VZCZCXRO9777
PP RUEHAG RUEHAST RUEHBI RUEHCI RUEHDF RUEHIK RUEHLH RUEHLN RUEHLZ
RUEHNEH RUEHPW RUEHROV RUEHSR RUEHVK RUEHYG
DE RUEHAH #1528/01 3310238
ZNR UUUUU ZZH
P 260238Z NOV 08
FM AMEMBASSY ASHGABAT
TO RUEHC/SECSTATE WASHDC 1908
INFO RUCNCLS/ALL SOUTH AND CENTRAL ASIA COLLECTIVE PRIORITY
RUCNCIS/CIS COLLECTIVE PRIORITY
RUCNMEM/EU MEMBER STATES COLLECTIVE PRIORITY
RUEHAK/AMEMBASSY ANKARA PRIORITY 4534
RUEHBJ/AMEMBASSY BEIJING PRIORITY 2344
RUEHKO/AMEMBASSY TOKYO PRIORITY 2209
RUEHIT/AMCONSUL ISTANBUL PRIORITY 2782
RHMFIUU/CDR USCENTCOM MACDILL AFB FL PRIORITY
RUEAIIA/CIA WASHDC PRIORITY
RHEFDIA/DIA WASHDC PRIORITY
RUEKJCS/JOINT STAFF WASHDC PRIORITY
RHEHNSC/NSC WASHDC PRIORITY
RUEKJCS/SECDEF WASHDC PRIORITY
RUCPDOC/DEPT OF COMMERCE WASHDC PRIORITY
RUEATRS/DEPT OF TREASURY WASHDC PRIORITY

UNCLAS SECTION 01 OF 02 ASHGABAT 001528 
 
SIPDIS 
 
STATE FOR SCA/CEN 
 
E.O. 12958: N/A 
TAGS: PGOV AMED EIND ETRD SOCI TX
SUBJECT: TURKMENISTAN'S PHARMACEUTICALS MARKET 
 
¶1.  (SBU) SUMMARY:  Turkmenistan's pharmaceutical market offers a 
wide variety of basic pharmaceuticals made in Europe, Russia, 
Ukraine, Turkey, India and China, sold through drugstores owned by 
the Ministry of Health or private entities which have received 
Ministry licenses for distributorships and commercial activity.  A 
limited number of private individuals operate small illegal 
distributorships of, primarily, European and Russian natural 
biostimulants and vitamins.  Ministry of Healthcare and Medical 
Industry officials have many rent-seeking opportunities due to the 
Ministry's involvement in the business of importing pharmaceuticals. 
 Untangling the web of corruption will be difficult.  END SUMMARY. 
 
DISTRIBUTORS OF PHARMACEUTICALS:  MOSTLY GOVERNMENT 
 
¶2.  (SBU) Of about ten registered and licensed distributors 
pharmaceuticals in the country, the largest is the Ministry of 
Health.  The Ministry sells pharmaceuticals through a wide network 
of drug stores, both attached to hospitals and located separately. 
The  Hungarian company Gedeon Richter is the only large pharmacy 
chain, whichoperates in Turkmenistan.  It runs a small drug-store 
chain in Ashgabat. 
 
PRIVATE DISTRIBUTORS MUST OBTAIN MINISTRY AUTHORIZATION 
 
¶3.  (SBU) A private distributor/supplier of pharmaceuticals must 
receive a license from the Ministry of Health before getting 
involved in this sector.  The Ministry of Health created a 
department, the Center for Drugs Registration, which is responsible 
for registration of pharmaceuticals for distribution and sale in the 
country. 
 
LEGISLATION ABOUT PHARMACEUTICAL DISTRIBUTION 
 
¶4.  (U) Turkmenistan's law "On Pharmaceutical Activity and Supply of 
Pharmaceuticals" (passed July 5, 2002) says that the state regulates 
pharmaceutical activity and supply of pharmaceuticals by carrying 
out the following actions:  1) registration of pharmaceuticals; 2) 
licensing pharmaceutical activity; 3) certification of specialists, 
engaged in pharmaceutical activity; 4) expert examination for 
environment and sanitary and epidemiological safety with regard to 
pharmaceutical production; and 5) quality control and control over 
production, storage, and sale of pharmaceuticals. 
 
MINISTRY MUST ALSO REGISTER NEW OR CHANGED PHARMACEUTICALS 
 
¶5.  (U) The Ministry of Health is also responsible for registration 
of pharmaceuticals.  The law requires state registration for new 
pharmaceuticals; new combinations of previously registered 
pharmaceuticals; pharmaceuticals which have been previously 
registered but in different forms, with new dosages, additives, or 
recommended for treatment of different diseases. 
 
