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Corruption in Kyrgyzstan healthcare blamed for disastrous response to COVID-19

Article by Ryskeldi Satke

March 1, 2021

Corruption in Kyrgyzstan healthcare blamed for disastrous response to COVID-19

COVID-19’s impact on the global community revealed many inefficiencies in how the countries responded to the spread of the pandemic across borders. While some states have achieved promising results, others have struggled with response measures due to healthcare capacity limitations. In certain cases, capacity is not the only concern which contributed to the public health crisis. Kyrgyzstan is one of the examples where the country’s corruption record has exacerbated the Kyrgyz Government’s response measures to contain COVID-19. The Central Asian nation’s corruption perception index in 2019 was scored 30 out 100 by global watchdog Transparency International, finding itself next to the countries, such as Djibouti, Ukraine and Azerbaijan, that have similar records.[1]


Widespread corruption in the state institutions, including healthcare, is one of the primary triggers of political instability in Kyrgyzstan, where governments have been overthrown on three occasions since 2005.[2] Conceivably, the Kyrgyz Government has come under criticism during the COVID-19 crisis for a lack of transparency and oversight of the donations, ‘grants and loans’ from its own citizens and international organisations, including IMF, ADB, KfW, AIIB, IDB, WB and the EU.[3] Meanwhile, Amnesty International lambasted the country’s authorities for forcing medics to work long hours during the pandemic without extra pay for service in “prison-like” conditions.[4]


However, a dysfunctional healthcare is only one of the primary worries in the country, which was outlined by the USAID funded International Republican Institute’s nationwide poll in Kyrgyzstan’s seven regions and two largest cities ahead of the controversial parliamentary election on October 4th 2020.[5] The Kyrgyz Government’s response to COVID-19, corruption and healthcare were named as the most important problems in the nation, according to a survey.[6] Endemic corruption was also addressed by the World Health Organization’s (WHO) report on Kyrgyzstan’s two decades-long health financing reform, pointing out as recently as 2019 the “conflict of interest” tendencies among state officials including the country’s presidential administration.[7] WHO’s recommendations to the Kyrgyz authorities stated:


“Where it is not possible to avoid having some members with a conflict of interest, clear policies on declaration and recording of conflicts at council/committee meetings, and procedural rules for handling situations of conflict of interest (e.g. recusal rules from some discussions and decisions), should be developed and adopted by the appropriate ministries.”[8]


Despite consistent guidance from international organisations, the Kyrgyz Government failed to sustain transparency policy when spending $645 million on COVID-19 emergency response during the pandemic in 2020. The Organized Crime and Corruption Reporting Project (OCCRP) platform scrutinised the country’s accountability mechanism which has “offering no detailed information on where the funds” were going.[9] The OCCRP report indicated that the Kyrgyz authorities “did not have the resources to track down the spending”. Similarly, cases of corruption in rural medical clinics and hospitals highlight a deeply entrenched culture of bribery and impunity. In one such case, medics and personnel of the southern Leilek district hospital in Batken region were appealing to the country’s former president and chief prosecutor in the middle of the COVID-19 public health emergency for assistance with addressing burgeoning corruption at the hospital.[10] Protesting medics complained that the hospital director “turned work in the hospital into a business. He opens extra vacancies and hires freelancers. Everyone who gets a job gives from 10,000 to 20,000 soms ($120-$230) to the head nurse of the hospital… Some people say that they gave the money personally to the director”.


Likewise, the country’s former Minister of Health, Kosmosbek Cholponabyev, was arrested and taken into custody in September 2020 for abuse of power while in office and organising a corruption scheme, which inflicted financial “damage to the state budget in the amount of nearly nine million soms” ($106,000).[11] Previously, the Security Council of Kyrgyzstan stated that there are eight corruption risks in the national Mandatory Health Insurance Fund (MHIF) relating to the transfer, redistribution of compulsory health insurance funds and collusion with pharmaceutical companies.[12]


The World Bank’s assessment of the Kyrgyz primary healthcare improvement programme indicated that MHIF is a “single purchaser of health services” in the country “managing 80% of the domestic public financing for health, contracting with 261 health institutions and providing health care services at all levels.”[13]


