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A new direction in medicine has been launched in Uzbekistan - the use of robotic surgeons



Uzbekistan is undergoing a significant modernization of its healthcare system to ensure comprehensive access to quality medical services for the population. Over the past seven years, funding for healthcare has increased from 5.9 trillion soums to 33.5 trillion soums, a sixfold increase. Medical facilities are being equipped with modern equipment, and new ones are being constructed. To bring medical services closer to the population, screening examinations are being organized in local areas.

In recent years, considerable attention has been paid to providing fair compensation and incentives for healthcare workers. Specifically, as of June 1, 2022, the monthly salaries of medical and pharmaceutical workers with the highest and first qualification categories increased by 15%, those with the second qualification category and no category, as well as other medical and pharmaceutical workers, saw a 10% increase, and the salaries of other healthcare institution employees rose by 15%. Additionally, doctors who work in remote areas receive a salary bonus, which serves as a motivation for healthcare professionals.

It is important to note that the salaries of healthcare workers increase proportionally with the quality of their work, encouraging them to improve their performance. For example, a top-category surgeon who performs high-tech surgeries and holds a scientific degree earns 12.3 million soums per month (equivalent to up to 1000 USD). Similarly, a top-category doctor working in a family medicine clinic and holding a scientific degree earns 12.7 million soums per month (equivalent to over 1000 USD). If such a doctor works in remote areas, their salary amounts to 14.7 million soums (equivalent to over 1150 USD).

The increase in the monthly salaries of healthcare professionals has led to an improvement in the quality of services provided within the healthcare system. Moreover, it has increased interest in the field among young people and enhanced the competitiveness of the medical system relative to other sectors.

Significant attention is being paid to the renovation of medical institutions and the construction of new buildings. Within the framework of the Investment Program for 2024, construction and renovation works are planned for 1.3 trillion soums across 147 medical institutions. In the past six months, construction and renovation have been completed at 36 facilities, which have been put into operation.

A primary goal of the ongoing transformation processes is to elevate the capabilities and potential of healthcare institutions in Uzbekistan to a level fully consistent with international standards. Therefore, particular emphasis is placed on establishing advanced and modern medical institutions. Among the newly established facilities in recent years are the National Children's Medical Center, the National Medical Center, and the Scientific-Practical Medical Centers for Adult and Pediatric Hematology. Additionally, a new building and complex for the Nephrology and Oncology Medical Center are being constructed, complete with all necessary amenities. The strengthening of the material and technical base of the medical sector is a priority. It is noteworthy that these changes in medicine are occurring not only in the capital and regional centers but also in the most remote regions of Uzbekistan.

Currently, innovative solutions, new diagnostic methods, and treatments are being utilized at all levels of healthcare. For instance, over the past three years, 15 new types of neurosurgical operations have been introduced at the Republican Specialized Scientific-Practical Medical Center for Neurosurgery. At the Republican Specialized Scientific-Practical Medical Center for Therapy and Medical Rehabilitation, precise diagnoses are made using MRI, multi-slice CT, angiographic radiography, balloon catheters, diagnostic and transfer catheters, stents, and endovascular technologies. In the Interventional Cardiology Department of the center, several high-tech surgical operations are performed, such as stenting of the heart and renal vessels, angioplasty of leg vessels, carotid artery stenting, uterine fibroid embolization, and prostate embolization. As a result, 1776 complex and unique surgeries were successfully performed at the center in 2023 alone.

In recent years, the positive changes in the system have led to the establishment of a transplant department at the Republican Specialized Scientific-Practical Medical Center for Hematology. In 2023, about 100 patients with myeloma and lymphoma underwent autologous stem cell transplantation. After this procedure, 70% of patients experienced pain relief and an improved quality of life.

Significant progress has been made in Uzbekistan in the prevention, early detection, and treatment of tuberculosis. Medical institutions responsible for combating this disease have been fully reconstructed in accordance with infection control regulations and equipped with modern medical equipment. "Asthma and Chronic Obstructive Pulmonary Disease Schools" have been established at primary healthcare institutions to educate patients on improving quality of life and preventing disease exacerbation. Vaccination of infants against the disease has reached 99.8%. By 2023, the incidence of tuberculosis had decreased by 45% compared to 2010, and the mortality rate had dropped by 87%. In June 2024, Uzbekistan hosted a prestigious international conference on "Fulfilling the Commitments of the UN High-Level Meeting on Tuberculosis: Regional Dialogue in Europe and Central Asia," attended by WHO Regional Director for Europe Hans Kluge, recognizing Uzbekistan's achievements in this area.

