BISNIS - Uzbekistan Report

06 JUN 95

FM AMEMBASSY TASHKENT

IMI: MEDICAL INDUSTRY IN UZBEKISTAN

1. TO FOLLOW IS MARKET RESEARCH FOR THE MEDICAL BUSINESS DEVELOPMENT MISSION TO UZBEKISTAN, JUNE 14-17, 1995.

MEDICAL INDUSTRY IN UZBEKISTAN: MEDICAL EQUIPMENT AND SUPPLIES, PHARMACEUTICALS AND HEALTHCARE SERVICES

I. OVERVIEW

THE GOVERNMENT CONTINUES TO BE THE PRLMARY SOURCE OF FUNDING FOR HEALTHCARE IN UZBEKISTAN. THE GOVERNMENT'S HEALTHCARE BUDGET IS DISBURSED THROUGH A VARIETY OF SOURCES INCLUDING: 1) THE UZBEKISTAN MINISTRY OF PUBLIC HEALTH, 2) LOCAL AND RECIONAL GOVERNMENTS (HOKIMYATS) AND 3) SPECIALIZED FACILITIES SERVING SELECTED MINISTRIES AND STATE-OWNED ENTERPRISES. IN 1994, USD 79.5 MILLION OR 11.1 PERCENT OF THE BUDGET OF THE GOVERNMENT OF UZBEKISTAN WAS ALLOCATED TO HEALTHCARE NEEDS THROUGH THE MINISTRY OF PUBLIC HEALTH. PROVIDING FOR LESS THAN 20 PERCENT OF THE REQUIRED AMOUNT OF MEDICINE AND LESS THAN 40 PERCENT OF HEALTHCARE SERVICE NEEDS, BUDGET CONSTRAINTS HAVE FORCED THE MINISTRY OF PUBLIC HEALTH TO LIMIT ITS EXPENDITURES TO FUNDING FOR SALARIES, FOOD AND MEDICINE. AMONG THE PRIORITY PROJECT AREAS TO BE FINANCED THROUGH OTHER SOURCES (AS WELL AS THE MINISTRY OF PUBLIC HEALTH IF FUNDS BECOME AVAILABLE) ARE THE IMPROVEMENT OF MATERNAL AND INFANT HEALTHCARE AND MEASURES AGAINST THE SPREAD OF INFECTIOUS DISEASE INCLUDING IMPROVEMENT OF ENVIRONMENTAL CONDITIONS.

MATERNAL AND INFANT HEALTHCARE

THE HEALTH OF INFANTS IN UZBEKISTAN IS DIRECTLY RELATED TO THE STATE OF HEALTH AND EDUCATION OF THEIR MOTHERS, AS WELL AS TO THE NUMBER OF CHILDREN IN THE FAMILY. IN UZBEKISTAN, THERE ARE FIVE MILLION WOMEN OF FERTILE AGE (15-49). THE AVERAGE WOMAN BEARS 5 CHILDREN, BUT APPROXIMATELY 200,000 WOMEN HAVE 10 OR MORE.

WHILE THE BIRTH RATE IN UZBEKISTAN IS HIGH, UP TO 44 PERCENT OF WOMEN OF CHILD BEARING AGE HAVE HEALTH PROBLEMS, SUCH AS ANEMIA, HEART DISEASE, KIDNEY PROBLEMS, AS WELL AS DIFFICULTIES WITH THEIR ENDOCRINE SYSTEMS. WHILE THOSE WITH HEALTH PROBLEMS ARE ENCOURAGED NOT TO HAVE CHILDREN, AND A CONTRACEPTIVE PROGRAM WAS INTRODUCED BY THE GOVERNMENT IN 1990, FEWER THAN 30 PERCENT OF WOMEN IN UZBEKISTAN MAKE USE OF CONTRACEPTIVES. THE USE OF HORMONAL CONTRACEPTIVES IS ESPECIALLY LOW (MOST RECENTLY ESTIMATED AT 85,000 PERSONS). NO MORE THAN 80,000 MARRIED COUPLES REGULARLY USE CONDOMS, AND STERILIZATION IS USED IN ONLY EXTRAORDINARY CASES.

THE IMMUNIZATION PROGRAM OF THE GOVERNMENT OF UZBEKISTAN HAS ALSO DETERIORATED SINCE THE BREAK UP OF THE SOVIET UNION. IN 1990 OVER 80 PERCENT OF ALL CHILDREN RECEIVED THE DIPHTHERIA VACCINE, NEARLY 80 PERCENT RECEIVED THE VACCINE FOR WHOOPING COUGH, 90 PERCENT THE POIJO VACCINE, AND OVER 85 PERCENT THE MEASLES VACCINE. IN 1993 THOSE PERCENTAGES HAD FALLEN TO TO 49, 45, 46, AND 82, RESPECTIVELY.

WHILE THE GOVERNMENT HAS DIRECTED MUCH ATTENTION TO THIS AREA, THERE ARE STILL SERIOUS SHORTAGES OF VACCINES. FOR EXAMPLE, IN 1993 AN ESTIMATED 800,000 DOSES OF THE MEASLES VACCINE WERE REQUIRED TO MEET THE POPULATION'S NEEDS. SLNCE THE GOVERNMENT HAS NOT PURCHASED ANY MEASLES VACCINE SINCE 1992, AND UNICEF ONLY DONATED 350,000 DOSES IN 1992, LESS THAN HALF OF THE NEED WAS COVERED. THERE ARE SIMILAR SHORTAGES OF OTHER VACCINES. MOREOVER, THERE IS A LACK OF ADEQUATE REFRIGERATED STORAGE FACILITIES.

CURRENTLY, THE U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT, UNICEF, AND THE WORLD HEALTH ORGANIZATION ARE WORKING WITH THE GOVERNMENT TO IMPROVE I NFANT AND MATERNAL HEALTHCARE, INCLUDING THE USE OF CONTRACEPTIVES, AS WELL AS THE STORAGE AND DISTRIBUTION OF VACCINES.

PREVENTION OF INFECTIOUS DISEASES AND NEGATIVE ENVIRONMENTAL CONDITIONS

AS IS USUALLY THE CASE IN BOTH DEVELOPED AND DEVELOPING COUNTRIES, INFECTIOUS DISEASES ARE MORE WIDELY SPREAD IN RURAL AREAS. IN UZBEKISTAN, THERE IS A HIGH LEVEL OF INFECTIOUS RESPIRATORY TRACT DISEASES AND GASTROINTESTINAL DISEASES IN RURAL AREAS. THESE CAN BE ATTRIBUTED TO POOR QUALITY OF THE DRINKING WATER, AN ABSENCE OF PROPER SEWAGE FACILITIES, AS WELL AS POOR ORGANIZATION AND OPERATION OF LOCAL MEDICAL FACILITIES, AND A SEVERE SHORTAGE OF MEDICINE.

THE ASSOCIATION OF MANY OF THESE PROBLEMS WITH POOR ENVIRONMENTAL CONDITIONS IS EXEMPLIFIED BY THE FACT THAT ONLY 1,184 OF UZBEKISTAN'S 3,009 RURAL SETTLEMENTS HAVE ACCESS TO POTABLE WATER. THE REMAINING 1,825 SETTLEMENTS HAVE SERIOUS PROBLEMS RELATED TO THE UTILIZATION OF OPEN RESERVOIRS WITHOUT PROPER SANITATION, AS WELL AS THE ABSENCE OF PROPER CHLORINATION AND FILTRATION EQUIPMENT. INDUSTRIAL POLLUTION IS ALSO A SERIOUS PROBLEM. THE GOVERNMENT RECENTLY ESTIMATED THAT ONLY 230 OF OVER 8,000 INDUSTRIAL ENTERPRISES WERE ADEQUATELY FOLLOWING POLLUTIONCONTROL STANDARDS.

TREATMENT LOCATIONS

OF 16.8 MILLION REGISTERED PATIENTS IN 1993, 4.8 MILLION RECEIVED IN-PATIENT TREATMENT IN HOSPITALS; 191,428 IN DEPARTMENTS WITHIN THE HOSPITAL, AND AN ADDITIONAL 275,284 AT OUT-PATIENT CLINICS. IT FOLLOWS THAT THE VAST MAJORITY OF PATIENTS (OVER 11.5 MILLION) RECEIVE TREATMENT AT HOME. CURRENT TRENDS INDICATE THAT THIS NUMBER WILL INCREASE UNLESS THERE IS A DRAMATIC IMPROVEMENT IN CARE AND CONDITIONS PREVAILING AT GOVERNMENT FACILITIES.

