestic product (GDP) (million NCU) |
UNECE, Sep
2005 |
||||||
|
General
government expenditure (million NCU) |
Public Expenditure Review, World Bank, 2004; 1995-2003 using share of
GGE to GDP given in PER, 2004. includes extra budgetary and foreign funding;
Yr. 2004-www.mf.uz |
||||||
|
Exchange rate (NCU per US$) |
UNECE, Sep
2005 |
||||||
|
International dollar rate (NCU per international dollar) |
UNECE, Sep
2005 |
||||||
|
Total population (in
thousands) |
UNPOP |
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|
Source:
World Health Organization |
|
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3. The role and share of the private sector.
The role of the private sector is also increasing in connection with the
development of stationary and surgical clinics, polyclinics and private
practices, the majority of which are being formed as small and medium
businesses. In 1995, the
Government introduced a licensing system, and only licensed physicians are
permitted to practice in the private sector. Currently, less than 1% of
physicians work in the private sector.
Over the past decade the Government has
vigorously pursued privatization, although continued effort is required.
Several polyclinics and hospitals were privatized by contracting private
services at public facilities. The Private sector health expenditure share has
increased, (ranging between 0.6% [1990] and 2.6% [2002] of GDP), and has
contributed to about one-fourth of the total health expenditures in 2002. Private doctors are permitted to charge a fee
for service, but must provide at least 20% of health services within the state
system, which is then paid for by the Government. Service quality and fees are
not regulated. There are more than 80 private hospitals and
956 surgical centers and polyclinics in Uzbekistan. Nearly, all pharmacy
enterprises in the country are either private or with a small state stake in
them (less then 35%).
4. Health Sector Reforms
ADB notes that the
Government has embarked on several health-sector reform initiatives, since the
mid-1990s. In 1996, a Presidential decree (UP-2107), improving primary health
care for the rural population was introduced. In 1998, a comprehensive reform
agenda, which introduced emergency hospitals and initiatives on the
public-private mix for secondary health services, was adopted to improve
quality in access to quality and affordable health care. Through these
initiatives, several efficiency gains were achieved, including closing hospital
beds, reducing hospital admissions, and improving outpatient care. A series of
long-term state programs for woman and child health, including integrated
management of childhood illnesses, micronutrient deficiency control (primarily
iron and iodine), and family planning were endorsed in 2002. However, many
programs were limited in terms of geographic coverage and budget deficit; they
lacked integration and were supported solely by international agencies.
Overall, the country is making progress in improving health care, but
considerable effort is required to accelerate reforms.
B. IFI Funded Projects
Uzbekistan has a
significant number of healthcare projects, which supposed to be implemented
through International Finance Institutions' loans. These projects are expected
to help stimulate a growing market over the next few years and are funded by
the Government of Uzbekistan, World Bank, ADB and other multilateral and bilateral
institutions.
Some of the major
projects to be implemented in the course of 2006 and beyond include:
·
World Bank’s Health II Project with IDA
commitment of $40 million;
·
Asian Development Bank’s Woman and Child Health
Development Project with ADB commitment of $40 million;
·
State Medical Emergency Hospitals Equipment Project
worth $
23.8 million from the Islamic Development Bank;
·
Project
on providing medical equipment for
171 district sub-divisions of the branch of the Republican Centre for Emergency
Medical Aid. The project will be funded with $25 million long-term credit
extended by the Kuwait Fund for Arab Economic Development on preferential terms
·
Project on
delivering medical-diagnostic and medical equipment to Uzbekistan's specialized
centers for surgery, urology, cardiology and eye micro-surgery in Tashkent. The
project will be funded to the tune of $20 million long-term credit provided by
the Islamic Development Bank on preferential terms.
We will discuss in detail the first three projects
1. World Bank’s Health II
Project
World Bank’s Second
Health Project for Uzbekistan aims to improve the quality and overall
cost-effectiveness of health care services. The project has the following four
components: Component 1) will extend further support for the development of
Primary Health Care (PHC) services. In concert with the Asian Development Bank,
all Primary Care Centers (SVPs), as well as some remaining SVPs not covered
under Health I, will be supplied with a package of equipment. More remote SVPs
will be supplied with telecommunication equipment and transportation to improve
patient services, referrals, and overall management of these facilities.
Component 2) will support broad activities to continue to improve health care
financing and management systems, to improve the efficiency in the delivery of
services and to help increase sustainability of primary health care reforms.
Activities to improve health care financing and management systems will include
financing and management pilots initiated under the first Health project, and
extending and geographically expanding an adapted version of the rural PHC
financing model nationally. Component 3) aims at contributing to the control of
communicable and non-communicable diseases, and to improve public health
services, including surveillance, and health promotion. Component 4)
concentrates its activities through the Central Project Implementation Bureau
(CPIB), and Oblast Project Implementation Bureaus (PIBs) of the MOH.
