Over the past seven years, healthcare funding in Uzbekistan has increased sixfold. Medical institutions across the regions have been modernized. More than 400 high-tech surgeries, previously performed only in the capital, are now carried out in provinces and districts. A system has been established to connect primary care with specialized medical services.

Uzbekistan has 29 doctors per 10,000 people, a ratio comparable to those of the United States, the United Kingdom, and Finland, and higher than the corresponding figures for Türkiye and Canada. However, the efficiency of healthcare delivery and the quality of treatment remain insufficient.

Due to the weak performance of primary healthcare services in the districts, the incidence of diseases and complications has not declined. Non-communicable diseases cause an estimated annual loss of around $1 billion to the national economy.

One in four ambulance calls involves patients with chronic conditions. In some areas, emergency services are effectively performing the functions of outpatient polyclinics. There are imbalances in the distribution of personnel, hospital beds, and financial resources between district and regional medical institutions.

The introduction of a medical insurance system has been repeatedly postponed. Appointment scheduling and healthcare services have yet to be fully digitized.

As a result of these shortcomings, two Deputy Ministers of Health have been dismissed, and another has received an official warning.

The key issues related to improving the performance of primary healthcare, disease prevention, medical personnel’s professional development, and enhancing treatment quality were discussed at the meeting. A new operational framework was defined based on population coverage, disease analysis, and patterns of medical visits.

The primary healthcare system will undergo reform. Each medical team will sign a bilateral agreement with the population under its care. Citizens will be free to choose their family doctor, including private practitioners.

A guaranteed package of medical services will be approved, under which the state budget will fully fund services and medications.

Primary care physicians and nurses will be employed on a full-time basis only. The number of obstetricians and gynecologists in polyclinics will be doubled, and a pediatrician position will be allocated for every 3,000 children.

Rural health posts and family polyclinics will be optimized based on population coverage. Central outpatient clinics will be transformed into consultative and diagnostic departments within district hospitals, where all specialized medical professionals will be concentrated.

The base salary for a family doctor will be the equivalent of $500, and for nurses, it will be $300. An equivalent bonus will be paid for holding a qualification certificate. Additional salary increases will be provided for active work within mahallas, educating patients with chronic illnesses, early detection of cancer, diabetes, stroke, and heart attacks, and preventing complications. As a result, family doctors can earn up to $1,500, and nurses between $600 and $800.

This system will be piloted this year in 15 districts and cities, and starting next year, it will be implemented throughout the Samarkand region.

At the same time, the responsibility of family doctors and nurses will be strengthened. Cases of heart attacks, strokes, early maternal and child deaths, and disability resulting from chronic diseases will be classified as emergencies.

The corrupt practice of requiring decisions by medical advisory commissions for determining disability status will be abolished. Instead, decisions will be made based on documentation prepared by family doctors and reviewed by the Medical-Social Expert Commission.

Sector officials and regional hokims have been instructed to implement the “90 Days of Change in Healthcare” program, which includes organizing waiting areas and corridors in medical institutions and improving sanitary standards. A “Clean Hands” program aimed at enhancing hygiene and sanitary conditions will be introduced in schools and social institutions.

Specialized medical care was also discussed at the meeting. 

In republican medical centers, only high-tech, complex surgeries will be performed using state budget funds.

The system for issuing and managing electronic referrals will be completely revised, with the approval of a standardized list of conditions and a unified base tariff.

Referrals issued for treatment at the national level will be posted on a unified electronic platform accessible to both public and private clinics. Patients can choose a suitable medical facility based on the available offers.

Special attention has been given to pediatric oncohematology, as 75 percent of such cases in Uzbekistan are diagnosed at late stages. In response, a five-year national program to combat childhood cancer is being developed, with no less than $110 million in funding.

The regulation of medication use was discussed separately. In developed countries, only drugs with proven efficacy are used. In Uzbekistan, however, 42 percent of imported medications lack verified effectiveness, yet they continue to be prescribed by doctors and used by the public.

The Minister of Health has been instructed to remove from clinical protocols any drugs proven ineffective or whose effectiveness is insufficiently supported by evidence.

All medical institutions, especially children’s hospitals, will undergo inspections focused on the rational use of antibiotics.

Special attention was also given to the quality of medical education.

Over the past seven years, annual enrollment in medical universities has increased to 25,000 students, with 40 percent studying at private institutions. However, there is currently no transparent system for assessing knowledge and skills.

To address this, graduates of medical universities and colleges will now be evaluated on their knowledge of modern diagnostic and treatment methods through a transparent assessment system. For this purpose, a National Medical Assessment Center is being established to assess students and practicing healthcare professionals.

All public and private clinics will undergo accreditation. Responsibility for the professional development of medical specialists will be transferred to universities, specialized centers, and regional institutions.

It was also instructed to introduce dual education, transfer universities under the supervision of clinics, and grant them financial autonomy.

Overall, responsible officials have been tasked with ensuring the efficient use of budget funds, accelerating digitalization, implementing health insurance, enforcing discipline, and achieving public satisfaction with the quality of medical services.