SPECIALIZED HEALTHCARE FACILITIES

THERE ARE MANY OTHER GOVERNMENT INSTITUTIONS IN UZBEKISTAN WHICH OPERATE MEDICAL AND HEALTHCARE FACILITIES NOT FINANCED BY THE MINISTRY OF PUBIJC HEALTH. THESE INCLUDE: THE CENTRAL ASIAN RAILWAYS COMPANY "UZBEKISTAN TEMIR YOLARI", THE MINISTRY OF DEFENSE, THE NATIONAL AIRLINE "UZBEKISTAN HAVO YOLARI", THE MINISTRY OF ENERGY, THE MINISTRY OF INTERNAL AFFAIRS, AND MANY OTHERS. THESE CLINICS AND HOSPITALS ARE BETTER EQUIPPED AND PROVIDE BETTER SERVICES THAN THE MINISTRY OF PUBLIC HEALTH'S DISTRICT CLINICS. THEY ALSO HAVE A HIGHER QUALITY STAFF, ATTRACTED BY HIGHER SALARIES AND BETTER WORK CONDITIONS. ALSO INCLUDED IN THIS GROUP IS THE "FOURTH DEPARTMENT OF THE MINISTRY OF HEALTU" WHICH SERVES FAMOUS STATESMEN, POLITICAL FIGURES, AND HONORED INDIVIDUALS IN THE ARTS, CULTURE, SCIENCE, ETC. MOREOVER, UZBEKISTAN HAS A WIDE NETWORK OF SANATORIUMS AND HEALTH RESORTS WHTCH ARE FINANCED BY THE RESORT ADMINISTRATION OF THE TRADE UNION FEDERATION OF THE REPUBLIC OF UZBEKISTAN.

PRIVATIZATION

AS IN OTHER AREAS OF THE UZBEKISTAN ECONOMY, PRIVATIZATION HAS A LONG WAY TO GO. MOST OF THE GOVERNMENT'S LEGISLATION PROVIDING FOR THE PRIVATIZATION OF THE HEALTHCARE INDUSTRY HAS CONCENTRATED ON THE RE- ORGANIZATION OF PHARMACIES AND SMALL CLINICS, MAKING RELATIVELY LITTLE IMPACT ON THE LARGER ENTERPRISES.

IN 1994, THE CABINET OF MINISTERS PASSED A RESOLUTION ON THE PRIVATIZATION OF STATE PHARMACIES AND RATIFIED A RESOLUTION WITH REGARD TO PRIVATE MEDICAL PICTICE. DURING 1994, THE GOVERNMENT RE-ORGANIZED 1,700 PHARMACIES AS COMPANIES UNDER JOINT-STOCK AND COLLECTIVE OWNERSHIP, TRANSFERRED AN ADDITIONAL 500 PHARMACIES INTO PRIVATE HANDS, AND PRIVATIZED 178 MANUFACTURERS OF MEDICAL EQUIPMENT.

FURTHERMORE, THE GOVERNMENT HAS PLANS TO PRIVATIZE MANY MEDICAL FACILITIES OF THE MINISTRY OF PUBLIC HEALTH DURING THE 1995 CALENDAR YEAR. THESE WILL INCLUDE: 24 DENTAL FACILITIES, 12 PRE-NATAL CLINICS, 224 HEALTHCARE DIVISIONS, AND 13 MEDICAL SUPPLY DISTRIBUTION FACILITIES. THE GOVERNMENT IS ALSO CONSIDERING THE POSSIBIIJTY OF DIVESTING ITS SHARES IN MEDIUM -SIZED HEALTHCARE FACILITIES, THOUGH NO CLEAR PLAN HAS YET BEEN DEVELOPED.

COSTS AND PAYMENT STRUCTURES

AS NOTED ABOVE, THE VAST MAJORITY OF HEALTHCARE IN UZBEKISTAN IS STILL FINANCED BY THE GOVERNMENT. REAL COSTS ARE DIFFICULT TO ASSESS, HOWEVER, SINCE RECENT STATISTICS ARE LACKING AND THE ARTIFICIAL VALUE OF THE RUBLE, IN USE UNTIL THE END OF 1993, DISTORTS EARLIER FIGURES. NEVERTHELESS, GIVEN THAT THE PRIVATIZATION PROCESS IS STILL IN A PRELIMINARY STAGE AND THAT GOVERNMENT STRUCTURES HAVE NOT VARIED DRAMATICALLY FROM THE SOVIET-ERA SYSTEM, IT IS POSSIBLE TO APPROXIMATE THE GENERAL PAYMENT STRUCTURE USING EARLIER FIGURES.

IN 1991, 65 PERCENT OF HEALTHCARE COSTS WERE FINANCED THROUGH NATIONAL BUDGET EXPENDITURES OUTSIDE OF THE MINISTRY OF PUBLIC HEALTH WHILE 32 PERCENT WERE ACCOUNTED FOR UNDER THE LATTER'S BUDGET. THE REMAINING 3 PERCENT WAS FINANCED THROUGH "FEES FOR SERVICES PROVIDED". IN 1992, THE NATIONAL BUDGET PICKED UP OVER 80 PERCENT OF THE COST WITH THE MINISTRY OF PUBLIC HEALTH, AND THE PRIVATE SECTOR COVERING THE REMAINING 20 PERCENT. (A FURTHER BREAKDOWN IS UNAVAILABLE.)

RESTRICTIONS ON TYPES OF TREATMENT

ASIDE FROM FISCAL LIMITATIONS THERE ARE FEW MANDATORY RESTRICTIONS ON GOVERNMENTAL FUNDING FOR SPECIFIC MEDICAL PROCEDURES AND/OR TREATMENTS RELYING ON CERTAIN TYPES OF EQUIPMENT OR MEDICINES. THE ONE EXCEPTION IS NARCOTIC- BASED PHARMACEUTICALS WHICH ARE STRICTLY REGULATED UNDER PROCEDURES ESTABLISHED DURING THE SOVIET ERA.

HEALTHCARE REFORM

THE GOVERNMENT'S PLANS FOR HEALTHCARE REFORM IN UZBEKISTAN FALL INTO THE FOLLOWING AREAS: 1) REVISION OF PRINCIPLES GOVERNING PUBLIC HEALTHCARE FINANCING; 2) ALTERING THE HEALTHCARE INFRASTRUCTURE, TO INCLUDE MORE OUT-PATIENT SERVICES; 3) REFORM OF MEDICAL EDUCATION AND PERSONNEL POLICY; 4) IMPROVEMENT OF POLICY OF PRODUCTION AND PROCUREMENT OF PHARMACEUTICALS AND MEDICAL SUPPLIES; 5) PRIVATIZATION OF HEALTHCARE FACILITIES.

IN 1992, THE GOVERNMENT OF UZBEKISTAN AND THE MINISTRY OF PUBLIC HEALTH BEGAN TO RATIONALIZE THEIR ALLOCATION OF FUNDS THROUGH PER CAPITA CALCULATIONS BASING HEALTHCARE BUDGETS FOR REGIONAL CLINICS ON THEIR SURROUNDING POPULATIONS. SIMILAR REASONING WAS APPLIED TO HOSPITALS WILL FUNDS BEING PROVIDED ON THE BASIS OF THE NUMBER OF PATIENTS TREATED.

CURRENTLY, HOSPITALS RECEIVE APPROXIMATELY 60 PERCENT OF THE GOVERNMENT'S HEALTHCARE FUNDING, OUT-PATIENT CLINICS 30 PERCENT, WITH 5.6 PERCENT GOING TOWARDS SCIENTIFIC RESEARCH AND THE DEVELOPMENT OF NEW MEDICAL TECHNOLOGY. THE PERCENTAGE OF FUNDS ALLOCATED TO OUT-PATIENT CLINICS IS EXPECTED TO INCREASE OVER THE COMING YEAR AS THE GOVERNMENT MOVES TO REDUCE TOTAL NUMBER OF HOSPITAL BEDS AS A MEANS OF IMPROVING CONDITIONS IN THE REMAINING UNITS. FOR EXAMPLE, OVER THE PAST THREE YEARS, THE NUMBER OF HOSPITAL BEDS HAS BEEN REDUCED BY OVER 20 PERCENT, AND THE NUMBER OF PATIENTS HOSPITALIZED IN HOSPITALS DECREASED BY OVER 600,000. THIS DECREASE WAS LARGELY COVERED BY OUT- PATIENT CLINICS, WHICH TREATED OVER 520,000 PEOPLE IN 1993 ALONE. IN TERMS OF PERSONNEL POLICY THE MINISTRY OF PUBLIC HEALTH HAS TAKEN STEPS TO REDUCE TOP MANAGEMENT STAFF BY 35 PERCENT. IN 1991 THE RATIO OF MANAGERS TO PHYSICIANS WAS 1 TO 12, BUT IN 1993 IT BECAME 1 TO 21. IMPROVEMENT OF MEDICAL TRAINING IS SIMILARLY EMPHASIZED THOUGH IT IS UNCLEAR AS TO WHICH SPECIFIC MEASURES HAVE BEEN INSTITUTED.