The overall objective
of the project is to improve the quality and overall cost-effectiveness of
health care services in Uzbekistan. This will be achieved through
(a) completing the
primary care program in 8 regions (Samarkand, Sukhandarya, Namangan, Andijon,
Djizzak, Ferghana, Navoiy, Syr Darya), and other regions as agreed, and
institutionalization of general practitioners nationally;
(b) extending
financing and management reforms related to efficiency and effectiveness of
service delivery;
(c) improving public
health services, including surveillance, training in public health and control
of communicable disease; and
(d) building capacity
in the Ministry of Health to better monitor and evaluate the reforms, and
better manage the restructuring process.
The Health II project
follows and builds upon Health I. The Health I Project supported the
restructuring of primary care and outpatient services in rural areas. The
Government, for its part, has begun building new primary care centers, and
rehabilitating some selected facilities already in operation.
The Bank support has
provided funding for: (i) equipment, supplies, and small amounts of emergency
pharmaceuticals; (ii) development of a new cadre of medical personnel through
short-term training programs for general practitioners and universal nurses,
and, for the long-term, by redefining medical education curricula; and (iii)
management and financing reforms that promote decentralization, incentive-based
payment systems, and management innovations. The reforms have been enacted
mainly in three pilot oblasts, Ferghana, Navoiy and Syr Darya. In addition,
elements of the program have been initiated elsewhere, most recently in Khorezm
and the semi-autonomous region of Karakalpakstan. This first World Bank health
project commenced in 1998 and ended in 2004.
The Health II Project
will build on Health I, with a limited number of important extensions and
refinements. Five new regions will have primary care facilities equipped. The
rural primary care models of Health I will be extended to new urban area
pilots. New GP training centers will allow full national replication of GP
training. A greater emphasis will be placed on access to pharmaceuticals,
continuous medical education and quality improvement.
The financing and
management pilots will be replicated nationally. Some extensions such as
physician bonus schemes will be developed to address distribution issues. New
provider payment pilots for hospital services will be initiated. A new
rationalization strategy will focus on consolidation of hospital services and
facilities.
The legal agreement is
flexible, and allows for extending the program to more than 8 regions as funds
become available through government funding, donor support, or re-allocation
from savings.
A new component,
Improving Public Health Services, will contribute to the control of emergent
communicable diseases and the long-standing issue of non-communicable diseases,
and will improve public health services, including surveillance and health
promotion. The project is expected to be completed in 2010.
2. Women and Child Health Development Project
The Asian Development Bank (ADB) is supporting
primary health care reform and building the health care delivery system for
woman and child health in Uzbekistan, through a loan approved for US$40
million.
The Project will focus on poor rural women and
children, and will be carried out in six of the country's 13 oblasts
(districts) - Buhkara, Fergana (pilot site), Kashkadarya, Khorezm, and
Tashkent, and the Republic of Karakalpakstan - selected for their high poverty
rates and health problems.
The national maternal mortality ratio,
officially estimated at 34 per 100,000 live births in 2001, has not improved
since the 1990's. The infant mortality rate at 62 deaths per 1,000 live births
in 2002 has also changed little since the early 1990s. Wide geographical
disparities exist, with rural areas reporting almost double the rate of urban
areas.
The incidence of communicable diseases is also
increasing. HIV/AIDS registered cases have almost doubled in the past two
years, while tuberculosis incidence has doubled over the past decade.
The overall goal of the Project is to help the
Government achieve health related Millennium Development Goals, including
reducing maternal and child mortality and morbidity, and reducing infectious
diseases among the rural poor and vulnerable.
To achieve this, the Project has two broad
objectives - to support health sector reform initiatives for primary health
care, and improve the efficiency of the health care delivery system for woman
and child health.
"Investments are designed to shift some
resources from hospitals in urban settings to rural clinics servicing less
accessible and less prosperous communities," says Karima Saleh, an ADB
Health Economist.
The project will strengthen management of local
governments, strengthen quality of care in rural clinics, provide referral
links to rural secondary hospitals, optimize human resources, and build
institutional capacity for retraining doctors and nurses.
It will also help prevent the spread of
blood-borne infectious diseases, including HIV/AIDS, by building a nationwide
blood safety program. In addition, the project will support reform efforts in
health care finance, and build capacity to manage these reforms to increase
health system efficiency.
The project complements the World Bank's
Health-II project, which supports the Government's primary health care
initiative.
A $300,000 technical assistance grant will
accompany the loan to provide training to the Ministry of Health on woman and
child-related health issues.
The total cost of the project is $70 million
equivalent, of which the Government is providing $30 million. The Ministry of
Health will implement the project, which is due for completion in December
2009.
3. State Medical Emergency Hospitals Equipment
Project
Islamic Development Bank (IDB) will provide $25 million to supply
regional branches of the National Intensive Care Center with specialized
equipment.
