The community's voice at the center of change: ENPUD consultant’s work in Kazakhstan
Kazakhstan: from collecting testimonies to systemic change
In 2026, ENPUD’s consultant continues work in Kazakhstan under the initiative “Incorporating recommendations on planning to ensure continuity of healthcare services related to OAT into national health strategies of the Republic of Kazakhstan.”
Despite many years of implementing opioid agonist therapy (OAT), one of the key problems remains the lack of mechanisms to ensure continuity of therapy during hospitalization in somatic (general medical) inpatient facilities. In practice, this leads to refusals of hospital admission, interruptions of treatment, risks of patients leaving hospitals without authorization, deterioration of health, and violations of the rights of people receiving OAT.
To change this situation, ENPUD’s consultant initiated systematic work to document rights violations, mobilize the community, collect an evidence base, and develop advocacy mechanisms needed to advance changes at the national level.
Over the past months, large-scale efforts were made to strengthen engagement with the community of OAT participants from different regions of Kazakhstan. Through regular consultations, Zoom meetings, and continuous communication in WhatsApp groups, stable channels of communication were established that allow rapid reporting of problems people face when receiving treatment and medical care.
One important result was the development of tools for documenting rights violations and the launch of an anonymous survey among program participants. Patients from multiple regions of the country took part in the study. The collected data confirmed serious barriers to accessing inpatient medical care and demonstrated the need for systemic solutions to ensure continuity of treatment.
At the same time, an analysis was conducted of the regulatory and legal framework governing OAT implementation, the use of controlled substances, and patient hospitalization. Special attention was paid to identifying legal and organizational gaps that hinder the continuity of therapy in inpatient settings.
Based on the collected data, analytical materials, working documents, and draft official appeals to state bodies were prepared. This work is building the evidence base necessary for further dialogue with the Ministry of Health of the Republic of Kazakhstan and relevant institutions.
A separate line of work has been monitoring methadone procurement and supply. After signals of possible disruptions appeared, the consultant together with the community and partners organized continuous monitoring of the situation, gathered information from regions, advised patients, and prepared appeals to state bodies. A hotline was set up for rapid community support, and informational materials for patients were developed.
In a relatively short period, it was possible not only to unite the community around common goals but also to move from discussing problems to generating evidence, analysis, and concrete proposals for their resolution. This work lays the foundation for future systemic changes aimed at ensuring continuity of OAT and upholding every person’s right to accessible, quality treatment.
The work continues. Today, the community’s voice is becoming an important part of the healthcare decision-making process in Kazakhstan.
#ENPUD #Kazakhstan #HarmReduction