A PRINCIPAL REASON FOR CURRENT SHORTAGES OF PHARMACEUTICALS AND MEDICAL SUPPLIES IN UZBEKISTAN LIES IN A GOVERNMENT REDUCTION IN THE NUMBER OF DIFFERENT MEDICINES PRODUCED FROM 3,000 TO 400-500. THE GOVERNMENT HAS SUBSEQUENTLY BEEN FORCED TO IMPORT PHARMACEUTICALS AT CONSIDERABLE EXPENSE FOR PUBLIC DISTRIBUTION. IN AN EXPORT TO REDUCE THIS DEPENDENCE ON IMPORTS, THE GOVERNMENT HAS INSTITUTED A NUMBER OF JOINT VENTURES (JV) TO PRODUCE PHARMACEUTICALS DOMESTICALLY. THESE INCLUDE: INDLAN-UZBEKISTAN JVS IN BUKHARA AND TERMEZ, A TURKISH- UZBEKISTAN JV IN SAMARKAND, GERMAN-UZBEKISTAN JVS IN NUKUS AND TASHKENT, AND AN ITALIAN-UZBEKISTAN JV IN KARSHI. AMONG THE FIRMS WORKING WITH UZBEKISTAN ENTERPRISES IN THIS AREA ARE: HOECHST (GERMANY), SAICO (ITALY), PHARMADUL (SWEDEN), ORION (FINLAND), AND TORRENT (INDIA).

II. MARKET SIZE AND TRENDS

DEMOGRAPHICS

IN 1993, THE POPULATION OF UZBEKISTAN WAS ESTIMATED AT 22,198,600 FORTY-ONE PERCENT OF WHICH WAS UNDER THE AGE OF 15. ALSO IN THAT YEAR, IT WAS DETERMINED THAT PER EVERY THOUSAND PERSONS THERE WERE 30.9 BIRTHS BUT ONLY 6.6 DEATHS, INDICATING A TREMENDOUS GROWTH IN THE COUNTRY'S POPULATION. ESTIMATES PUT THE COUNTRY'S 1996 POPULATION AT 23.4 MILLION.

THE MAIN CAUSE OF DEATH IN 1993 WERE CIRCULATORY DISEASES WHICH RESULTED IN 65,898 DEATHS. LESSER CAUSES WERE RESPIRATORY DISEASES (24,968 DEATHS), ACCIDENTS, POISONING OR TRAUMA OF SOME KIND (10,853 DEATHS), AND MALIGNANT TUMORS (10,576 DEATHS). THERE WERE 3,021 OUT-PATIENT CLINICS, 2,331 HOSPLTALS, AND 221 EMERGENCY MEDICAL STATIONS IN UZBEKISTAN IN 1993. THE AVERAGE HOSPITAL STAY FOR THAT YEAR WAS 14.5 DAYS.

TN 1993, THE RATIO PHYSICIANS TO INHABITANTS OF UZBEKTSTAN (PER 10,000) WAS AS FOLLOWS: THERAPEUTISTS - 8.0; SURGEONS - 3.6; OBSTETRICIANS/GYNECOLOGTSTS - 2.2; PEDIATRICTANS - 5.6; PSYCHTATRISTS - .6; STOMATOLOGLSTS - 2.U; AND DENTISTS - .2.

THE NUMBER OF HOSPITAL BEDS FOR PERSONS 15 YEARS OF AGE AND OLDER IS CURRENTLY 117.1 PER 10,000. THE CORRESPONDING NUMBER FOR THOSE UNDER 15 YEARS OF AGE IS 57.7 PER 10,000. AS ALREADY POINTED OUT, THE GOVERNMENT IS IN THE PROCESS OF ELIMINATING BEDS AND DIRECTING GREATER EMPHASIS ON OUT-PATIENT CARE. THE NUMBER OF HOSPITAL BEDS DECREASED FROM 251,789 IN 1990 TO 205,811 IN 1993.

MARKET VALUE AND POTENTIAL FOR GROWTH

ACCORDING TO ESTIMATES BY THE STATE COMMITTEE ON STATISTICS AND FORECASTING, UZBEKISTAN IMPORTED USD 5.4 MILLION OF MEDICAL EQUIPMENT AND SUPPLIES IN 1993. NEVERTHELESS, IT IS DIFFICULT TO ESTIMATE THE FULL POTENTIAL OF THE MARKET. TREMENDOUS SHORTAGES IN NEARLY EVERY CATEGORY OF PHARMACEUTICAL, BASLC MEDICAL SUPPLY AND MEDICAL EQUIPMENT ARE ACCOMPANIED BY SEVERELY LIMITED GOVERNMENT BUDGETS AND UNDEVELOPED PRIVATE MARKETS.

IN 1992, THE GOVERNMENT DECLARED THAT IT HAD IMMEDIATE NEEDS FOR PHARMACEUTICALS TOTALLING USD 65 MILLION. IN ORDER TO REACH THIS AMOUNT, THE GOVERNMENT NEGOTIATED CREDITS WITH TURKEY, SPAIN, HUNGARY AND INDIA, TO PURCHASE MEDICINES. THE STATE-OWNED PHARMACY ASSOCIATION "DORY- DARMON" NOW ESTIMATES TUAT THE GOVERNMENT WOULD NOW HAVE TO SPEND USD 112 TO MEET THE POPULATION OF UZBEKISTAN'S ANNUAL NEEDS FOR PHARMACEUTICALS ALONE.

THE MARKET IN UZBEKISTAN FOR ALL GOODS IS GROWING. IN GENERAL, EXPORTS IN 1994 INCREASED BY 10.3 PERCENT OVER 1993. HOWEVER, WHEN LOOKING AT HARD CURRENCY EXPORTS THE PERCENTAGE OF GROWTH JUMPS TO 86.8 PERCENT. WITH GREATER HARD CURRENCY EARNINGS, THERE IS BOUND TO BE A RISE IN IMPORTS AS WELL. IMPORTS IN 1994 INCREASED BY 14.9 PERCENT OVER 1993.

WHILE FIGURES SPECIFICALLY FOR PHARMACEUTICALS AND MEDICAL EQUIPMENT AND SUPPLIES DO NOT EXIST, IT IS IMPORTANT TO NOTE THAT THE NUMBER OF PHARMACEUTICAL AND MEDICAL FOREIGN FIRMS AND JOINT VENTURES IN THE UZBEKISTAN MARKET INCREASED FROM 12 IN SEPTEMBER 1994 TO 35 IN APRIL 1995. IT SHOULD ALSO BE NOTED THAT THERE IS A ENORMOUS FLOW OF PHARMACEUTICALS ENTERING UZBEKISTAN THROUGH "UNOFFICIAL" CHANNELS.

III. HEALTHCARE INSURANCE AND REGULATIONS AFFECTING MEDICAL PRACTICE

INSURANCE REGULATIONS

UNLIKE RUSSIA, IN UZBEKISTAN THERE ARE CURRENTLY NO MANDATORY MEDICAL INSURANCE FUNDS BEING ESTABLISHED AT THE NATIONAL OR REGIONAL LEVEL. THE GOVERNMENT IS CURRENTLY DISCUSSING, BUT HAS NOT YET APPROVED, A LAW ON MEDICAL INSURANCE, WHICH IF PASSED IS LIKELY TO FOLLOW EXAMPLES ESTABLISHED IN RUSSIAN LAW. THE INSURANCE SECTOR IS POORLY DEVELOPED OVERALL, WITH VERY FEW COMPANIES OFFERING ANYTHING OTHER THAN LIFE INSURANCE.

AS THE GOVERNMENT HAS NOT YET APPROVED THE LAW ON MEDICAL INSURANCE, THERE IS NO POTENTIAL FOR FOREIGN INSURANCE COMPANIES OBTAINING REIMBURSEMENT ON MEDICAL TREATMENTS PROVIDED THROUGH UZBEKISTAN'S NATIONAL HEALTHCARE SYSTEM. MOREOVER, MEDICAL MALPRACTICE IS VIRTUALLY UNAVAILABLE, NOR IN THE ABSENCE OF SUPPORTING LEGAL STRUCTURES IS THERE A POWERFUL INCENTIVE ENCOURAGING ITS DEVELOPMENT.

LICENSING PROCEDURES

THERE IS NO DISTINCTION IN LICENSING OF FOREIGN OR DOMESTIC MEDICAL PROFESSIONALS IN UZBEKISTAN. IN ORDER TO OBTAIN A MEDICAL LICENSE, ONE MUST APPLY TO THE COMMISSION FOR LICENSING AT THE MINISTRY OF HEALTH AND SUBMIT THE FOLLOWING:

1) A COMPLETED APPLICATION FORM; 2) COPIES OR EVIDENCE OF THE APPLICANT'S MEDICAL DEGREE; 3) CONCLUSION OF THE LOCAL SANITARY INSPECTION FOR THE RELEVANT MEDICAL FACILITY; 4) AN APPLICATION/APPROVAL FROM THE LOCAL HEALTHCARE BODY; 5) PAYMENT OF A LICENSING FEE, INCLUDING A STATE TAX OF 600 SOMS (APPROXIMATELY USD 24) AND THE MINISTRY OF HEALTH TAX OF 75 SOMS (USD 3).