The medical equipment and related services to be
procured under this project comprises the following components:
·
Surgical
equipment;
·
Equipment
for operating blocks;
·
Equipment
for intensive therapy chambers and detoxication;
·
Equipment
and accessories for anesthesia;
·
Equipment
for reception and emergency aid;
·
Special
treatment and diagnostic equipment;
·
Morgue
equipment;
·
Equipment
for sterilization department;
·
Equipment
for pharmacy;
·
Laboratory
equipment.
·
Systems
of emergency power supply
The training will be conducted for two groups of
trainees: professional doctors on utilization and technical staff on
maintenance. Training would be included in contracts for supply of medical
equipment.
Procurement of items financed by the Islamic Development Bank will be
undertaken through the procedures as specified in the Islamic Development
Bank’s Guidelines: Guidelines for Procurement of Goods and Works under Islamic
Development Bank Financing, December 2003, and is open to all eligible bidders
as defined in the guidelines.
Specific procurement notices for contracts to be bid under the Islamic
Development Bank’s International Competitive Bidding (ICB) procedures will be
announced, as they become available, on the IDB Website ( www.isdb.org) ; the
website of the Republican Research Centre of Emergency Medicine of Uzbekistan
(www.rrcem.uzsci.net), the Medical Portal of Uzbekistan (www.med.uz); “Pravda
Vostoka” Newspaper published in Uzbekistan and other publications. It is
expected that the project will be completed in 2007.
C. Medical Equipment
1. Best sales prospects
Preferred Best Sales
Prospects, based on all available information, are as follows:
- Surgical Instruments and Appliances
- Blood Transfusion Centers
- Laboratory Analyses Equipment
- Surgical and Laboratory Sterilizers
- Aesthetic surgery
- Equipment for primary care centers (SVPs)
- Ultrasonic Diagnostics Equipment
- Dental Professional Equipment
- Dental Tools and Appliances
- Monitoring Systems, Electro-Diagnostic
- X-ray equipment
- Ophthalmologic Instruments and Appliances
- Endoscopes and laser equipment
- Medical lasers
- Gynecology and urology Professional
Equipment
Uzmedexport, a state company, imports medical equipment for the public
sector and has three subsidiaries, two (Medpribor and Medcomplekt) of which are
engaged in imports of medical equipment.
Medpribor imports medical equipment and Medcomplekt imports “turn key”
equipment, spare parts for medical equipment, and disposables.
2. Domestic Production
There is virtually no domestic production of
most medical equipment and supplies. There is a local production of disposable
syringes and orthopedic equipment. However, these fall well short of meeting
the demand. The only orthopedic factory, located in Tashkent, produces the
hands and legs prosthetic devices, corsets, and orthopedic shoes. Fixation
instruments for osteosynthes are also manufactured in a small number. Production
facilities to produce disposable syringes, infusion and transfusion system have
been launched after independence. Joint venture “Pharm Glass” produces medical
glass products.
3. Foreign suppliers and U.S. Market Position
An overwhelming
majority of medical equipment used in Uzbekistan is imported. Germany and
Russia are the largest exporters of medical equipment to Uzbekistan. US, United
Kingdom, Finland, and Japan also account for significant share of the medical
equipment market.
German companies
have been successful because of their solid reputation for quality. Russian
companies are popular because of their lower prices and enjoy the advantage of
geographic proximity, common language, products with the same standards and
cheep after-sales service.
4. Competitive Factors
Key factors for
Uzbekistan buyers within the medical equipment industry are high quality,
reliability, durability, practical features, price and advanced technologies.
Firms often compete
on service. A knowledgeable and experienced sales staff is important to not
only sell the equipment, but also to train the future end-user. In addition, a
company's ability to provide an after-sales service program strongly influences
a buyer's decision.
U.S. manufacturers
interested in marketing their medical equipment in Uzbekistan could
considerably improve their market position by more aggressive marketing and by
taking advantage of:
a. Long established
Uzbek agents and dealers who have excellent contacts with purchasing managers
and administrative directors of hospitals.
b. Products
manufactured in the U.S. accompanied by brochures in Russian or Uzbek
languages.
c. The absence of a
wide range of domestic production in the majority of the product categories of
medical equipment.
d. High quality
products offered by U.S.-manufacturers at competitive prices.
D. Pharmaceuticals
1.
Overview
During pre-independence, the drug regulation
and procurement system was under Moscow’s control. In 1995, Ministry of Health
set up the Department of Drug and Medical Equipment Quality Control (HDDMEQC).
In 1997 the first act on drugs and pharmaceutical activities was developed and
a national drug policy was adopted in 1999.
