At a glance
CDC established a Central Asia office in the Republic of Kazakhstan in 1995 and expanded operations ten years later with funds from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). CDC partners with ministries of health to address COVID-19 and HIV and strengthen capacity to respond to disease outbreaks.
Overview
CDC now has offices in the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Tajikistan, and the Republic of Uzbekistan. CDC Central Asia works closely with ministries of health (MOHs) and partner organizations to address the following public health areas:
- Global health security
- HIV
- One Health
Global health security
Strategic focus
CDC's global health security work in Central Asia focuses on strengthening disease outbreak response, surveillance, laboratory systems, and workforce development.
Surveillance systems
CDC has led trainings on infectious disease forecasting, geographic information systems and advanced analytical methods, including spatial analysis. This technology and training improve regional public health capacity and increase collaboration and data-sharing among local, national, and international partners. CDC is working with MOHs to introduce new approaches and strengthen surveillance, including the development of new protocols and updating current guidelines.
Laboratory strengthening
CDC is strengthening the capabilities of public health and hospital-based laboratories of the MOHs in Central Asia. CDC supports regional and reference-level laboratories with:
- Workforce development
- Improving quality management systems
- Biosafety and biosecurity
- Monitoring for and testing of SARS-CoV-2 variants
- Establishing laboratory testing algorithms for especially dangerous pathogens in public health surveillance in the context of standard case definitions
- Laboratory equipment and reagents
Workforce development
CDC supports training public health professionals through the Field Epidemiology Training Program (FETP). Field epidemiologists—or disease detectives—learn to identify and contain outbreaks before they become larger epidemics.
The Central Asia FETP was established in 2003 as a two-year residency program, with support from CDC and MOHs in Central Asia. FETP consists of three levels of training: frontline, intermediate, and advanced. Participants learn to gather critical data and turn it into evidence-based action.
FETP trainees and graduates have conducted over 400 epidemiological investigations, 155 disease surveillance system evaluations, and over 200 outbreak investigations. About 80% of Central Asia FETP graduates hold influential positions in their government’s MOH. In 2020, CDC partnered with the Asfendiyarov Kazakh National Medical University to offer a master’s degree for advanced FETP residents.
CDC started the Global Laboratory Leadership Program (GLLP) to support the development of human resources for laboratory services in Kazakhstan in 2023. Participants learn essential skills in laboratory leadership. Multidisciplinary and multisectoral participant cohorts are encouraged to support the integration of the One Health approach at all levels of national health laboratory systems. They are also encouraged to support the sustained development of communities of practice for health laboratory leaders.
CDC provided technical support to establish a Laboratory Training Center at the Scientific Practical Center for Sanitary Epidemiological Expertise and Monitoring of National Center for Public Health.
Emergency response
The CDC Central Asia offices help strengthen emergency preparedness by training staff across government agencies, supporting cross-sectoral collaboration, and helping to develop emergency preparedness guidelines.
CDC collaborates with partners to enhance border health management in response to COVID-19 and other communicable diseases.
Key achievements
- CDC supported the establishment of Public Health Emergency Operations Centers in four Central Asian countries.
- In Kyrgyzstan:
- CDC and partners created the first web-based tool that provides an electronic registry for all notifiable infectious diseases, including COVID-19.
- CDC supported the MOH in strengthening mortality surveillance, including the development of an electronic death registration system.
- CDC and partners created the first web-based tool that provides an electronic registry for all notifiable infectious diseases, including COVID-19.
- In Uzbekistan:
- CDC helped develop clinical practice guidelines on Brucellosis and Crimean-Congo hemorrhagic fever for clinicians and infectious-diseases specialists.
- CDC helped develop clinical practice guidelines on Brucellosis and Crimean-Congo hemorrhagic fever for clinicians and infectious-diseases specialists.
HIV
Strategic focus
CDC is a key implementer of PEPFAR. CDC works with the governments of Kazakhstan, Kyrgyzstan, and Tajikistan to build sustainable, high-impact national HIV response programs with the goal of achieving epidemic control.
CDC's activities include:
- Scaling up HIV prevention and treatment services in areas with high infection rates.
- Helping develop and implement evidence-based strategies and guidelines for HIV infection control.