HOW TO APPLY FOR REGISTRATION OF A PHARMACEUTICAL 
 
¶6.  (U) Applications for registration of pharmaceuticals should 
include a sample of pharmaceutical in the proposed packaging, with 
name and trademark; the producer's name and address; a license for 
pharmaceutical manufacturing; names of active substances (synonyms); 
production form and composition of pharmaceutical; method of 
application, indication, and contra indication for use; dosage 
information; pharmacy purchasing terms; expiration date and storage 
conditions; information on this pharmaceutical's registration in 
other countries; results from pre-clinical and clinical studies; 
release specifications; certificate of quality, including Good 
Manufacturing Practice (GMP) standard conformance; and a receipt for 
payment of the registration fee. The Ministry of Health is supposed 
to respond to the application within a three-month period. 
Registration is valid for five years.  After the expiration of the 
five-year term, a pharmaceutical requires re-registration with the 
Ministry of Health.  According to an unofficial source, the amount 
of bribe needed for registration can reach as high as $10,000 fee -- 
ten percent of the authorized capital stock. 
 
OTHER PAPER REQUIREMENTS AND EXCEPTIONS 
 
 
ASHGABAT 00001528  002 OF 002 
 
 
¶7.  (U) Certificates of Quality and Certificates of Conformance to 
Good Manufacturing Practice (GMP) and National Quality Standards are 
additional prerequisites for registration and import.  The Ministry 
can lift the registration requirement if pharmaceuticals are brought 
into the country for the following purposes:  as samples brought 
into the country for clinical studies,  registration purposes, a 
trade show and conference (not for the purpose of sales); for 
personal use of citizens; for treatment of specific animals in zoos; 
and for responding emergency situations.  Import of pharmaceuticals 
for the purpose of humanitarian aid is regulated by the Cabinet of 
Ministers. 
 
ADVERTISING REGULATIONS 
 
¶8.  (SBU) After registration with the Ministry of Health is 
completed, a distributor can place advertisements in state-owned 
health periodicals, run commercials through a state-owned television 
health program, or place advertisements on billboards.  Companies 
with good ties in the Ministry have an easier time with distribution 
procedures and placing advertisements. 
 
ORIGINS OF PHARMACEUTICALS IMPORTED INTO TURMENISTAN 
 
¶9.  (SBU) The Ministry of Health maintains a list of essential 
pharmaceuticals that are supposed to be available at state-owned 
pharmacies and hospitals.  In the early 1990's, Turkmenistan 
received most of these required pharmaceuticals from Ukraine as 
in-kind payment for natural gas supplies.  Presently, the Ministry 
of Health buys pharmaceuticals made in Russia, Ukraine, Turkey, 
India, Pakistan and China.  Also, the Ministry supplies 
pharmaceuticals to its specialized health units to treat diabetes 
and tuberculosis.  According to the head of the Diabetic Center of 
Ashgabat, the Ministry provides the center with pharmaceuticals from 
U.S. manufacturer Eli Lilly.  However, low prices of Asian-produced 
products guarantee that the largest portion of imported 
pharmaceuticals come from Asia.  Commercial drug stores offer a wide 
variety of good quality but expensive pharmaceuticals from such 
producers as Gedeon Richter, Hoffman-la-Roche, Nycomed, Pfizer, 
Schering-Plough, Berlin-Chemie, and others.  Due to complex and 
expensive registration and licensing procedures, some commercial 
suppliers distribute pharmaceuticals through their own unofficial 
networks of public and private health care providers. 
 
ONLY GERMAN COMPANIES EXHIBIT AT HEALTH TRADE SHOW 
 
¶10.  (SBU) At the International Health Exhibition held in Ashgabat 
on November 8-11, 80 companies from 25 countries exhibited health 
care products and technology.  President Gurbanguly Berdimuhamedov 
encouraged German companies Hospitalia International and Siemens to 
develop turnkey construction projects for multipurpose clinics for 
each region of Turkmenistan, including medical equipment and 
training of clinic staff.  Hospitalia International and Siemens have 
traditionally equipped all of Turkmenistan's modern clinics and 
diagnostic centers. 
 
¶11.  (SBU) COMMENT:  As illustrated in the example of 
pharmaceuticals in Turkmenistan, the result of government 
involvement in business activities is corruption.  Stakeholders in 
Turkmen ministries and agencies have a vested interest in 
maintaining the status quo, including in the Ministry of Healthcare 
and Medical Industry.  This also explains why today, Turkmenistan 
imports pharmaceuticals from Russia, Ukraine, Turkey, India, 
Pakistan and China, and why notoriously corrupt companies such as 
Siemens are so active in Turkmenistan.  Untangling the web of 
corruption will be difficult.  END COMMENT.