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State monopoly: Why private clinics are not allowed to make HIV testing

19 July 2019
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The representatives of the Kazakhstan Association of Medical Laboratories addressed such a question to the Atameken National Chamber of Entrepreneurs of the Republic of Kazakhstan.

Today, private laboratories are deprived of the opportunity to conduct HIV tests due to the lack of an appropriate license. The only accredited medical facility is the Kazakhstan Scientific Centre for Dermatology and Infectious Diseases and AIDS Prevention and Control Centres. Although from 2002 to 2010 this analysis was carried out by all licensed laboratories and there were no problems.

"The government has allocated billions of tenge for analysis and diagnosis. HIV laboratory diagnostics is a licensed activity, and there are no restrictions in the law on persons who can be involved in the analysis. However, private laboratories are denied a license by the Health Department with reference to the order of the Ministry. This is artificial deterrence" Alla Kim, president of the Kazakhstan Association of Medical Laboratories, said. 

According to the business community, laboratories with a full range of services are more attractive to the public. 

"It turns out that the laboratories provide a wide range of services, and the blood tests for HIV are taken to the AIDS centre. The next day, the client receives all the results of the blood tests except for one. It takes some time to deliver the blood to the AIDS centre, wait for the test and results. In addition, the analysis at the legal entity centers is conducted on a fee-paying basis," Alla Kim added. 

General Director of the OLYMP Yerlan Suleimenov supported his colleague. The entrepreneur noted that a number of regions conduct analysis for a fee for private clinics, and the centers of Uralsk and Kostanay refused to conduct any research. It should be noted that such analysis is included in the guaranteed volume of free medical care.

"The Association appealed us, we questioned the legality of the provision of services by AIDS centers on a fee basis after getting the results of the audit, which revealed violations," the representative of the Committee of Internal State Audit of the Ministry of Finance of the Republic of Kazakhstan said.

By the way, only 4 AIDS centers out of 12 provided their services free of charge, in 2 centers free of charge analysis is available to individuals, 2 centers and Sanzhar Asfendiyarov Kazakh National Medicine University provide the service for a fee.

In turn, the Ministry of Health assures that the existing system allows keeping the spread of HIV infection at the concentrated stage. 

"To date, the spread of HIV infection is observed in key groups at risk of HIV infection. Therefore, the work of AIDS centers, which we have in each region, is aimed at prevention groups. This is the maximum coverage of the survey, identification, recording, therapy and further monitoring. According to the Code, HIV testing is defined as an authorized body. In this connection, the Ministry of Health has determined the procedure for screening in AIDS centres, which are centres of competence. The material and technical base of the AIDS centres provides for the full scope of diagnostic examination and treatment measures," Vice-Minister of Health Lyazat Aktayeva said. 

Council Chairperson Kairbek Suleimenov emphasized that these actions are a direct violation of licensing procedures and the Civil Code. In addition, the position of the Ministry of Health of the Republic of Kazakhstan is at variance with the position and recommendations of the WHO, of which Kazakhstan is a party.

At the end of the meeting, the Council will recommend 

the Prosecutor General's Office to protest against the orders (Nos. 246 and 508) of the Ministry of Health, which contradicts the Entrepreneurial Code and limit the freedom of competition.

"In our opinion, the Ministry of Health should make changes and additions to the regulatory legal acts in terms of expanding the range of organizations engaged in laboratory diagnosis of HIV infection, to determine the order of interaction with health care organizations engaged in laboratory testing for HIV infection in the conditions of the study. Also, the Ministry of Health should consider issuing a separate order regulating the medical examination for HIV infection, carried out on a paid basis," Kairbek Suleimenov said.

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