COVID-19 in the Caspian Region: Implications for Health Policy
The rapid, dangerous spread of the COVID-19 pandemic tests the capacity and resilience of healthcare systems around the world. Caspian countries are also forced to identify and implement innovative solutions to care for large influxes of patients; produce reliable rapid-tests and labs to process them; acquire, distribute, and utilize essential personal protective gear and medical equipment; and train medical personnel on how to handle this novel coronavirus. Most countries of the South Caucasus and Central Asia early on instituted social distancing guidelines to contain the spread of the virus as well as put efforts to strengthen the healthcare systems in anticipation of a spike in the number of cases and improve cooperation with foreign partners through bilateral initiatives and international organizations. While tackling the health issues, these countries also have to mitigate the economic and societal impacts of the needed quarantine measures with varying capabilities in terms of financial, infrastructure, and policy resources.i
Georgia was one of the first countries in the region to take a proactive approach and prioritize the allocation of resources toward implementing containment measures. In addition to issuing stringent social distancing guidelines and quarantining any incoming travelers to slow the rate of transmission within the country, Georgia’s government quickly redesigned health facilities and reoriented national and private labs to support the COVID response. These efforts allowed Georgia to relieve and redistribute pressures on the healthcare system during the early stages of the pandemic, resulting in a utilization rate today of less than 12 percent of the available hospital capacity.ii Similarly, Azerbaijan decided to put all confirmed patients, regardless of their symptoms, under strict hospital quarantine – one of the many measures made possible by using around 113 million manats ($67 million) of state funds in addition to the voluntary contributions from individuals, entrepreneurs, and organizations.iii
The pandemic also prompted the Caspian countries to come up with innovative policy solutions. Kazakhstan, for instance, responded to the public health challenge by boosting the digitalization of primary healthcare services and strengthening the diagnostic capacity of labs. To understand the whole picture of the infection’s prevalence and to support vulnerable populations, the government is conducting random testing among various groups – a strategy that will help to account for regional and social disparities in access to healthcare. Despite the gradual decrease in active cases, Kazakhstan continues to enhance the health system in preparation for a possible second wave.iv
Nonetheless, countries of the Caspian region still have to address a number of systemic vulnerabilities that were exacerbated by the pandemic’s rapid progress. In that regard, the Georgian government emphasizes addressing the deficit of qualified healthcare workers as an important medium- to long-term policy priority. Medical workers are exposed to a serious risk of contracting the virus, with an infection rate of 13 percent in Georgia – a figure that is relatively low compared to the other countries of the region. Ensuring the safety of medical workers requires not only the availability of personal protective equipment but also the appropriate training on how to properly use that equipment. Azerbaijan’s attempt at pre-emptive reforms to improve the healthcare system and mitigate infrastructure glitches, too, was stalled midway by the global pandemic crisis with the mandatory health insurance initiative being postponed until January 2021.v
The fight against COVID-19 is far from over, and the Caspian countries must remain tough and vigilant even as their economies gradually start to reopen. Uzbekistan, for instance, traced 50 percent of new coronavirus cases to Uzbek nationals returning from abroad.vi Similarly, Afghanistan had to confront the challenge of accommodating more than 300,000 Afghans returning from heavily infected areas such as Iran over the past few months.vii In these circumstances, drafting a “roadmap to normalcy” is not going to be an easy task for the region’s governments.
“Health threats and diseases know no borders,” as Mitch Wolfe, Chief Medical Officer of the U.S. Centers for Disease Control and Prevention (CDC), pointed out.viii Addressing the challenges posed by the COVID-19 pandemic will require strong regional and international cooperation. In addition to coordinating continually with the World Health Organization and following its official guidelines for responding to the outbreak, the countries of the Caspian region have been actively communicating and working together on a bilateral basis as well as through regional organizations, such as the Turkic Council. This way, Turkey was the first country to donate testing kits to Azerbaijan; Kazakhstan sent numerous humanitarian aid packages to its southern neighbors, Kyrgyzstan and Tajikistan; Uzbekistan also delivered protective equipment along with 1,000 tons of flour and food products to Kyrgyzstan. These are just a few examples of intra-regional assistance in the face of a common public health threat.