Source: Primary Health Care Quality Improvement Programme, World Bank, 2017


Kyrgyz media repeatedly raised the subject of corruption incidences in the MHIF, which is ultimately a result of its twisted legislative foundation.[14] MHIF is the single payer institution in the country’s health sector with “responsibility for pooling health funds and purchasing health services” under the law “On health insurance of citizens in the Kyrgyz Republic” and regulation on the Mandatory Health Insurance Fund under the Government of the Kyrgyz Republic.[15] In addition to having a defective legal base, MHIF conducts its own internal audit of expenditure and it is in charge of “supplying, distributing, storing, purchasing goods and services, and financing healthcare organisations”. Essentially, corruption risks in MHIF are consorted with a lack of clear regulations and weak oversight. WHO’s Regional Office for Europe working report in 2018 stated that “external assessment and inspection by the Mandatory Health Insurance Fund and by the Medical Accreditation Commission exercise central control but provide little support for organisational development, benchmarking, improving performance or public accountability”.[16] WHO’s regional office also shared similar concerns regarding the country’s “governance, monitoring and inspection of public-sector healthcare organisations” that are “fragmented, weak and ineffective”.[17]


However, a bribery case involving MHIF officials in January 2020 reignited public debate when one of its top department employees was arrested for extorting a 143,000-som ($1,686) bribe in the nation’s capital Bishkek.[18]


Source: Public Opinion Poll Residents of Kyrgyzstan, IRI, 6-15 August 2020


Subsequently, Kyrgyz journalists from the investigative group ‘PolitKlinika’ online publication released in early July 2020 their investigation into public procurement involving the country’s health authorities in February 2020 prior to the COVID-19 crisis. The report revealed that the prices for personal protective equipment (PPE) and medical masks were over inflated and excessive for certain items.[19] For example, protective suits with a market price tag of 2,000 soms ($23) per unit in Bishkek city were purchased for 6,000 soms ($70) per suit. The same for respiratory masks that were purchased for 300-400 soms ($3.5-$4.7) per item when the local market prices for the very same masks ranged from 30 to 150 soms ($0.3-$1.7). Public outrage resulted in a criminal investigation launched on July 10th by the country’s Financial Police on former Kyrgyz president’s directive to probe health officials responsible for a corrupt procurement scheme.[20]


Whether PPE and medical masks were properly distributed during the initial COVID-19 crisis in the country’s poorly funded hospitals and clinics remains debatable after a public scandal in the Bishkek city hospital following personnel complaints regarding PPE shortage.[21] Similarly, ADB and UNDP assessments on the impacts of COVID-19 stated that by “29 June 2020, 783 Kyrgyz Republic health workers had been diagnosed with COVID-19 (15% of all confirmed cases in the country to this date). This very high proportion raises questions about the supply of personal protective equipment (PPE) for health professionals and highlights the need for additional training of health workers on infection prevention and control. Part of the aid received by the government might need to be channelled towards establishing sufficient domestic stores and/or production of affordable yet high-quality PPE.”[22]


Concurrently, the Ministry of Health and the local authorities were scrutinised by the country’s Interim officials after a change of government following the political crisis in October 2020.[23] Deputy Prime Minister Elvira Surabaldieva criticised the lack of transparency for medical and humanitarian aid that was donated to the country during the initial COVID-19 emergency. Simultaneously, a lack of adequate supply of PPE and medical masks steered complaints from the outspoken Kyrgyz health workers who took their criticism of authorities online, sharing their struggle experiences and frustrations on social media.[24] In one instance, a young medic wrote on his Twitter account: “The media write that doctors are provided with personal protective equipment. In fact, I was given a mask with holes on my duty today that is unlikely to protect me from being infected with coronavirus. And then they wonder why doctors are infected with COVID-19.”[25] 