HDDMEQC of the
Ministry of Health is the main regulatory body responsible for proper
implementation of the Act and for overall drug policy and regulation. It was set up in 1995 by presidential decree
as the drug control body with both executive and regulatory functions. It is
the sole state policy institution in the fields of quality control,
standardization and certification of drugs, medicinal foods and medical
equipment. The main goal of the Department is to ensure implementation of a
comprehensive national drug policy. The Department leads and coordinates the
following subdivisions: a state center for expertise and standardization of
medical means (which includes a quality control laboratory), a vaccine and
microbiology laboratory, the pharmacotoxicology unit and the units for quality
control of medical equipment and scientific methodology and information. There
are also several committees, including: the pharmacological and pharmacopoeia committees;
the formulary committee; the new medical equipment committee; the licit drugs
committee; and the pharmaceutical inspectorate registration office.
The comprehensive list of drugs procurement
permitted in the country comes to about 3,500. The essential drug list was
introduced in 1998, and includes 240 of these products. The public sector
supplies 20% of the country’s need. Dori-Dormar, 51% state-owned, imports drugs
for the public sector from the newly independent states, and Uzbekmedexports, a
state company, imports drugs for the public sector from other countries. The
drugs are in central warehouses and distributed by the state Farmatsija system
through the regional divisions. All vaccines are distributed through sanitary
epidemiological services. Since 1994, 60% of pharmacies have been privatized
and all drugs for ambulatory care have co-payments, although in-patient care
drugs are subsidized. MOH subsidizes at least 20 of the most basic drugs on the
essential drug list. The licensing committee of MOH certifies pharmacies,
distributors, and manufacturers.
2. Best sales prospects
Table
below provides information regarding drugs most demanded in the Uzbek market
Import of pharmaceuticals for the
period 1999-2004 (in thousands US$)
|
HS code |
Product Name |
1999 |
2000 |
2001 |
2002 |
2003 |
2004 (Jan-Sep) |
|
3003 |
Medicament mixtures (not 3002, 3005, 3006), not in
dosage or packaged for retail |
891.2 |
1,289 |
2,035.9 |
37,081 |
7,614 |
627.5 |
|
3004 |
Medicament
mixtures (not 3002, 3005, 3006), put in dosage or packaged for retail |
47,402 |
39,954.3 |
54,811.7 |
66,635.6 |
73,478.2 |
76,698.9 |
|
3005 |
Wadding, gauze,
bandages, impregnated or coated or packaged for retail |
1,212.1 |
1,359.8 |
1,457.1 |
1,249.8 |
589.5 |
685.9 |
|
3006 |
Pharmaceutical
goods, specified sterile products sutures, laminaria, bloodgrouping reagents,
dental cements & fillings, first aid kits, contraceptives from hormones
or spermicides |
0 |
548.6 |
343.1 |
570.9 |
1,856.9 |
866.9 |
|
Total |
49,505.3 |
43,151.7 |
58,647.8 |
105,537.3 |
83,539 |
78,879.1 |
|
Source: The State Committee
for Statistics of the Republic of Uzbekistan
In 2002 there was an abrupt growth of
pharmaceuticals imports, which was associated with an increase in humanitarian
aid supplies of pharmaceuticals.
Some other major factors affecting the imports
of pharmaceuticals are:
• Epidemiological situation in country;
• Increase or decrease of domestic production
volume;
• Domestic and the World market prices;
2.
Domestic Production
Currently, the country
is dependent on imported drugs; only 10% are manufactured locally, most are
herbal. Only 3% of drugs on the essential list are domestically produced. Despite this, Uzbekistan boasts
the most developed bio-pharmaceuticals industry in Central Asia. During Soviet times there
were two main pharmaceutical enterprises located in Uzbekistan: “Uzkhimpharm”
and an enterprise specializing in the production of vaccines, serum,
immunobiological medicine. The latter produced more than 60 products, including
phytin, rutin galanthamine, anti-snakebite serums and others.
Domestic production of pharmaceuticals is developing, albeit, slowly. Currently, Uzbekistan’s
pharmaceutical sector is divided into state and private sector ownership. The main state-owned player in the market is
“Uzkhimpharm” with more than 70 subsidiaries, among which are R&D institutes
and pharmaceutical plants. There are
also about 30 privately owned enterprises in Uzbekistan engaged in the
production and packing of pharmaceuticals.
Uzbekistan is rich in terms of raw materials needed for
pharmaceutical industry and possesses a good research and scientific base. The sole institute in Central Asia for
vaccines and serum is located in Tashkent, Uzbekistan. There are some other
promising research-scientific institutes in Uzbekistan that could become
players on the market in the future. Locally grown plants are widely used in
preparing pharmaceuticals. Uzbekistan produces anti tuberculosis, analgesic,
vitamin, non-steroid antiphlogistic, diuretic means, some types of antibiotics,
as well as bandaging materials. However, the country doesn’t produce products
such as insulin, psycho-neurological medicines, narcotics analgesics, and
hormonal agents, requiring them to be imported.
3.