The Caspian region has also received significant support from the United States. The U.S. Centers on Disease Control and Prevention recently confirmed its initial commitment of $6.8 million in healthcare assistance in Central Asia through its Central Asia office in Almaty, in addition to funds allocated through USAID and other state agencies to overcome the pandemic.ix The CDC is also launching another regional office for Eastern Europe and the Caucasus to be based in Tbilisi, Georgia. Through these health agency offices, the United States continues to strengthen healthcare systems in the Caspian region by contributing to the diagnostic and emergency response capacity through the provision of technical support, equipment, and special advanced training to epidemiologists.
The lessons learned during the COVID-19 pandemic can strengthen healthcare systems and international cooperation globally. The promising start of joint collaboration efforts to mitigate the impact of COVID-19 on healthcare systems suggests countries in the Caspian region may become more willing to work together on public health projects even after the current pandemic crisis is over. The region will likely experience improved cooperation in providing medical assistance across borders and improved testing capabilities for various diseases due to the mechanisms established during this pandemic. The pandemic also highlighted the necessity for countries in the Caspian region, multilateral organizations, and the United States to continue to support local efforts in handling the COVID-19 crisis and other public health emergencies to ensure the resilience of healthcare systems in these countries as well as a strong desire in the region to see U.S. leadership and expertise in the fight against the disease.
Ambassador (Ret.) Jimmy Kolker, Former Assistant Secretary for Global Affairs at the U.S. Department of Health and Human Services and U.S. Deputy Global AIDS Coordinator
Efgan Nifti, Executive Director, Caspian Policy Center
Akbota Karibayeva, Programs Manager, Caspian Policy Center
Dante Schulz, Research Intern, Caspian Policy Center
i This article addresses some points discussed at a virtual conference on COVID-19’s implications for health policy in the Caspian region, hosted by the Caspian Policy Center on 27 May 2020. “PRESS RELEASE: Caspian Policy Center Hosts a Virtual Convening on Health Policy Implications of COVID-19 with Experts from the White House, U.S. Centers for Disease Control and Prevention (CDC), and the Regional Ministries of Health in the Greater Caspian Region.” Caspian Policy Center. 27 May 2020. https://www.caspianpolicy.org/press-release-covid-19-in-the-caspian-region-implications-for-health-policy/ https://www.youtube.com/watch?v=tWfomWGAeBY (retrieved 11 June 2020).
ii Tamar Gabunia, First Deputy Minister of Internally Displaced Persons from the Occupied Territories, Labor, Health and Social Affairs of Georgia. “COVID-19 in the Caspian Region: Implications for Health Policy.” Caspian Policy Center. 27 May 2020.
iii Zaur Aliyev, Chairman of the Board of the State Agency for Mandatory Health Insurance of Azerbaijan. “COVID-19 in the Caspian Region: Implications for Health Policy.” Caspian Policy Center. 27 May 2020.
iv Saule Kassymova, Acting Director of the Department for Strategy and International Cooperation. “COVID-19 in the Caspian Region: Implications for Health Policy.” Caspian Policy Center. 27 May 2020.
v Aliyev, 2020.
vi Bakhodir Yussupaliev, First Deputy Minister of Health, Director of the Agency for Sanitary and Epidemiological Wellbeing of Uzbekistan. “COVID-19 in the Caspian Region: Implications for Health Policy.” Caspian Policy Center. 27 May 2020.
vii Wahid Majrooh, Deputy Minister of Public Health of Afghanistan. “COVID-19 in the Caspian Region: Implications for Health Policy.” Caspian Policy Center. 27 May 2020.
viii Mitchell Wolfe, Chief Medical Officer, U.S. Centers for Disease Control and Prevention. “COVID-19 in the Caspian Region: Implications for Health Policy.” Caspian Policy Center. 27 May 2020.
ix Daniel Singer, Regional Director for Central Asia, U.S. Centers for Disease Control and Prevention. “COVID-19 in the Caspian Region: Implications for Health Policy.” Caspian Policy Center. 27 May 2020.