However, the outspoken medic later complained he was reprimanded for posting a message online and deleted his Twitter account. His next public appearance was shown on the country’s TV network when he apologised for spreading false information earlier. The International Partnership for Human Rights (IPHR) regional watchdog later concluded that the Kyrgyz State Committee on National Security was detaining whistle blowers to “hold ‘preventive’ discussions with them, threatened them with criminal prosecution and released them after they publicly ‘apologised’ and ‘repented’. Many of those targeted were accused of disseminating incorrect information about the spread of COVID-19 in different parts of Kyrgyzstan, while some were medical professionals who had highlighted problems relating to the pandemic (such as the lack of means of protection) at hospitals or other health care facilities.[26]


Source: Public Opinion Poll Residents of Kyrgyzstan, IRI, 6-15 August 2020


The Kyrgyz Government’s response to COVID-19 pandemic left the majority of the country’s poverty-stricken nation dissatisfied with nearly 70 per cent of the population expressing disapproval of how the Kyrgyz authorities handled the public health crisis, according to an IRI poll. It appears that public tension in the aftermath of the COVID-19 crisis was not in favour of the now overthrown government of former President Sooronbay Jeenbekov who was also ultimately toppled following a controversial parliamentary election on October 4th. The latest political disturbances in Kyrgyzstan are increasingly indicative of the urgent need for healthcare reform based on realistic goals rather than status quo. Kyrgyz public health professionals believe that endemic corruption in the country’s ailing healthcare is not the only issue. Dr. Rakhman Toichuev of the National Academy of Science told the author that a lack of competent officials in the Ministry of Health and the imperfect legislative basis for the health system are perhaps the most significant concerns.


However, the healthcare crisis amid the first and second waves of COVID-19 sparked a fresh round of public debates in the country regarding reform of the health services. There are various views as to how to move forward from corruption-prone and stagnant healthcare to transparent and efficient service provider. Kyrgyz health officials and lawmakers seem to favour integration of MHIF and Ministry of Health after the Interim government announced a sweeping reform of the state bodies.[27] Contrarily, experts disagree that such intermediary steps will bring results thus leading to negative outcomes since the country scores poorly on reforms overall. Bermet Baryktabasova, an expert on evidence-based medicine, argues that “everyone works as much as the level of development of the country as a whole allows. One cannot expect ideal work from the Ministry of Health, the MHIF, when the work of all other state bodies, the government, and so on is imperfect.” [28]


The latest ADB and UNDP policy study paper in response to the COVID-19 crisis recommended the Kyrgyz authorities “reduce or abolish financial contribution (e.g., co-payments) and administrative barriers (e.g., requirements concerning proof of residence, legal identification, etc.) to quality health services; and invest in mobile solutions and digitalisation” which would contribute to more transparency in healthcare.[29] Global development groups also advised the country’s Government to “strengthen health information systems with emphasis on mapping essential service lists against resource requirements and available budgets; mapping public and private pharmacies and suppliers, identifying regional and spatial disparities (including informal peri-urban settlements); and strengthening inventory and procurement management.”[30]


Certainly, it is true that Kyrgyzstan has not done more to improve standards of living for the country’s poverty-stricken population since gaining independence in 1991, let alone eradicating deeply entrenched bribery and corruption in the Government including healthcare. It has been widely known among domestic healthcare experts that corruption risks occur in the system of procurement, namely in the procurement of PCR tests, in laboratories and the procurement of PPE and other medical drugs.[31] Critics argue that a lack of control over purchases paves way for corruption. Therefore, addressing these concerns must be on the Kyrgyz Government’s priority list for improvement-oriented goals in healthcare. However, it is unlikely that the country’s healthcare will have drastic changes in the nearest terms due to unresolved structured issues within the Kyrgyz state.


Ryskeldi Satke is a regional editor for Central Asia at the Third Pole multilingual web platform. Follow him on Twitter @RyskeldiSatke.


Image by Official website of Bishkek City Hall.