Foreign suppliers and U.S. Market Position
As noted above, today
over 3,500 medicines are registered in Uzbekistan. Among them over 2,000
medicines are manufactured by foreign pharmaceutical companies, about 1,300 of
medicaments are manufactured by producers from the CIS countries, 250 names of
substances and means for diagnostics are registered, over 300 kinds of
medicines are made in Uzbekistan.
Over 80 pharmaceutical
companies (foreign representative offices) are operating on the territory of
the Republic of Uzbekistan. The largest suppliers of pharmaceutical products to
Uzbekistan are Russia, Ukraine, Germany, Poland, France and the USA.
Many foreign suppliers participate in drugstore
chains business and try to influence control on the retail market themselves.
More than 200 foreign firms from more than 60 countries of the world sell their
products in Uzbekistan.
Below are the 5
leading foreign manufacturers of medicines that export their products to
Uzbekistan and their market share:
Glaxo SmithKline 9%
Icn Pharmaceuticals 8%
KRKA 7%
Gedeon Richter 7%
Berline Chemie 6%
Other companies 63%
Table below summarizes US market position
compared with other countries:
Pharmaceuticals imports to Uzbekistan by country of
origin
|
HS code |
Country name |
Measurement unit |
01/01/2002-31/12/2002 |
01/01/2003-31/12/2003 |
||
|
Quantity |
Value Thousand US$ |
Quantity |
Value Thousand US$ |
|||
|
3003 |
Total |
Tons |
76 |
37,081.1 |
83 |
7,614.4 |
|
|
From foreign countries |
|
67 |
36,981.1 |
58 |
7,322.4 |
|
|
USA |
|
57 |
36,523.5 |
18 |
6,760.8 |
|
|
Other foreign countries |
|
10 |
457.7 |
40 |
561.6 |
|
|
From CIS countries
|
|
9 |
100.0 |
25 |
292.0 |
|
|
Byelorussia |
|
3 |
28.7 |
11 |
147.4 |
|
|
Russia |
|
6 |
71.3 |
14 |
144.6 |
|
|
|
|
|
|
|
|
|
3004 |
Total |
Tons |
5,918 |
66,635.6 |
8,376 |
73,478.2 |
|
|
From foreign countries |
|
1,592 |
39,090.1 |
1,591 |
39,756.6 |
|
|
Austria |
|
36 |
2,813.8 |
49 |
3,116.3 |
|
|
Germany |
|
174 |
4,816.7 |
211 |
7,230.8 |
|
|
Hungary |
|
48 |
2,692.7 |
87 |
4,733.4 |
|
|
India |
|
170 |
2,757.1 |
410 |
3,349.5 |
|
|
Slovenia |
|
45 |
1,484.7 |
98 |
2,659.4 |
|
|
Switzerland |
|
40 |
2,335.2 |
44 |
2,794.8 |
|
|
Other foreign countries |
|
1,079 |
22,190.1 |
691 |
15,872.4 |
|
|
From CIS countries |
|
4,327 |
27,545.5 |
6,784 |
33,721.7 |
|
|
Byelorussia |
|
360 |
1,835.1 |
571 |
2,544.2 |
|
|
Russia |
|
3,797 |
20,338.5 |
5,811 |
26,621.8 |
|
|
Ukraine |
|
102 |
3,154.2 |
274 |
3,132.4 |
|
|
Other CIS countries |
|
68 |
2,217.7 |
128 |
1,423.3 |
|
|
|
|
|
|
|
|
|
3005 |
Total |
Kg |
189 |
1,249.8 |
57 |
589.5 |
|
|
From foreign countries |
|
11 |
208.5 |
32 |
329.0 |
|
|
Germany |
|
0 |
16.0 |
18 |
145.8 |
|
|
Latvia |
|
- |
- |
1 |
20.3 |
|
|
USA |
|
7 |
148.8 |
12 |
159.7 |
|
|
Other foreign countries |
|
3 |
43.7 |
0 |
3.2 |
|
|
From CIS countries |
|
179 |
1,041.2 |
26 |
260.5 |
|
|
Russia |
|
178 |
1,036.9 |
25 |
252.5 |
Source: The State Customs
Committee of the Republic of Uzbekistan
4. Competitive Factors
Clinical trials are
necessary to register domestic products. Efforts are being made to comply with
the WHO and the EU Good Clinical Practice guidelines and to align with the
international standards for randomized controlled clinical trials.
Uzbekistan inherited a
well-developed drug distribution system from the Soviet era. This includes the
centralized state Farmatsija system and its regional divisions and pharmacies.
The country has 3600 pharmacies, of which 2220 are formerly state owned and
privatized, the remaining being newly established pharmacies that are highly
decentralized. The pharmacies are almost completely privatized, either as part
of a self-supporting state joint shareholding association, Dori-Darmon (the
former sole drug distributor) or as a for-profit collective or individual
pharmacy. This successful privatization effort has helped to ensure competition
and provided new opportunities for circumventing the shortages of foreign
drugs.