IT WILL TAKE APPROXIMATELY 30-45 DAYS, FROM THE TIME OF SUBMISSION OF ALL DOCUMENTS, TO OBTAIN A LICENSE.

IV. MEDICAL PRODUCT SAFETY REGULATIONS:

PHARMACEUTICALS

TO BE MARKETABLE IN UZBEKISTAN, PHARMACEUTICALS MUST MEET THE FOLLOWING REQUIREMENTS;
  1. ALL PRODUCTS MUST HAVE A SAFETY CERTIFICATE FROM ITS COUNTRY OF ORIGIN.
  2. ALL PRODUCTS MUST ALSO HAVE A REGISTRATION CERTIFICATE FROM THE COMMITTEE OF PHARMACOLOGY OF THE UZBEKISTAN MINISTRY OF PUBLIC HEALTH. TO OBTAIN SUCH A CERTIFICATE, ONE MUST SEND A LETTER TO THE COMMITTEE WITH A LIST OF ALL PHARMACEUTICALS WHICH ARE INTENDED FOR IMPORT INTO THE REPUBLIC. THIS PROCESS CAN TAKE 6-14 DAYS.
  3. THERE ARE SPECIAL LABORATORIES FOR PHARMACEUTICAL QUALITY CONTROL WHICH HAVE BEEN ESTABLISHED BY THE CUSTOMS DEPARTMENT, HOWEVER, NOT EVERY CUSTOMS CHECKPOINT HAS ONE. THESE LABORATORIES CONTROL PHARMACEUTICALS WHICH ARE BEING IMPORTED INTO THE TERRITORY OF UZBEKISTAN AND CERTIFY THEIR COMPLIANCE WITH PROPER QUALITY STANDARDS.
  4. A SAMPLE OF EACH TYPE OF PHARMACEUTICAL WHICH ARRIVES AT THE CUSTOMS WAREHOUSE MUST BE SENT TO THE CENTRAL LABORATORY OF CONTROL AND ANALYSIS. THE LABORATORY IS OPERATED BY THE STATE JOINT-STOCK ASSOCIATION "DORY-DARMON". THIS ANALYSIS USUALLY TAKES 3-7 WORKING DAYS AND COSTS 50 SOMS (USD 2).
  5. CONCLUSION OF A PRICE EXAMINATION BY THE MINISTRY OF FOREIGN ECONOMIC RELATIONS (TECHNICALLY UNRELATED TO THE CERTIFICATION OF THE PHARMACEUTICALS THEMSELVES).
  6. REGISTRATION WITH: THE COMMITTEE FOR PHARMACEUTICALS "PHARMKOMITET", MR. ZUHRULLO SALIKHODJAEV, PRESIDENT, TEL. (011-7-3712) 41-16-34.
AS NOTED ABOVE, THERE ARE SEVERE RESTRICTIONS ON THE REGISTRATION AND DISTRIBUTION OF NARCOTIC-CONTAINING PHARMACEUTICALS. FOR MORE INFORMATION ON CERTIFICATION AND LICENSING FOR IMPORT OF THESE PRODUCTS, CONTACT: MRS. I. KHALMEDOVA, CHIEF LOW CONSULTANT OF THE MINISTRY OF HEALTH, TEL. (011-7-3712) 41-17-63, OR MR. SERGEI KARYSH, HEAD OF INSPECTION AT THE MINISTRY OF HEALTH, TEL. (011-7- 3712) 41-17-70.

MEDICAL EQUIPMENT AND SUPPLIES

DETAILED PROCEDURES FOR LICENSING AND REGISTRATION OF MEDICAL EQUIPMENT IMPORTS INTO UZBEKISTAN ARE NOT AS DEVELOPED AS THOSE FOR PHARMACEUTICALS.

STARTING IN MAY 1995, ONE OF THE LABORATORIES OF "MEDTEKNIKA", WHICH WAS RECENTLY ACCREDITED IN GERMANY, BEGAN CONDUCTING CERTIFICATION TESTS UNDER THE SUPERVISION OF "GOSSTANDART", THE STATE COMMITTEE FOR STANDARDS. THESE PROCEDURES APPLY BOTH TO NEW AND REFURBISHED MEDICAL EQUIPMENT.

COMPANIES INTERESTED IN IMPORTING MEDICAL EQUIPMENT AND SUPPLIES INTO UZBEKISTAN SHOULD CONTACT: JOINT-STOCK ASSOCIATION "MEDTEKNIKA", MR. KABUL PULATOV, TEL. (011-7- 3712) 64-17-46.

QUESTIONS CONCERNING MEDICAL EQUIPMENT STANDARDS MAY ALSO BE ADDRESSED TO: MR. RAKHIM HASHIMOV, CHIEF OF REGISTRATION DEPARTMENT, "GOSSTANDART", TEL. (011-7-3712) 46-19-60.

ADDITIONAL CONTACT

GENERAL INFORMATION ON MEDICAL SAFETY STANDARDS AND CERTIFICATION PROCEDURES IN UZBEKISTAN MAY BE OBTAINED FROM: MR. NASIR DJURAEV, CHIEF PHYSICIAN, SANITARY AND EPIDEMIOLOGIC STATION, 14 TURSUNKULOV STREET, TASHKENT 700131, TEL. (011-7-3712) 78-59-46 OR 78-59-38.

V. PRODUCT DEVELOPMENT, PURCHASING AND DISTRIBUTION PRODUCT DEVELOPMENT

DUE TO THE UNDERDEVELOPED STATE OF DOMESTIC PRODUCTION, THE MAJORITY OF ALL MEDICAL EQUIPMENT AND MEDICINES IN UZBEKISTAN IS IMPORTED FROM ABROAD. HOWEVER, BUDGET PERMITTING, THE GOVERNMENT HAS DESIGNATED A NUMBER OF PROJECTS AS PRIORITIES FOR IMPROVEMENT DOMESTIC PRODUCTION CAPACITY. TUESE INCLUDE CONSTRUCTION OF THE FOLLOWING FACILITIES:
  1. A PLANT IN KARSHI TO PRODUCE PLASMA SUBSTITUTION SOLUTIONS.
  2. A PLANT IN NUKUS TO PRODUCE PLASMA SUBSTITUTION SOLUTIONS.
  3. A JOINT-VENTURE PLANT IN TASHKENT, IN COOPERATION WITH TORRENT (INDIA), TO PRODUCE READY-NADE MEDICINES.
  4. A JOINT-VENTURE PLANT, IN COOPERATION WITH SAMSUNG (SOUTH KOREA), TO PRODUCE AN ANTI-HEPATITUS VACCINE.
  5. A PLANT IN FERGANA TO PRODUCE INFUSIVE SOLUTIONS.
  6. A PLANT IN YANGIYUL TO PRODUCE READY-TO-USE MEDICINES.
  7. A JOINT-VENTURE PROJECT IN SAMARKAND, IN COOPERATION WITH A TURKISH FIRM, TO INSTALL PACKAGING MACHINERY FOR MEDICINE TABLETS.
  8. A JOINT-VENTURE PLANT, IN COOPERATION WITH AN INDIAN FIRM, TO PRODUCE PHARMACEUTICALS.
MANY OF THESE PROJECTS WILL BE FINANCED THROUGH LOCAL OR REGIONAL GOVERNMENT BUDGETS OTHER THAN RELYING ON THE BUDGET OF THE MINISTRY OF PUBLIC HEALTH.

PRODUCT PURCHASING AND DISTRIBUTION

IN GENERAL LOCAL AND REGIONAL GOVERNMENTS FINANCE PURCHASES FOR LOCAL AND REGIONAL HOSPITALS, RESPECTIVELT, WHEREAS THE MINISTRY OF PUBLIC HEALTH FINANCES PURCHASES FOR REPUBLICAN CLINICS AND HOSPITALS IN ADDITION TO COVERING ESSENTIAL REGULATORY FUNCTIONS.

FURTHERMORE, THE REGIONAL BODIES OF THE MINISTRY OF PUBLIC HEALTH PLAYS A KEY ROLE IN THE DISTRIBUTION OF MEDICAL EQUIPMENT AND PHARMACEUTICALS, MOVING PRODUCTS THROUGH ITS REGIONAL DIVISIONS ("OBLZDRAV"), TO ITS DISTRICT DIVISIONS ("RAIZDRAV"), AND ON TO HOSPITALS AND CLINICS. THE MINISTRY ALSO DISTRIBUTES VACCINES TO CHILDREN DIRECTLY.

ANOTHER MAIN DISTRIBUTOR OF MEDICINES IS THE STATE JOINT- STOCK ASSOCIATION "DORY-DARMON", WHICH SUPPLIES ITS OWN REGIONAL BRANCHES WITH MEDICINES AND PHARMACEUTICALS. WHILE THE STATE DISTRIBUTION NETWORK IS RESPONSIBLE FOR NEARLY 90 PERCENT OF MEDICAL EQULPMENT DISTRIBUTION IN UZBEKISTAN, ITS SHARE OF PHARMACEUTICAL DISTRIBUTLON IS LESS THAN 40 PERCENT, AND DECREASING AS MORE AND MORE PRIVATE FLRMS START UP OPERATION.

