The GOVERNANCE of the health system with regard to COVID-19 relates to pandemic response plans and the steering of the health system to ensure its continued functioning. It includes emergency response mechanisms, as well as how information is being communicated, and the regulation of health service provision to patients affected by the virus.
There was a pandemic response plan in place before the outbreak, but it was not activated.
A rapid assessment of the preparedness of the health sector was carried out in January 2020, hospital and laboratory assessments were conducted in February 2020, and an operational simulation exercise at Manas Airport was conducted in February 2020. Following these assessments, various measures were identified and planned to ensure preparedness (training specialists, providing necessary supplies, materials and equipment, and informing the public).
The intersectoral interagency contingency plan for COVID-19 (revised and extended to 12 months) was endorsed by the Vice Prime-Minister on 20 March 2020. The overall objective of this preparedness and response plan is to support the Government and the Ministry of Health to lead and ensure an effective, timely and coordinated response that will mitigate the impact of the COVID-19 outbreak in Kyrgyzstan. The objective will be achieved through a clear response coordination mechanism and strategy, and clearly defined roles and responsibilities of all relevant national and international partners.
The UN Framework for the Immediate Socio-economic Response to COVID-19 in Kyrgyzstan (Framework) is being developed to formulate the United Nations’ urgent support to the Kyrgyz Republic to address the socio-economic impact of the crisis. The Framework will be responding to a dual imperative, namely to provide and leverage fast response to support Government efforts to mitigate the immediate socio-economic impact of the crisis, while helping the Government to pave the way for a sustainable, longer term recovery. The UN system has over the past months been adjusting its activities to minimize the disruption to the country’s development trajectory caused by the COVID-19 pandemic. The framework sets out how the UN will continue to do this, and will guide the UN’s joint planning process for the second half of the current UNDAF programme cycle, from mid-2020 to 2022. Accordingly, the framework will guide the planning for the UN response and will effectively respond to the call from H.E. President Mr Sooronbai Jeenebekov for the UN to align its country programme with the needs of the COVID response. It also supports the roadmap of the UN system in supporting the country’s mainstreaming of the Sustainable Development Goals (SDGs).
On 17 March 2020 Kyrgyzstan reported the first 3 cases of COVID-19. Based on Government Decree No. 583 of 2011 on infectious diseases in the Kyrgyz Republic, an early warning mechanism alert should be initiated when the there is a danger of:
• a serious public health event;
• a disease of unknow aetiology, that can cause significant morbidity or mortality in humans, or may affect or exceed the capacity of the national response;
• a serious risk that infectious disease will spread;
The main legislation for the response to COVID-19 in Kyrgyzstan is the Government Order No. 30 of 29 January 2020, the Order No. 52 of the Minister of Health of 29 January 2020 on preventing the spread of COVID-19, and the protocol No.1 of 29 January 2020, based on the meeting of the Republican Task Force on preventing the introduction and spread of the coronavirus on the territory of Kyrgyzstan.
Fast-track custom clearance procedures are in place for humanitarian aid.
Kyrgyz mechanisms and response structure – Operational preparedness for COVID-19
Government and Ministry of Health
The Ministry of Emergency Situations is the operational branch of the Government’s Republican Task Force to coordinate all kinds of emergencies. It has a general emergency preparedness and response plan for outbreaks of infectious diseases. The Ministry of Health also has a general plan for infectious disease outbreaks and particularly for pandemic influenza diseases.
Country level Coordination
The Government established in January 2020 a special COVID-19 Task Force under the Prime Minister. The Republican Task Force consists of all ministries and State Agencies, including the Ministry of Health, the Ministry of Emergency Situations, the Ministry of Interior, the State National Security Agency, the State Committee for Defence, the Security Council, the Ministry of Foreign Affairs, the Ministry of Economy, the Ministry of Finance, the Ministry of Culture and Tourism, the Ministry of Transportation and Roads, the State Border Service, the State Customs Service, the Veterinary Service, the Phytosanitary Agency and others.
Meetings of the Republican Task Force take place when needed. There is also an operational Task Force at the Crisis Management Centre at the Ministry of Emergency Situations. The Ministry of Health, as all other ministries, is advising and informing the operational Task Force 3 times per day.
Ministry of Health inside the health system
The Ministry of Health has established its own COVID-19 Task Force, including a 24/7 secretariat.
The Ministry of Health Task Force consist of the Public Health Department of the Ministry of Health and the Department of Health Care Delivery and Drug Policy, the Department of Disease Prevention and State Sanitary-Epidemiological Surveillance, the Republican Centre of Quarantine and Especially Dangerous Infections, the Department of Drug Supplies and Medical Equipment, the Republican Health Promotion Centre etc.
The Task Force receives information 3 times per day from all health care facilities and laboratories of 7 oblasts and the national virologic laboratory, and laboratories of Osh city and Bishkek city. They are reporting about the number of patients, the number and health status of suspected COVID-19 cases in hospitals, the number and health status of people under examination and home observation, and the number and results of laboratory tests performed.
All 22 points of entry also report 3 times per day about the number of people passing borders and the number and health status of people under observation.
In general, activities of the health sector regarding infectious diseases, in case of an impending threat of their further spread, are funded through the Governmental Epidemiological Fund of the Ministry of Health. In case of public health emergency, additional financial support by the Government will be provided.
WHO international/national coordination
The support from international development partners is organized by two main coordination platforms, the Disaster Response Coordination Council (DRCU) led by the Ministry of Health and WHO, and the Development Partner Coordination Council led by WHO and the World Bank. Health partners with WHO technical support developed the Country Contingency Plan (CCP) which identified priority areas of interventions to strengthen the country’s preparedness, readiness and response to COVID-19 in line with the Global Strategic Response Plan. The Health Sector Contingency Plan costed activities, with an accumulated total of USD 15.8 million. Upon activation of the state of emergency, international partners escalated the response, implementing strategic interventions in line with identified priorities.
The WHO Country Office is coordinating external contributions to the health sector through monthly meetings. Since January 2020 the meetings are on a bi-monthly basis to update on the situation and coordinate support activities by development partners and the Ministry of Health. Development partners are reporting regularly on their activities to support the COVID-19 response.
The WHO Regional Office for Europe has designated four international reference laboratories (in the Netherlands, Germany, UK and Russia) for the verification of national laboratory results. As mentioned in the section on testing, in Kyrgyzstan the National Virologic Laboratory is the reference lab for COVID-19.
The WHO Country Office initiated a first discussion of country preparedness for vaccination against COVID-19 within the COVAX Facility with UN agencies and all other relevant partners at country level. The Gavi Secretariat and the WHO Regional Office took part in the discussion.