Dori-Darmon is the
main source of drugs for hospitals. Each hospital places an annual order with
Dori-Darmon, and deliveries are normally made on a weekly basis. There are also
private drug distributors, which mainly supply drugs to pharmacies, polyclinics
and private practices. The sanitary epidemiological services directly
distribute vaccines.
Foreign drugs for
public-sector needs are primarily purchased in two ways. Dori- Darmon is
responsible for all purchases of drugs from the NIS, and Uzmedexport, a trading
company under the auspices of the Ministry of Health, undertakes all public-sector
purchases from other countries. Uzbekmedexport relies on Dori-Darmon for
technical information and advice. There are also a number of private importers,
contact details of which are provided below.
Since 1994, prices
have been fixed for the 20 most basic drugs. For all other products, price
regulation is based on maximizing wholesale and retail mark-ups (20% and 25%
respectively).
Despite the fact that
the price of local manufactured pharmaceuticals are cheaper than imported ones,
imported products are sought after considered because of the design and
quality, which is a very important factor in today’s market of Uzbekistan.
E. MARKET ACCESS
1. General background information:
The Government of
Uzbekistan generally welcomes foreign supplier initiatives and is interested in
new technologies. Some medical
equipment purchases can be funded through international organization projects,
which are detailed above. It is advisable
for US producers and suppliers of
pharmaceutical products wanting to enter into the domestic market of Uzbekistan
to consider working through a network of trade dealers, distributors and
drugstores, which arrange a system of product promotion and after sale
services.
2. Import customs tariffs
The resolution of
the Cabinet of Ministers of September 19, 2005 number PP 183 "On
additional measures of regulating import custom duties" establishes new
rates of import customs duties effective November 1, 2005.
Import
customs duties on pharmaceuticals
|
HS code |
Product
name |
Rates of
customs duties
(in % from the
customs cost) |
|
3003 |
Medicament mixtures (not
3002, 3005, 3006), not in dosage or packaged for retail |
5 |
|
3004 |
Medicament mixtures (not
3002, 3005, 3006), put in dosage or packaged for retail |
5 |
|
3005 |
Wadding, gauze, bandages, impregnated
or coated or packaged for Retail |
30 |
|
3006 |
Pharmaceutical goods,
specified sterile products sutures, laminaria, blood-grouping reagents,
dental cements & fillings, first aid kits, contraceptives from hormones
or spermicides |
5 |
Import customs duties
for on medical equipment
|
HS code |
Product name |
Rates of customs
duties (in % from the customs cost) |
|
9001, 9018-9033
00 000 |
Optical fibers and optical
fiber bundles; Instruments and appliances used in medical, surgical, dental
or veterinary sciences, including scintigraphic apparatus, other electro-medical apparatus and sight-testing instruments;
parts and accessories thereof: Electro-diagnostic apparatus (including
apparatus for functional exploratory examination or for checking
physiological parameters); parts and accessories thereof, |
5 |
|
9002-9004, 9011-9013, 9015-9017 |
Lenses, prisms,
mirrors and other optical elements, of any material, mounted, being parts of
or fittings for instruments or apparatus, other than such
elements of glass not optically worked; parts and accessories thereof,
Objective lenses and parts and accessories thereof, except
for |
10 |
|
9003 19 100 |
Rims for glasses from precious metal or rolled
precious metal |
30 |
|
9022*(except
902490 000) |
Apparatus based
on the use of X-rays or of alpha, beta or gamma radiations, whether or not
medical, surgical, dental or veterinary uses, including radiography or
radiotherapy apparatus, X-ray tubes and other X-ray generators, high tension
generators, control panels and desks, screens, examination or treatment
tables, chairs and the like; parts and accessories thereof: Apparatus based
on the use of X-rays, whether or not for medical, surgical, dental or
veterinary uses, including radiography or radiotherapy apparatus |
5 |
*zero rate of
customs duties applied
3. Regulations and technical requirements
As stated above,
there are serious budgetary constraints limiting the volume of equipment and
supplies purchased by medical entities in Uzbekistan.
Ministry of Health
officials and local companies prefer working directly with manufacturers, and
not with intermediaries. Medical equipment and supplies are primarily financed
from the State budget and loans from the World Bank or other banks and
agencies.
To sell medical
equipment to Ministry of Health entities, a U.S. company must be sure: (1) the
Ministry of Health has some funding either from the state budget or a loan, and
(2) the main Ministry of Health suppliers of medical equipment and
pharmaceuticals (such as Uzmedexport and Uztenderconsulting) have the necessary
information about the American company's products. U.S. companies interested in
doing business in Uzbekistan should provide the two main Uzbekistan suppliers
with catalogues of their products and information on the companies, their goods
and services.