PROPERTY RIGHTS

PURSUANT TO LAWS, DECREES AND RESOLUTIONS OF THE REPUBLIC OF UZBEKISTAN ON PROPERTY AND ON MEASURES TO LNTENSIFY ECONOMIC REFORM, THE PROTECTION OF PRIVATE PROPERTY AND PROMOTION OF ENTREPRENEURSHIP, AND ON FOREIGN INVESTMENT AND GUARANTEES OF FOREIGN ACTIVITY, THE GOVERNMENT GUARANTEES LEGAL PROTECTION OF NON-STATE PROPERTY, TO INCLUDE PRIVATE PROPERTY OF ITS OWN CITIZENS OR FOREIGNERS. THEREFORE, ONCE A UNIT OF MEDICAL EQUIPMENT HAS BEEN PURCHASED BY A COMPANY OR MEDICAL CARE FACILITY THE GOVERNMENT GUARANTEES THE RIGHT OF OWNER SHIP OF THE EQUIPMENT.

VI. FINANCING ISSUES:

MEDICAL PRODUCT TRANSACTIONS ARE TYPICALLY FINANCED BY THE GOVERNMENT, BOTH FOR HARD CURRENCY AND THROUGH BARTER TRANSACTIONS. IN ADDITION, SUBDIVISIONS OF THE MINISTRY OF PUBLIC HEALTH HAVE "SOCIAL QUOTAS" IN THE FORM OF MONEY OR SALEABLE GOODS (I.E. COTTON) ALLOCATED BY THE STATE GOVERNMENT TO SERVE AS A MEANS FOR PAYMENT. WHILE SUCH MEANS ARE AT THE DISPOSAL OF THESE SUBDIVISIONS AND MAY BE SPENT AT THEIR OWN DISCRETION, IN PRACTICE, IT IS OFTEN NECESSARY TO OBTAIN GOVERNMENT APPROVALS WHICH MAY OR MAY NOT BE POSSIBLE.

PRIVATE FIRMS WHICH HAVE BEEN IMPORTING PHARMACEUTICALS AND OTHER MEDICAL SUPPLIES HAVE ALSO EXPERIENCED CONSIDERABLE DIFFICULTY IN OBTAINING HARD CURRENCY DUE TO AN OCTOBER 15, 1994 DECREE BY THE CABINET OF MINISTERS, REQUIRING THAT ALL DOMESTIC SALES OF GOODS AND SERVICES BE IN THE LOCAL CURRENCY (SOMS). WHILE A LIMITED NUMBER OF BANKS AND PRIVATE ENTERPRISES ARE LICENSED TO CONDUCT HARD CURRENCY TRANSACTIONS, NON-LICENSED ENTERPRISES ARE OFTEN UNABLE TO OBTAIN REASONABLE OR EFFICIENT ACCESS TO HARD CURRENCY ACCOUNTS.

VII. IMPORT RESTRICTIONS:

TARIFFS

AT THE MOMENT THERE ARE NO TARIFFS APPLIED TO THE LMPORTATION OF MEDICAL EQULPMENT AND MEDICINES LNTO UZBEKISTAN. THIS IS EXPECTED TO CHANGE AS OF JULY 1995, BUT IT LS UNCLEAR WHAT TARIFF WILL BE PLACED ON THE ABOVEMENTIONED ITEMS.

IMPORT LICENSING

PURSUANT TO A RESOLUTION BY THE CABINET OF MINISTERS OF MARCH 25, 1994 ON MEASURES FOR REGULATING FOREIGN TRADE TRANSACTIONS IN UZBEKISTAN, A UNIFIED PROCEDURE WAS DEVELOPED FOR THE LICENSING OF IMPORTS IRRESPECTIVE OF THE FORM OF OWNERSHIP. THIS PROCEDURE GOVERNS A SELECTED LIST OF PRODUCTS INCLUDING:
  1. 1) MEDICINES, POISONS, NARCOTICS AND PSYCHOTROPIC DRUGS (CS EEA CODES: 1302, 2938, 2941, 3006, 3822-90).
  2. RAW MATERIALS FOR PRODUCING MEDICINES AND PRODUCTS OF MEDICINE EXTRACTED FROM WILD ANIMALS AND PLANTS (CS EEA CODES: 0206-10-100, 0206-22-100, 0206-29-100, 0206-30-100, 0206-41-100, 0206-49-100, 0206-90-100, 0510, 0511, 1211, 1302 [EXCEPT 1302-19-300, 1302-31, 1302-39], 3001, 3002, 9601).
GOODS NOT INCLUDED ON THIS LIST MAY BE IMPORTED WITHOUT LICENSE SUBJECT TO THE CUSTOMS LEGISLATION OF THE GOVERNMENT OF UZBEKISTAN.

TO OBTAIN A LICENSE FOR THE PRODUCTS LISTED ABOVE, IMPORTERS MUST SUBMIT: 1) AN APPLICATION FORM PROVIDED BY THE MINISTRY FOR FOREIGN ECONOMIC RELATIONS, 2) A CONTRACT SLGNED BY THE BUYER AND SELLER AND 3) A CERTIFICATE OF ORIGIN FOR THE GOODS, 4) EVIDENCE OF PAYMENT FOR RELEVANT LICENSING FEES. LICENSES ARE ISSUED FOR THE TERM REQUIRED TO EFFECT THE TRANSACTION, BUT GENERALLY NOT TO EXCEED ONE YEAR. ON REASONABLE GROUNDS PRESENTED BY THE IMPORTER. THE TERM OF THE LICENSE MAY BE EXTENDED. DECTSIONS RELATING TO ISSUANCE OF A LICENSE ARE GENERALLY MADE WITHIN 10 DAYS.

VIII. FOREIGN MEDICAL INDUSTRY COMPANIES ACTIVE IN THE MARKET:

BEAUFOUR-IPSEN INTERNATIONAL (FRANCE)
6, SODIC AZIMOV STREET
TASHKENT 700047
UZBEKISTAN
TEI, (7-3712) 33-70-51
FAX (7-3712) 32-07-03

BERLINER - CHEMIE (GERMANY)
TASHKENT, UZBEKISTAN
TEL (7-3712) 45-10-44

BOEHRINGER INGELHEIM (AUSTRIA)
ROOM 530
32, MATBUOTCHILAR
TASHKENT 700083
UZBEKISTAN
TEI, (7-3712) 33-24-74
FAX (7-3712) 33-91-55

BRISTOL-MYERS-SQUIBB (UK)
98, UZBEKISTANSKY PROSPECT
NO. 28,30 DOM KINO
TASHKENT, UZBEKISTAN
TEL (7-3712) 45-75-26, 49-90-83
FAX (7-3712) 89-12-62
CONTACT:  MRS. SAODAT MURATKHODJAEVA

CIBA-GEIGY A.G. (SWITZERLAND)
62, AMIR TIMUR STREET
TASHKENT 7OOOOO
UZBEKISTAN
TEI, (7-3712) 77-32-48
FAX (7-37]2) 35-46-49

DEEPHARMA LTD.
TASHKENT, UZBEKISTAN
TEL (7-3712) 34-21-96
CONTACT:  MR. RASHMI BLALT

DINA (INDIA)
10, FARKHADSKAYA STREET
TASHKENT 700015
UZBEKISTAN
TEI, (7-3712) 77-25-17
FAX (7-3712) 77-44-45

DR. REDDY'S (INDIA)
TASHKENT, UZBEKISTAN
TEL/FAX (7-3712) 77-75-65
CONTACT:  MR. ANIL GUPTA

ELI LILLY AND CO. (USA/SWITZERLAND)
10, KLARA TSETKIN STREET
TASHKENT, UZBEKISTAN
TEL/FAX (7-3712) 33-16-29
CONTACT:  MRS. SVETLANA PANTELEEVA

ELVIM LTD. (LATVIA)
KV. 10, DOM LLB
MED. GORODOK
TASHKENT, UZBEKISTAN
TEL (7-3712) 46-42-67
CONTACT:  MR. ALISHER DJABBAROV

GERMED HANDELGESELLSCHAFT MBH (GERMANY)
40, PROSPECT RASHIDOVA
700029 TASHKENT
UZBEKISTAN
TEL (7-3712) 56-53-66, 39-45-36
FAX (7-3712) 39-16-82