- Supporting Republican AIDS Centers and Republican Narcological Centers in Kazakhstan, Kyrgyzstan, and Tajikistan.
Key achievements
- CDC supported partners in Kyrgyzstan to achieve the first international accreditation of a Central Asian laboratory on the ISO 17043 standard.
- CDC and a partner introduced pre-exposure prophylaxis as a prevention method for people with increased risk of HIV in Kazakhstan and Kyrgyzstan.
- CDC began to support the development and execution of a bio-behavioral survey for men who have sex with men and people who inject drugs in Kyrgyzstan.
One Health
One Health is a collaborative, multisectoral, and transdisciplinary public health approach. One Health seeks to achieve optimal public health outcomes by recognizing the interconnection between people, animals, plants, and their shared environment.
Key achievements
- Across several regions in Kazakhstan, CDC helped enhance Crimean-Congo hemorrhagic fever surveillance by investigating its occurrence among humans, animals, and ticks.
- CDC helped develop a national One Health Program and implement the One Health Zoonotic Disease Prioritization Tool in Uzbekistan.
- CDC analyzed distribution of tick-borne pathogens among hospitalized patients and ticks in the Pavlodar region of Kazakhstan. This work informed recommendations for the MOH regarding laboratory diagnostics of tick-borne diseases.
Cooperative biological engagement program
CDC collaborates with the U.S. Department of Defense's Defense Threat Reduction Agency and its Cooperative Biological Engagement Program. Through this collaboration, CDC strengthens clinical and laboratory capacity to minimize biosecurity threats in the Central Asia region.
CDC works with public health laboratories across Kazakhstan to build:
- A robust and reliable network of quality management systems.
- A sustainable biosafety and biosecurity program for medical laboratories.
- Disease surveillance and laboratory testing capacity.
- A necessary legal and regulatory framework.
CDC and the Kazakhstan MOH partner with hospitals to improve surveillance and testing of especially dangerous pathogens and antimicrobial drug-resistant pathogens.
Key achievements
- CDC assisted all 17 regional laboratories within the National Center for Expertise in Kazakhstan to achieve ISO 15189 standard certification for laboratory quality management.
- CDC provided technical assistance on biosafety and biosecurity program development. This included medical laboratories of the National Center of Expertise in Kazakhstan through training activities for 9 regional laboratories.
- CDC supported the establishment of a National Center for Antimicrobial Resistance in Uzbekistan in 2017. This center now conducts surveillance and antimicrobial susceptibility testing.
Success story spotlight
Hope and Healing: The Role of Methadone Clinics in HIV Treatment in the Kyrgyz Republic
Olga Anatolievna Gritsak has been a dedicated nurse for 53 years, with the last 17 spent at the Opioid Substitution Therapy (OST) Clinic at the No.2 Republican Center for Psychiatry and Narcology (RCPN) in Bishkek. She is more than a nurse to her 58 patients; she is a compassionate figure, known as a caring babushka, who opens the clinic early every morning to dispense methadone and is the last to leave at night.
The OST clinic provides a lifeline for people who inject drugs, offering oral methadone treatment to help them stop injection drug use. These clinics are critical for patients who are often isolated due to severe stigmatization, providing not only medical care for hepatitis C and HIV/AIDS but also essential mental health and social support. The aim is to stabilize patients on methadone, improve their overall health, and help them reintegrate into society, thus reducing the risks associated with injection drug use.
Despite the supportive environment within the clinic, stigma and discrimination against people who inject drugs and people living with HIV/AIDS remain pervasive in the Kyrgyz Republic. Barriers to accessing these vital services include self-stigma, social discrimination, and the frequent unlawful detention of OST clinic patients by law enforcement, which deters many from seeking treatment.
CDC has been active in the Kyrgyz Republic since 2011, supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The CDC collaborates with the Ministry of Health’s Republican Center for Bloodborne Viral Hepatitis and HIV Control (RCBVHHC) and RCPN to enhance HIV prevention, counseling, and testing. Their efforts also focus on strengthening laboratories, HIV care and treatment, strategic information systems, and other public health functions.
Despite challenges, the work of dedicated individuals like Olga ensures that hope and healing remain possible for those affected by drug addiction and HIV/AIDS in the Kyrgyz Republic.
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