To sell medical
equipment to other, non-Ministry of Health financed state medical entities, an
American company should have a distributor or a dealer that will go to these
clinics and hospitals to evaluate their needs, demonstrate the equipment,
persuade medical personnel to buy the equipment, and provide after sale service
and training. If the company and medical personnel come to an agreement, the
chief medical officer of the hospital or clinic will go to the relevant
regional or municipal authorities to request funding.
The successful U.S.
supplier should discuss and agree on a marketing strategy with a prospective
distributor. Once the agent/distributor is selected, it is preferable to
maintain this relationship for a number of years. Abrupt changes in
distribution patterns distract the users from trusted suppliers and have been
detrimental to U.S. suppliers who have taken this action in the past. It may
take up to two years to introduce a new product, owing to the conservative and
complex nature of the Uzbekistan market.
Trade shows can be a
means for exporters to find distributors and end-users. The annual Tashkent
International Health care Exhibition (TIHE) has been held since 1994. To
register for this exhibition, contact International Trade and Exhibition (ITE)
(see the contact list below for TIHE info).
4. Product Standards
All imported medical
equipment and supplies must be registered. As stated above, the act of
registering or re-registering products for medical use in Uzbekistan is
performed by the Head Department for the Drug and Medical Equipment Quality
Control (HDDMEQC) at the Ministry of Health of Uzbekistan.
The HDDMEQC of the
Ministry of Health is the main national institution responsible for supervising
the implementation of the Act and drug regulation. It was set up in 1995 by
presidential decree as the drug control body with both executive and regulatory
functions. It is the sole state policy institution in the fields of quality
control, standardization and certification of drugs, medicinal foods and
medical equipment. The main goal of the Department is to ensure implementation
of a comprehensive national drug policy. The Department leads and coordinates
the following subdivisions: a state center for expertise and standardization of
medical means (which includes a quality control laboratory), a vaccine and
microbiology laboratory, the pharmacotoxicology unit and units for quality
control of medical equipment and scientific methodology and information.
The length of the
registration period depends on the type of equipment or medical supply but
according to regulations, it should not exceed 60 calendar days from the date of receipt of all
documents and samples specified above by the Head Department.
The process
of registration begins upon receipt of bank notification about payment of full
cost and upon receipt of all documents and samples specified below. An applicant for
registration of medical goods is a successful bidder with whom the contract for
the supply of medical goods has been entered into and who has authorization
from a manufacturer.
For all
goods subject to registration in the Republic of Uzbekistan, the Supplier shall
submit the following materials to the Head Department within 3 weeks from the
receipt time of the Notification of Contract Award, and copy the purchaser
(unless the goods have already been registered in the Republic of Uzbekistan
and the registration certificate remains valid at the time of the goods
delivery to Uzbekistan):
1.
Request
for registration.
2.
Application
form.
3.
General
information about the product.
4.
Certificate
of origin and certificate of quality.
5.
Registration
certificate or equivalent document confirming registration of medical equipment
and products for medical purposes in the country of origin as well as in any
other countries where the considered goods have been registered.
6.
Registration
documents of products for medical purposes as measuring device in the country
of origin and/or other countries (if any).
7.
Manuals/Instructions
of the product and its technical passport.
8.
Information
(acts and protocols) about technical and clinical examinations and laboratory
research.
9.
Certificate
of end products of medical equipment.
10.
Standard-technical
documentation, including methods and orders of examination of products for
medical purposes. Testing methods of medical equipment (for measuring devices).
Information about compliance to international standards and standards (if
required) of given type of product.
11.
Samples
of packing and documents regulating the quality of packing materials.
12.
Warranty
information.
13. Information about use/application of the products in medicine (on main medical literature publications).
14.
Prospects,
catalogues, data sheets.
15.
Copy
of the contract.
16.
Samples
of medical equipment and products for medical equipment, required for
registration (all the samples must be of the same series.
17.
Manufacturer’s
Letter of Attorney given to an authorised individual to carry out registration.
Letter of Attorney must be formed and notarized according to established order.
The
documents stated under items 4, 5, 6, 8, 9 should be submitted in original, or
in copy notarized in appropriate order. The documents stated under items 7, 8,
9, 10 should be submitted in original and translated into Russian (or Uzbek)
language. Originals and copies of documents must be accurate, easily readable,
include signs and seals/stamps, without amendments and corrections.
Two copies
of all above-mentioned documents (original and notarized copies if necessary)
and samples of products for medical purposes in quantity required for
examinations, should be submitted directly to Head Department of Drug and
Medical Equipment Quality Control.
Once registered, a
product is included in the State register of medical equipment and medical
related products. Registration is valid for five years.
All medical equipment
imported to the territory of Uzbekistan requires governmental certification.
Used medical equipment may be registered in the Republic of Uzbekistan only
after passing the strict evaluations conducted by the HDDMEQC.