GLAXO EXPORT LTD. (UK)
11, ALMAZAR STREET
TASHKENT, UZBEKISTAN
TEL (7-3712) 41-49-78
CONTACT:  MR. LEVON SARKISOV

HOECHST A.G. (GERMANY)
6, KHOREZMSKAYA STREET
TASHKENT 700000
UZBEKISTAN
TEI (7-3712)  32-99-23

HOFFMAN LA ROCHE LTD. (SWITZERLAND)
ROOM 9, KORPUS 3,
5, MUSTAKILLIK MAIDONI
TASHKENT 700000
UZBEKISTAN
TEI, (7-3712) 39-47-30
TEL/FAX (7-3712) 39-45-16

INTERMED LABOR AND MEDTECH (GERMANY)
63, SADIK AZIMOV STREET
TASHKENT 700047
UZBEKISTAN
TEL/FAX (7-3712) 33-34-84

IVERSON (UK)
TASHKENT, UZBEKISTAN
TEL (7-3712) 45-85-67
CONTACT:  MR. MIKHAIL ZUSIN

KAMILLA (US/UZBEKISTAN)
2, USMAN USUPOV STREET
TASHKENT, UZBEKISTAN
TEL (7-3712) 41-19-40
FAX (7-3712) 41-58-46
CONTACT:  MR. SHOYUSUF AKHROROV

LEK D.D. (SLOVENIA)
41, BUYUK TURON STREET
TASHKENT 700000
UZBEKTSTAN
TEL/FAX (7-3712) 33-34-48

NOVO NORDISK A/S (DENNARK)
62/35 NAVRUZ STREET
JAKKE-SARAJSKI RAION
TASHKENT 700031
UZBEKISTAN
TEL (7-3712) 56-49-69, 56-50-43, 39-46-6H
FAX (7-3712) 89-15-41
CONTACT:  MRS. NATALIA PLATONOVA

OVERSEAS MARKETING CORPORATION LTD. (UK)
TASHKENT, UZBEKISTAN
TEL (7-3712) 61-20-67
CONTACT:  MR. TIMUR ISLAMOV

PASTER MERIE (FRANCE)
ROOM 20, DOM 35
C-1 TASHKENT, UZBEKISTAN
TEL/FAX (7-3712) 33-29-54
CONTACT:  MRS. ZUMRAD MADJIDOVA

PFIZER INTERNATIONAL (USA)
11, POLIGRAPHIC PROEZD
USMAN JUSUPOV STREET
TASHKENT 700]28
UZBEKISTAN
TEI, (7-3712) 46-32-19
CONTACT:  MR. KHAIRULLA A. KHASHIMOV

POLJUS PHARM (US/UK)
TASHKENT, UZBEKISTAN
TEL (7-3712) 65-08-65
CONTACT:  MRS. NASIBA NABIEVA

RADIOMETER COPENHAGEN (DENMARK)
2, PEREULOK VLADIMIRSKOGO
LUNATCHARSKOYE SHOSSE
TASHKENT 700077
UZBEKISTAN
TEL  (7-3712)  67-67-83
FAX (7-3712) 67-64-32
CONTACT:  MR. ANATOLY SHAPOVAOV

RHONE-POULENC AGROCHIMIE (FRANCE)
ROOM 204
22, LAKHUTI STREET
TASHKENT 700016
UZBEKISTAN
TEL (7-3712) 56-68-98, 56-65-98

RICHARD WOLF (GERMANY)
2, FARKHADSKAYA STREET
REPUBLICAN UROLOGLCAL CENTER
TASHKENT, UZBEKISTAN
TEL (7-37]2) 77-55-13, 65-09-19
CONTACT:  MR. ALEXANDER EGOROV

SAICO S.R.L. (ITALY)
15, A. IKRAMOV STREET
TASHKENT 700000
UZBEKISTAN
TEL (7-3712)  33-54-46
FAX (7-3712) 33-21-69
CONTACT:  MR. ULUGBEK KHASANOV

SANOFI-PHARMA (FRANCE)
TASHKENT, UZBEKISTAN
TEL/FAX (7-3712) 33-55-34
CONTACT:  MR. UTKUR RASULOV

SIBPHARM (RUSSIA)
84, USTO SHIRIN - 1 STREET
TASHKENT 700052
UZBEKISTAN

SCHERING A.G. (GERMANY)
65, SODIK AZIMOV STREET
TASHKENT 700047
UZBEKISTAN
TEI, (7-3712) 33-34-24, 33-37-30
FAX (7-3712) 33-95-89
SCHULER DENTAL (GERMANY)

88, PUSHKIN STREET
TASHKENT 7OOOOO
UZBEKISTAN
TEI, (7-3712) 68-66-06
FAX (7-3712) 68-53-53
CONTACT:  MR. KH. UBAYDULLAEV

SIEMENS (GERMANY)
23, TOLSTOY STREET
TASHKENT 700000
UZBEKISTAN
TEI, (7-3712) 32-37-51, 33-36-63
TEL/SAT (7-3712) 89-14-03, 89-14-04, 89-14-05
FAX/SAT (7-3712) 89-14-02
CONTACT:  MR. G. ABEDIN

STERLING HEALTH (ENGLAND)
27/39, C-1
TASHKENT 700000
UZBEKISTAN
TEL (7-3712) 32-24-46
CONTACT:  MR. SURAT IKRAMOV

SUMITOMO CORPORATION (JAPAN)
ROOM 53, BLOCK G
98, PROSPECT UZBEKISTANSKY
TASHKENT, UZBEKISTAN
TEL (7-3712) 45-81-21
FAX (7-3712) 45-83-33

SURKHAN AJANTA PHARMA LTD. (INDIA)
13A, MAURUKHUANA
TASHKENT 700060
UZBEKISTAN
TEL (7-3712) 32-01-48
FAX (7-3712) 33-84-71

TUERK HOECHST SAN VE TIC.A.S. (TURKEY)
6, KHOREZMSKAYA STREET
TASHKENT 7OOOO
UZBEKISTAN
TEI] (7-3712) 32-09-69

FOREIGN-OWNED HEALTHCARE FACILIITES

THERE ARE CURRENTLY NO MEDICAL FACILITIES OWNED OR ADMINISTERED BY FOREIGN COMPANIES IN UZBEKISTAN.

IX. IMPORTANT HEALTHCARE SECTOR CONTACTS:

HEALTHCARE FACILITIES

CLINIC AT THE LST STATE MEDICAL UNIVERSITY
2, PHARABI STREET
TASIIKENT,  UZBEKI S TAN
TEL (7-3712) 46-47-46, 41-58-19

CLINIC AT THE 2ND STATE MEDICAL UNIVERSITY
103, KARL MARX STREET
TASHKENT, UZBEKISTAN
TEL (7-3712) 33-37-15

REPUBLICAN CLINICAL HOSPITAL NO. 1
2, FARKHADSKAYA STREET
TASHKENT 7OOLO7
UZBEKISTAN
TEL (7-3712) 77-39-23, 77-59-74

REPUBLICAN CLINICAL HOSPITAL NO. 2
5, KABLUKOVA STREET
KIROVSKY RAION
TASHKENT, UZBEKISTAN
TEL (7-3712) 34-92-00, 34-81-56

REPUBLICAN CLINICAL HOSPITAL NO. 3
153, LENIN STREET
KIBRAI RAION
POSEOLOK "SALAR"
TASHKENT 702152
UZBEKISTAN
TEL (7-3712) 48-55-95, 29-88-52, 48-77-34

REPUBLICAN PSYCHIATRICAL CLINICAL HOSPITAL
STANTSIA SHUMILOVA
TASHKENT RAION
TASHKENT, UZBEKISTAN
TEL (7-3712) 48-55-95, 29-88-52, 48-77-34

REPUBLICAN OPHTHALMOLOGIC CLINICAL HOSPITAL
12, SAIDOVA STREET
SABIR RAKHIMOVSKY RAION
TASHKENT 700095
UZBEKISTAN
TEL (7-3712) 46-77-51

REPUBLICAN SANITARY AND EPIDEMIOLOGICAL STATION
14, TURSUNOVA STREET
TASHKENT 700131
UZBEKISTAN
TEI] (7-3712) 78-53-65, 78-47-43

AIDS CENTER (SPID)
TASHKENT, UZBEKISTAN
TEL (7-37]2) 76-37-76
REPUBLICAN ANTI-TUBERCULOSIS DISPENSARY
6, REMESLENNAYA STREET
TASHKENT 700060
UZBEKISTAN
TEL (7-3712) 76-36-31
REPUBLICAN SPECIALIZED PSYCHOTHERAPEUTIC DISPENSARY FOR

CHLLDREN
KOLSKY PEREULOK
MIRZO ULUGEK RAION
TASHKENT 700001
UZBEKISTAN
TEL (7-3712) 67-73-59, 67-73-50, 67-98-37

REPUBLICAN MEDICAL AND SPORTS DISPENSARY
9, YANVARIA STREET
TASHKENT 700003
UZBEKISTAN
TEL (7-3712) 45-61-41, 45-61-45

HEAD BUREAU OF FORENSIC MEDICAL EXAMINATION AT THE
MINISTRY OF HEALTH
143, SALANATINA
PHRUNZENSKY RAION
TASHKENT 700121
UZBEKISTAN
TEL (7-3712) 50-85-70, 50-87-20