[1] Anti-Corruption Research Center Transparency International Kyrgyzstan, Transparency International,

[2] Another revolution in Kyrgyzstan?, European Parliament, October 2020,

[3] Alexandra Li, No Transparency in Kyrgyzstan’s Coronavirus Spending, OCCRP, June 2020,; Olga Ruslanova, How Much Will COVID-19 Cost for Kyrgyzstan?, CABAR, June 2020,

[4] Kyrgyzstan: Medics suffer rights violations, pay high personal price during COVID-19 pandemic, Amnesty International, September 2020,

[5] Kyrgyzstan Poll Suggests High Voter Intent Ahead of Parliamentary Elections, IRI, September 2020,

[6] Ibid.

[7] WHO – Regional Office for Europe, Governance of health financing and strategic purchasing of services in Kyrgyzstan, 2019,

[8] Ibid.

[9] Alexandra Li, No Transparency in Kyrgyzstan’s Coronavirus Spending, OCCRP, June 2020,

[10] Jazgul Masalieva, Medical workers of Leilek complain to President of corruption, 24kg, May 2020,

[11] Aida Dzhumashova, Kosmosbek Cholponbaev placed in pretrial detention center 1 in Bishkek, 24kg, September 2020,

[12] President of the Kyrgyz Republic, Security Council Information,

[13] The World Bank, Technical Assessment: Kyrgyz Republic – Primary Health Care Quality Improvement Program (P167598),

[14] Kaktus Media, 8 corruption risks in the MHIF. Will eradicate, December 2016,

[15] Ainura Ibraimova, Baktygul Akkazieva, Aibek Ibraimov, Elina Manzhieva and Bernd Rechel, Kyrgyzstan: Health system review, Health Systems in Transition, Vol. 13 No. 3 2011, European Observatory,; Law of the Kyrgyz Republic: About health insurance of citizens in the Kyrgyz Republic, Ministry of Justice of the Kyrgyz Republic, October 1999 No. 112,; Regulations on the Mandatory Health Insurance Fund under the Government of the Kyrgyz Republic, Ministry of Justice of the Kyrgyz Republic, September 2018 No. 420,

[16] Quality of care review in Kyrgyzstan, Working document, WHO – Regional Office for Europe, September 2018,

[17] Kyrgyzstan – Governance of health financing and strategic purchasing of services in Kyrgyzstan (2019), WHO – Regional Office for Europe,

[18] Tatyana Kudreyavtseva, Director of Bishkek branch of CMIF arrested for bribe extortion,, January 2020,

[19] Making money from coronavirus: A simple mask costs 25 soms, protective clothing costs 6000 soms (Longrid),, July 2020,

[20] Kyrgyzstan: fight against COVID-19 could denigrate into a corruption scandal, Acca, July 2020,

[21] Guliza Avazova, The head doctor of the hospital No. 1 in Bishkek was fired after the scandal with PPE, Kaktus Media, August 2020,

[22] COVID-19 in the Kyrgyz Republic: Socioeconomic and Vulnerability Impact Assessment and Policy Response, Institutional Document, ADB, August 2020,

[23] Dina Maslova, Elvira Surabaldieva criticised the Ministry of Health and local authorities for reports on humanitarian aid, Kaktus Media, December 2020,

[24] Robin Forestier-Walker, Kyrgyzstan gov’t faces backlash over doctor’s ‘forced confession’, Al Jazeera, April 2020,

[25] In Kyrgyzstan, medical staff is afraid to complain about poor working conditions, Acca, April 2020,

[26] Human rights impact assessment of the COVID-19 response in Kyrgyzstan, IPHR, July 2020,

[27] Kyrgyzstan plans to cut number of civil servants by 10%, Kabar, November 2020,

[28] Maria Orlova, Itching to reform. When you need to measure seven times,, November 2020,

[29] COVID-19 in the Kyrgyz Republic: Socioeconomic and Vulnerability Impact Assessment and Policy Response, ADB, Institutional Document, August 2020,

[30] Asian Development Bank, COVID-19 in the Kyrgyz Republic: Socioeconomic and Vulnerability Impact Assessment and Policy Response, August 2020,

[31] Marat Uraliev, Bermet Baryktabasova demanded to quickly develop a unified register of distribution of humanitarian aid, Kaktus Media, December 2020,

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