F. CONTACTS
1. U.S. companies
and individuals interested in learning more about Uzbekistan medical market are
encouraged to contact BISNIS, Uzbekistan. For additional information about how
BISNIS Uzbekistan can help your business, or for answers to specific questions
regarding the sector, please direct inquiries to:
Mr. Jahangir Kakharov
BISNIS
Representative in Uzbekistan,
56, Buyuk Turon
Street,
Tashkent, 700029,
Uzbekistan
Tel.: (998) 71 133
65 76
Fax: (998) 71 133 84
67
E-Mail: Jahangir.Kakharov@mail.doc.gov
www.bisnis.doc.gov
2. Major Trade events / Fairs contacts
April 24- 27, 2007
TIHE 2007
12th Tashkent
International Healthcare Exhibition
Venue:
Exhibition will be held in International Exhibition Centre
“UzExpocentre” in Uzbekistan.
Contacts:
Shakhnoza
Nizamova
Project Manager
tel : +998 71 113 01 80
fax : +998 71 151 21 64
E-mail : healthcare@ite-uzbekistan.uz
Rukhsara
Mamedsalakhova
Project Manager
tel : + 44 207 596 5091
fax : + 44 207 596 5111
E-mail : Rukhsara.Mamedsalakhova@ite-exhibitions.com
3. Government Officials contacts:
Mr. Feruz Nazirov, Minister
Ministry of Health
of Uzbekistan
12 Navoi Street
Tashkent 700011,
Uzbekistan
Tel: (998) 71 139 48
08
Fax: (998) 71 144 10
33
www.med.uz
Mr. Marat Khodjibekov, Deputy Minister
Ministry of Health
of Uzbekistan
12 Navoi Street
Tashkent 700011,
Uzbekistan
Tel: (998) 71 139 46 09
Fax: (998) 712 144
10 33
E-Mail: serka@bcc.com.uz
www.med.uz
Mr. Abdunamon Sidikov,
Head of External
Economic Activities Department
Ministry of Health
of Uzbekistan
30 Abdullaeva
Street,
Tashkent 700007,
Uzbekistan
Tel: (998) 712 68 26
32, 68 08 11, 1690021
Fax: (998) 712 1690021
Mr. Habibulla Jalilov
Head Department of
Drug and Medical Equipment Quality Control
Ministry of Health
of Uzbekistan
Usmankhodjaev
Street, 16 K.Umarov passage
Tashkent 700002,
Uzbekistan
Tel: (998) 712 49 47
93, 144 48 23,
Fax: (998) 71 144 48
25
E-mail: uzpharm@rol.uz
Mr. Mirkhakim Azizov,
General Director
Traumatology and
Orthopedic Scientific Research Institute
78 Musakhanova
Street
Tashkent 700047,
Uzbekistan
Tel: (998) 71 133 10
30
Fax: (998) 71 133 10
30
E-Mail: trauma@mail.tps.uz
Mr. Valery Shramkov, General Director
Uzmedexport
Republican Foreign Economic Enterprise
32B Abdullaeva
Street
Tashkent 700077,
Uzbekistan
Tel: (998) 712 68 75
44, 68 73 84
Fax: (998) 712 68 77
01
E-Mail:
pharm@globalnet.uz
Mr. Abduvohid Abudasamatov
Deputy
Director
Uzmedexport
32B Abdullaev
Street
Tashkent
700077 Uzbekistan
Phone: 998 72
687309
Fax: 998
712 687701
E-mail:
uzmed@glb.net
Dori-Darmon
State Joint-Stock Association
21 Akhunbabaev
Street
Tashkent,
Uzbekistan
Tel: +998 -71
120 48 84, 144 00 97, 120 38 09
Fax: 998
144 83 68
Email:
dori-darmon@mail.ru
Web-site: www.doridarmon.uz.
4. Private Sector Contacts:
Private firm Pharmed
Ibrat Street 1,
Tashkent, 700132, Uzbekistan
Phone: (998 71) 399-55-22, 399-55-33, 399-55-44
Fax: (998 71) 399-55-88
Email: info@pharmed.uz ; sales@pharmed.uz
Pharmaceuticals Firm Asklepiy
Bezakchillik Street 18
a,
Tashkent, 700044, Uzbekistan
Phone: +998 71 363-7854
/ 55 / 56 / 57 / 58
Fax: +998 71 120-7071
E-mail: info@asklepiy.uz
Private Clinic MDS-Service
Botkin Street, 110/3,
Tashkent, 700000,
Uzbekistan
Phone: (998 712) 169
70 80
Fax: (998 71) 169 70
84
E-mail: info@mds.uz
Private Clinic Callisto
Mashkhadiy Street, 31,
Tashkent, Uzbekistan
Phone: (998 712) 68 77
20, 68 31 84
E-mail: info@kallisto.uz
For more information on Uzbekistan,
visit BISNIS online at:
http://www.bisnis.doc.gov/bisnis/country/Uzbekistan.cfm
BISNIS
(www.bisnis.doc.gov) is part of the U.S.
Commercial Service (www.export.gov)