MEDICAL ADMINISTRATION OF THE MINISTRY OF INTERNAL AFFAIRS
12, AKHUNBABAEVA STREET
TASHKENT 700047
UZBEKISTAN
TEL (7-3712) 33-61-20, 41-O7-47

MEDICAL ADMINISTRATION OF THE CIVIL DEFENSE STAFF
5, ALLE PARADOV
TASHKENT, UZBEKISTAN
TEL (7-3712) 39-15-79
MEDICAL AND SANITARY ADMINISTRATION OF CENTRAL ASIAN

RAILWAYS
5, FIRST POLTORATSKI PROEZD
TASHKENT, UZBEKISTAN
TEL (7-3712) 32-48-27, 77-55-7O, 39-22-60

SANITARY AND EPIDEMIOLOGICAL SERVICE OF THE UZBEKISTAN
ADMINISTRATION OF CIVIL AVIATION
86, AVIAGORODOK
TASHKENT 700167
UZBEKISTAN
TEL (7-3712) 91-14-92, 99-85-34
CENTRAL COMMITTEE OF THE RED CRESCENT ORGANIZATION
33, AKADEMIK SULELMANOV STREET
TASHKENT 700017
UZBEKLSTAN
TEL (7-3712) 33-72-60

MEDICAL INDUSTRY ENTERPRISES

INDUSTRIAL FIRM "LBN-SINO"
TASHKENT, UZBEKISTAN
TEL (7-3712) 40-48-53
MEDICAL HEALTH IMPROVEMENT SCIENTIFIC-PRODUCTION CENTRE

"MADADKOR"
45, CHERVYAKOV ST.
TASHKENT 700005
UZBEKISTAN
TEL (7-3712) 91-40-88, 91-34-01, 59-63-73
FAX (7-3712) 91-40-88, 44-26-03, 44-31-83

PRIVATE FIRM "PHARMED"
IBRAT ST.
TASHKENT 700132
UZBEKISTAN
TEI, (7-3712) 47-98-90, 47-98-94
FAX (7-3712) 47-22-98

PRIVATE FIRM "RUTA"
ROOM 19-20
81 NUKUS ST.
TASHKENT 700015
UZBEKISTAN
TEI, (7-3712) 55-38-19
FAX (7-3712) 54-94-52

STATE JOINT-STOCK CONCERN "UZPHARMPROM"
37, MAVLIANOV ST.
TASHKENT 700084
UZBEKISTAN
TEL (7-3712) 34-65-48
FAX (7-3712) 34-77-88

MEDICAL PRODUCTS DISTRIBUTORS

ADMINSTRATION OF MATERIAL - TECHNIC SUPPLIES
"UZGLAVMEDHOZSNAB"
269, KARASARAISKAYA ST.
TASHKENT 700069
UZBEKISTAN
TEL (7-3712) 48-56-06, 67-49-00

CENTRAL BASE OF "UZMEDTEKHNIKA"
"MEDTEKHNIKA", POSEOLOK GEOPHIZIKA
KIBRAI RAION
TASHKENT 702164
UZBEKISTAN
TEI, (7-3712) 64-38-85

STATE JOINT-STOCK ASSOCIATION "DORY-DARMON"
76, PROFSOYUZNA ST.
TASHKENT, UZBEKISTAN
TEL (7-3712) 48-25-01, 48-25-03

MINISTRY OF HEALTH DEPARTMENTS

ADMINISTRATION OF MINISTRY
OF HEALTH OF UZBEKISTAN
12, NAVOI STREET
TASHKENT 7OOOLL
UZBEKISTAN
TEL (7-3712) 46-84-78

DEPARTMENT OF FOREIGN RELATIONS
TASHKENT, UZBEKISTAN
TEL: (7-3712) 41-16-34, 33-24-77

DEPARTMENT OF HEALTHCARE OF
TASHKENT REGION (OBLAST)
51, KHOREZMSKAYA STREET
TASHKENT 700476
UZBEKISTAN

HEAD ADMINISTRATION OF
HEALTHCARE OF HOKIMIYAT
48, LENINGRADSKAYA STREET
TASHKENT, UZBEKISTAN

RECEPTION-ROOM OF MINISTRY
OF PUBLIC HEALTH OF UZBEKISTAN
12, NAVOI STREET
TASHKENT 700011
UZBEKISTAN
TEL: (7-3712) 44-10-40, 96-46-73

MAJOR PROFESSIONAL MEDICAL ASSOCIATIONS

ASSOCIATION OF DERMATOLOGISTS
AND VENEROLOGISTS
LST TASHKENT STATE MEDICAL UNIVERSITY
TASUKENT, UZBEKISTAN
TEL: (7-3712) 67-74-96
CONTACT: A. VALIEV, CHIEF OF
THE DEPARTMENT OF SKIN DISEASES

ASSOCIATION OF ONKOLOGISTS
TASHKENT, UZBEKISTAN
TEL: (7-3712) 46-25-25
CONTACT: PROFESSOR MURATKHODJAEV M.K., DIRECTOR OF THE
INSTITUTE OF ONCOLOGY

BRANCH OF THE MORPHOLOGISTS' ASSOCIATION
TASHKENT, UZBEKISTAN
CONTACT: ZUFAROV K.A.,  MEMBER OF
THE PLENUM OF THE CO-ORDINATE COUNCIL OF
THE UZBEK ACADEMY OF SCIENCES

BRANCH OF THE ASSOCIATION OF
ROENTGENOLOGISTS AND RADIOLOGISTS
TASHKENT, UZBEKISTAN
TEL: (7-3712) 67-68-82
CONTACT: MAKSUMOV D.H., MEMBER OF THE CO-ORDINATE COUNCIL,
ASSOCIATE MEMBER OF THE UZBEK ACADEMY OF SCIENCES

MEDICOLEGAL ASSOCIATION
2ND TASHKENT MEDICAL STATE UNIVERSITY
TASHKENT, UZBEKISTAN
TEL: (7-37I2) 46-49-06
CONTACT: DJALOLOV D.D., CHIEF OF THE MEDICOLEGAL
DEPARTMENT

PHYSICIAN'S ASSOCIATION
TASIIKENT, UZBEKISTAN

TEL: (7-3712) 77-26-22
CONTACT: ABDULLA KHUDAIBERGENOV,
EXECUTIVE DIRECTOR: ATKHAM AKBAROV

REPUBLICAN TRADE UNION OF MEDICAL WORKERS
TASHKENT, UZBEKISTAN
TEL: (7-3712) 56-69-77

SOCIETIES

SOCIETY OF TRAUMATOLOGISTS AND ORTHOPEDISTS
TASHKENT, UZBEKISTAN
TEL: (7-3712) 33-10-30
CONTACT: TASHTEMIR ASHANKULOVICH UNGBAEV

SOCIETY OF PSYCHIATRISTS
TASHKENT, UZBEKISTAN
TEL: (7-3712) 91-18-62
CONTACT: SHAKHZADE ASKAROVICH MURTALIPOV

SOCIETY OF THE SPECIALISTS ON INFECTIOUS DISEASES
TASHKENT, UZBEKISTAN
TEL: (7-3712) 46-06-14
CONTACT: ISAK KURBANOVICH MUSABAEV

SOCIETY OF PATHOPHISIOLOGISTS
TASHKENT, UZBEKISTAN
TEL: (7-3712) 67-62-75
CONTACT: NUSRAT KHAMIDOVICH ABDULLAEV

THE REPUBLICAN SCIENTIFIC MEDICAL SOCIETIES (RSMS) OF THE UZBEK MINISTRY OF PUBLIC HEALTH

RSMS OF ANATOMISTS, HISTOLOGISTS, EMBRYOLOGISTS
CONTACT: KHAMIDJO
N ZUFAROV
TEL: (7-3712) 67-63-04

RSMS OF ACCOUCHEUR-GYNECOLOGISTS
CONTACT: DELI KARIMOVA
TEL: (7-3712) 78-25-04

RSMS OF IMMUNOLOGISTS AND ALLERGOLOGISTS
CONTACT: AZAD NADJITDINOV
TEL: (7-3712) 41-16-30

RSMS OF HEMATOLOGISTS AND TRANSFUSIOLOGISTS
CONTACT: SAIDJALAL BAKHRAMOV
TEL: (7-3712) 53-72-82
RSMS OF HYGIENISTS AND SPECIALISTS OF SANITARY SERVICE
CONTACT: TULLKIN ISKANDAROV
TEL: (7-3712) 41-16-24

