VZCZCXYZ0001
RR RUEHWEB

DE RUEHNT #0332/01 0770650
ZNR UUUUU ZZH
R 170650Z MAR 08
FM AMEMBASSY TASHKENT
TO RUEHC/SECSTATE WASHDC 9396
INFO RUEHAH/AMEMBASSY ASHGABAT 3825
RUEHTA/AMEMBASSY ASTANA 0039
RUEHEK/AMEMBASSY BISHKEK 4441
RUEHLM/AMEMBASSY COLOMBO 0310
RUEHKA/AMEMBASSY DHAKA 0272
RUEHDBU/AMEMBASSY DUSHANBE 0319
RUEHIL/AMEMBASSY ISLAMABAD 4037
RUEHBUL/AMEMBASSY KABUL 2308
RUEHKT/AMEMBASSY KATHMANDU 0349
RUEHNE/AMEMBASSY NEW DELHI 0983
RUEHVEN/USMISSION USOSCE 2393

UNCLAS TASHKENT 000332 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EUR/PGI DAVID TESSLER AND OES/IHB ANDREA LAURITZEN 
ASTANA FOR ALMATY/USAID 
 
E.O. 12958: N/A 
TAGS: PGOV TBIO EAID UZ
SUBJECT: TUBERCULOSIS:  UZBEKISTAN IS MAKING EFFORTS TO 
IMPLEMENT BERLIN DECLARATION 
 
REF: STATE 6989 
 
SENSITIVE BUT UNCLASSIFIED -- PLEASE PROTECT ACCORDINGLY 
 
¶1. (U) Summary:  Per request in reftel, the Government of 
Uzbekistan is making efforts to fulfill its commitments under 
the 2007 Berlin Declaration on Tuberculosis.  The 
tuberculosis threat in Central Asia is growing, and 
Uzbekistan is among the top ten countries in the world for 
the prevalence of drug-resistant strains of the disease.  A 
World Health Organization official in Tashkent working on the 
issue believes the Government of Uzbekistan has the political 
will to implement internationally-recognized tuberculosis 
control strategies.  He also noted the government has 
implemented an electronic tuberculosis case-reporting system; 
expanded a pilot project to collaborate on tuberculosis and 
HIV programs throughout the country; trained 
neighborhood-level officials about tuberculosis; and are 
running two multiple drug-resistant (MDR-TB) management pilot 
programs.  Major problems include: a lack of success under 
the directly observed treatment (DOTS) approach in 
identifying cases and completing the treatment courses; poor 
communication among medical professionals and between medical 
workers and patients; doctors over-prescribing medications; 
and keeping required medicines in stock.  USAID continues to 
implement tuberculosis-focused programs in Uzbekistan.  Early 
progress since the Berlin Declaration suggests the Government 
of Uzbekistan is taking the tuberculosis threat seriously and 
is prepared to cooperate with the international community. 
End summary. 
 
¶2. (U) As in other countries of Central Asia, the 
tuberculosis threat in Uzbekistan is growing.  There are 
approximately 40,000 active cases of tuberculosis in the 
country, with a rate of 148 cases per 100,000 population. 
Uzbekistan is also among the top ten countries in the world 
for the prevalence of drug-resistant strains of the disease. 
Thirteen percent of newly-registered tuberculosis cases are 
diagnosed as drug-resistant strains. 
 
¶3. (SBU) Bakhtiyar Babamuradov (please protect), WHO's 
Tashkent-based National Tuberculosis Coordinator, believes 
the Government of Uzbekistan does have the political will to 
implement its commitments under the Berlin Declaration. 
Specific progress on the items spelled out in paragraph 5 of 
the Berlin Declaration (per reftel) include:  implementation 
of an electronic tuberculosis case reporting system; 
expansion of a successful pilot project (originally in 
Tashkent City and Tashkent Region) to collaborate on 
tuberculosis and HIV programs to all areas of the country; 
training influential neighborhood-level (mahalla) officials 
about tuberculosis; and the implementation of two MDR-TB 
management pilot programs (in Karakalpakstan Province and 
Tashkent City) as well as a corresponding pilot program in 
the prison system (where tuberculosis is rampant). 
Babamuradov also noted that the Ministry of Health is 
actively developing a National Tuberculosis Strategy for 2009 
- 2014 that will be based on the STOP TB and the Plan to Stop 
TB in 18 High-Priority Countries in the WHO European Region, 
2007 - 2015. 
 
¶4. (SBU) Babamuradov noted that one area for improvement is 
to improve the strategy and quality of DOTS.  According to a 
USAID official, other problems include poor communication of 
diagnoses and treatment plans to patients.  Also, while 
patients may access tuberculosis treatment medicines at no 
cost, local doctors also often prescribe up to ten additional 
medicines to patients which are not free and are clinically 
worthless.  As a result of these rampant problems it is often 
difficult to properly identify cases and convince patients to 
complete the necessary treatment programs. 
 
¶5. (U) USAID continues an active program to counter 
tuberculosis.  Project Hope is implementing a regional 
tuberculosis control project in Central Asia that runs 
through 2009.  The Centers for Disease Control (CDC) does 
surveillance and laboratory quality work on tuberculosis. 
 
USAID funding also supports WHO experts on tuberculosis who 
have worked in Uzbekistan.  USAID staff also directly 
conducted a public outreach event at post on March 14 which 
focused on tuberculosis. 
 
¶6. (U) Comment:  The September 2007 Berlin Declaration is 
still very new, and it is typical for initiatives to get off 
the ground very slowly in Uzbekistan.  The country also had 
important Presidential elections in December 2007 that 
totally preoccupied the government until the New Year. 
Nonetheless, the actions taken thus far by the Government of 
Uzbekistan suggest it recognizes the serious threat posed by 
tuberculosis and is prepared to cooperate with the 
international community to curb it. 
 
HANSON