 

A new direction in global medicine—using surgical robots—has been launched in Uzbekistan. Such robotic equipment exists only in a few countries worldwide, including Uzbekistan. The main advantage of the Revo-i robot, produced in Korea, is that its surgical instruments are small and can bend and rotate much more than a human hand. The Revo-i robot is equipped with four manipulator "arms," which perform surgery through small incisions in the patient's body. One arm has a camera, while the others make incisions, cut tissues, or suture wounds. Operations performed by these "iron" surgeons are considered minimally invasive. The surgeon controls the robot via a special console and can see everything in fine detail on a display. Robotic surgery is significant because it allows for the complete removal of tumors, preventing recurrence. During surgery, nerve endings and other vital organs are not affected, and blood loss is minimized, promoting faster recovery. Successful surgical interventions depend primarily on the surgeon's skill. Precision and attentiveness are required during the procedure. The country has accumulated some experience in working with this robot, and specialists have undergone training in this area in Korea and other foreign countries.

Today, digital technologies have become a key tool and "locomotive" for development, accelerating reforms in all aspects of the state's social and economic life. Digital transformation in healthcare is an important and necessary step. Therefore, significant work is being done in Uzbekistan to implement advanced digital technologies in medicine. In particular, by the end of 2024, the "Electronic Polyclinic," "Electronic Hospital," and "Electronic Prescription" systems are expected to be fully implemented across all regions of the country. The newly launched "Situational Center" of the Ministry of Health's electronic platform serves as the main hub for integrating these systems. This will create a mechanism for managing all healthcare information systems through a unified complex. The center will ensure the smooth operation of information systems on the ground, providing the ability to view and analyze data from over 1,700 medical institutions in real-time.

The healthcare reforms being implemented in our country today are primarily aimed at bringing medical services closer to the people, extending high-tech specialized medical care to the district level, eliminating unnecessary hassles and bureaucratic obstacles, and creating convenient conditions for patients. Telemedicine plays an important role in achieving these objectives. Relevant presidential decrees and the "Digital Uzbekistan 2030" strategy set forth important tasks for integrating modern information technologies, including telemedicine, into healthcare. As part of these efforts, telemedicine technologies have been introduced in 25 specialized medical centers and clinics at higher medical educational institutions across the republic. As a result, online conferences, consultations, seminars, and conferences with leading specialists from countries such as the United States, Germany, South Korea, Turkey, India, Russia, and Japan have become possible, as well as the online broadcasting of complex surgeries for experience sharing. The broader adoption of telemedicine technologies is directly related to the digital infrastructure. Work is currently underway to establish unified standards for information systems, equip healthcare institutions, including primary healthcare, with necessary computer equipment, and connect them to a unified corporate network.

According to President Shavkat Mirziyoyev's decree "On Additional Measures to Deepen Reforms in the Healthcare Sector," the educational programs of the Tashkent Medical Academy received international accreditation in 2024. Nineteen educational programs, including all ten undergraduate programs, as well as programs for master's degrees, clinical residency, and advanced training, have been recognized as meeting international standards of global medical education.

The National Children's Medical Center also received JCI certification, indicating that the center meets the highest international standards for medical service quality and patient safety. This also signifies that the quality of medical care, patient safety, and appropriate treatment and management methods in the medical institution have reached a high level.

Fourteen laboratory complexes under the Committee for Sanitary and Epidemiological Well-being and Public Health have received ILAC MRA international accreditation.

Thanks to regular and effective immunization efforts, polio caused by wild polioviruses has been eradicated in Uzbekistan since 1996, and the country received a "Polio-Free Territory" certificate in 2002. In 2024, Hans Kluge, WHO Regional Director for Europe, presented Uzbekistan with a certificate for the elimination of hepatitis B through quality vaccination. Most importantly, the quality and efficacy of vaccines in Uzbekistan are monitored according to international standards and ensured at a high level in all healthcare institutions.

Among the main ideas of the "Uzbekistan - 2030" strategy is the creation of a healthcare system fully meeting the population's needs and international standards. Consequently, phased reforms are being implemented to ensure public health. These include plans to increase the average life expectancy of the population to 78 years by 2030, double the funds allocated for healthcare, reduce early mortality rates from cancer, cardiovascular diseases, diabetes, and respiratory diseases by 2.5 times, drastically reduce tuberculosis incidence from the current 34 per 100,000 population, and detect early-stage cancer in the population aged 30-69 years, aiming to double the five-year survival rate and halve infant mortality rates.

Additionally, the goal is to halve the incidence of hereditary diseases in children, increase the coverage of selective screening for hereditary diseases in infants by at least 50%.

The tasks also include raising early detection rates of non-communicable diseases to 70%, doubling the early detection of diabetes and hypertension among the adult population (aged 40 and older), reducing the mortality rate from cardiovascular, chronic respiratory diseases, and diabetes by 30% among the population aged 30-69 per 100,000 population. Annual preventive medical examinations and health assessments are conducted for 100% of the population aged 55 and older, as well as efforts to double the proportion of physically active individuals among the adult population (aged 40 and older). Additionally, by 2030, all medical institutions will be fully digitized.

 

Elmira Basitkhanova,

Deputy Minister of Health of Uzbekistan



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