RSMS OF DERMATOVENEROLOGISTS
CONTACT: ATKHAM VAISOV
TEL: (7-3712) 67-74-96

RSMS OF SPECIALISTS ON MEDICAL GENETICS
CONTACT: PULAT TASHKHODJAEV

RSMS OF GASTROENTEROLOGISTS
CONTACT: ULUGBEK ASKAROV
TEL: (7-3712) 77-36-51

RSMS OF GERONTOLOGY AND GERIATRIST
CONTACT: RAKHIM NURMUKHAMEDOV
TEL: (7-3712) 33-16-87

RSMS OF SPECIALISTS ON INFECTIONS
CONTACT: ISAK MUSABAEV
TEL: (7-3712) 46-06-14

RSMS OF HISTORIANS OF MEDICINE
CONTACT: V. I. ISKHAKOV

RSMS OF CARDIOLOGISTS
CONTACT: RAFAIL KATSENOVICH
TEL: (7-3712) 46-19-24

RSMS OF PHISIATRISTS
CONTACT: MAVDJUDA ALIAKHUNOVA
TEL: (7-3712) 34-13-55

RSMS OF PHYSICIANS-LABORATORY ASSISTANTS
CONTACT: KONSTANTIN KAZAKOV
TEL: (7-3712) 78-05-89

RSMS OF MICROBIOLOGISTS AND EPIDEMIOLOGIST
CONTACT: K.D.DJALILOV
TEL: (7-3712) 42-32-22

RSMS OF NEUROPATHOLOGIST
CONTACT: NABI MADJIDOV
TEL: (7-3712) 77-97-86

RSMS OF ONCOLOGISTS
CONTACT: NARIMAN MURATKHODJAEV
TEL: (7-3712) 46-25-25

RSMS OF OTOLARYNGOLOGISTS
CONTACT: KUCHKAR MIRAZIZOV
TEL: (7-3712) 67-62-91

RSMS OF OPHTHALMOLOGISTS
CONTACT: MUKHAMADJON KAMLLOV
TEL: (7-3712) 46-06-31

RSMS OF ORTHOPEDISTS AND TRAUMOTOLOGISTS
CONTACT: TASHTEMIR UNGBAEV
TEL: (7-3712) 33-10-30
RSMS OF ORGANIZERS OF HEALTHCARE AND SOCIAL-HYGIENLSTS
CONTACT: B.N.MAGZUMOV
TEL: (7-3712) 66-19-74

RSMS OF PEDIATRICIANS
CONTACT: BAKHTIYAR KADIROV
TEL: (7-3712) 39-81-16

RSMS OF PATHOANATOMISTS
CONTACT: MAIJKA ABDULLAKHODJAEVA
TEL: (7-3712) 46-46-85

RSMS PATHOPHYSIOLOGISTS
CONTACT: NUSRAT ABDULLAEV
TEL: (7-3712) 67-62-75

RSMS OF RADIOLOGISTS AND ROENTGENOLOGISTS
CONTACT: DJALAL MAKSUMOV
TEL: (7-3712) 67-68-82

RSMS OF DENTISTS
CONTACT: M.B.BEKMETOV

RSMS OF THERAPEUTIST
CONTACT: KARIM YULDASHEV
TEL: (7-3712) 34-55-00

RSMS OF UROLOGISTS
CONTACT: DMITRY ARUSTAMOV
TEL: (7-3712) 77-55-19

RSMS OF PHTHISIOLOGISTS
CONTACT: ABDULLA UBAIDULLAEV
TEL: (7-3712) 78-04-70

RSMS OF PHARMACEUTISTS
CONTACT: ZAKIR NAZIROV
TEL: (7-3712) 56-35-38

RSMS OF PHARMACOLOGISTS
CONTACT: UZU ZAKIROV
TEL: (7-3712) 56-37-38

RSMS OF SURGEONS
CONTACT: V.V.VAKHIDOV
TEL: (7-3712) 77-25-22

RSMS OF ENDOCRINOLOGISTS
CONTACT: YALKIN TURAKULOV
TEL: (7-3712) 62-25-67

MEDICOLEGAL RSMS
CONTACT: DJALIL DJALALOVICH DJALALOV
TEL: (7-3712) 46-49-06

MEDICAL-AND-TECHNICAL RSMS
CONTACT: A.A.FAZYLOV
TEL: (7-37]2) 68-25-39

RSMS OF IMMUNOLOGISTS
CONTACT: GARIB FERUZ YUSUPOVICH
TEL: (7-3712) 67-62-88

RSMS OF NEUROSERGEONS
CONTACT: MARAT KHIKMATOVICH KARIEV
TEL: (7-3712) 34-94-00

RSMS OF SERGEON FOR CHILDREN
CONTACT: AMIN SUIRAIMANOVICH SULAIMANOV
TEL: (7-3712) 67-42-42

RSMS OF PHYSIATRIST
CONTACT: SHAKHZADE ASKAROVICH MIRTALIPOV
TEL: (7-3712) 91-18-62

RSMS OF VKK AND VTAK
CONTACT: MIRZABEK DUSMURATOVICH DUSMURATOV
TEL: (7-3712) 35-00-72

MEDICAL INDUSTRY ENTERPRISES

STATE JOINT-STOCK CONCERN "UZPHARMPROM"
37, MAVLIANOV STREET
TASHKENT 700084
TEL (7-3712) 34-65-48
FAX (7-3712) 34-77-88
CONTACT:  MR. K. SHADIEV, CHAIRMAN

MEDICAL HEALTH IMPROVEMENT SCIENTIFIC PRODUCTION CENTER

"MADADKOR"
45, CHERVYAKOV STREET
TASHKENT 700005
TEL (7-3712) 91-34-01, 59-63-73
FAX (7-3712) 44-26-03, 44-31-83
CONTACT:  MR. VICTOR RUSALOV, CHIEF OF PRODUCTION

PRIVATE FIRM "PHARMED"
IBRAT STREET
TASHKENT 700132
TEL (7-3712) 47-98-90, 47-98-94
FAX (7-3712) 47-22-98
CONTACT: MRS. VERA IVASHKEVICH, MARKETING DEPARTMENT

PRIVATE FIRM "RUTA"
ROOM 19-20
81, NUKUS STREET
TASHKENT 700015
TEL (7-3712) 55-38-19
FAX (7-3712) 54-94-52

INDUSTRIAL FIRM "IBN SINO"
TEL (7-3712) 40-48-53
CONTACT: MR. IRKIN JURAEV, GENERAL DIRECTOR

X. TRADE PROMOTION OPPORTUNITIES

EVENT:         CONFERENCE ON THE QUESTION OF
               PROPHYLACTICS, DIAGNOSTICS AND TREATMENT OF
               IMMUNOLOGICAL CONDITIONS
DATE:          JUNE 1995
ORCANIZERS:    THE TASHKENT STATE MEDICAL INSTITUTE

EVENT:         CONFERENCE ON HEALTH OF MOTHERS AND INFANTS
               IN THE ARAL SEA AREA
DATE:          SEPTEMBER 1995
ORGANIZERS:    THE TASHKENT STATE MEDICAL INSTITUTE
               URGENCH BRANCH

EVENT:         PERSPECTIVES ON HERBAL MEDICINES
DATE:          OCTOBER 3-4, 1995
ORGANIZERS:    THE TASHKENT PHARMACOLOGICAL MEDICAL
               INSTITUTE

EVENT:         INTERNATIONAL TRADE EXHIBITION DEDLCATED TO
               MATERNAL, PRENATAL AND INFANT CARE
DATE:          OCTOBER 1995
ORGANIZERS:    INTERNATIONAL TRADE AND EXHIBITIONS LTD.
               BYRON LIOUSE
               112 SHIRLAND ROAD
               W9 2EQ LONDON
               TEL (44-7L) 286-9720
               FAX (44-71) 286-0177
                            266-1606
               TEL (7-3712) 34-15-93 (IN TASHKENT)

               "FOR A HEALTHY GENERATION" FUND
               MRS. GULNARA YULDASHEVA
               TEL (7-3712) 68-92-16

EVENT:         CONFERENCE ON RADIOLOGICAL DIAGNOSIS AND
               THERAPY, DEDICATED TO THE 1OOTH ANNIVERSARY
               OF THE DISCOVERY OF THE X-RAY
DATE:          NOVEMBER 8-9, 1995
ORGANIZERS:    THE TASHKENT STATE MEDICAL INSTITUTE
               ASSOCIATION OF RADIOLOGISTS

EVENT:         CONFERENCE ON THE ORGANIZATION OF EMERGENCY
               MEDICAL SERVICES
DATE:          NOVEMBER 15-16, 1995
ORGANIZERS:    THE CENTER FOR SPECIAL MEDICAL AID

EVENT:         MEDICINE AND HEALTH '96
DATE:          APRIL 1996
ORGANIZERS:    INTERNATIONAL TRADE AND EXHIBITIONS LTD.
               BYRON HOUSE
               112 SHIRLAND ROAD
               W9 2EQ LONDON
               TEL (44-71) 286-9720
               FAX (44-7L) 286-OL77
                           266-1606
               TEL (7-3712) 34-15-93 (IN TASHKENT)

               MINISTRY OF PUBLIC HEALTH
               TASHKENT, UZBEKISTAN