At the general meeting of the Koch-Metschnikow-Forum e.V. (KMF) in November 2022, it
was decided to transfer the activities of the KMF to countries other than Russia with a need to harmonize their healthcare system with standards due to the Ukraine war and the associated restrictions on activities in Russia Western European countries (specifically: Germany). Uzbekistan was considered as a field of activity because of its high interest in cooperation in the field of health. In official statements from the Uzbek side (correspondence from the Uzbek Embassy in Berlin), the goal of the Uzbek side was „turn Uzbekistan into the capital of medical tourism for 120 million residents of Central Asian countries“. In addition, Uzbekistan is a “country on the rise”, both geopolitically and economically.
On January 25, 2023, Prof. Hahn, Prof. Richter and Dr. Wetzel suggested to the Uzbek
ambassador that the German and Uzbek medical community should cooperate in the
healthcare sector and offered to put this cooperation in the hands of KMF, which is well
known and well-known thanks to its experience in Russia.
The ambassador responded positively to this offer, but suggested forming a German-Uzbek
health platform specifically for this purpose, for example founding an association whose
name included the name of the Uzbek doctor and philosopher Avicenna (Ibn Sinha,
980-1037 ) should occur.
The new association (German-Uzbek Medical Society Koch-Avicenna, abbreviation DUMG-
KA) was founded on February 22nd, 2023. Professors Dr. medical Helmut Hahn (1st
Chairman) and Dr. medical Axel Richter (2nd Chairman). The statutes of the DUMG-KA
were drawn up by attorney Dr. Knaul based on the statutes of the KMF.
The association was registered on May 25, 2023 under file number VR 40312 B at the District Court of Charlottenburg.
First Uzbekistan – Germany Health Forum Samarkand
Commissioning
On March 1st, 2023, a personal meeting took place in Berlin at the invitation of the Uzbek
side between Prof. Hahn, the journalist accredited in Uzbekistan, Dr. Birgit Wetzel and attorney Dr. Knaul with the Uzbek Minister of Health, Prof. Dr. medical Amrillo Inoyatov,
instead. On this occasion, the Uzbek Minister of Health commissioned the DUMG-KA to act as a partner of the Uzbek Ministry of Health in the planning and implementation of a German-Uzbek Health Forum, which was to take place in Samarkand at the end of May 2023.
Requirements of the Uzbek side:
The conference should have the motto „New Uzbekistan-New Healthcare“ and
conceptually serve to expand cooperation in the health sector between Germany and
Uzbekistan.
The following interim goals were set:
Development of a platform for the exchange of ideas and experiences between actors in
science, business and politics;
Identifying opportunities for joint projects in research, development and innovation;
Identifying priority issues such as public health, patient care, technology and health policy;
Development of partnerships between health organizations and companies from the medical device and drug industry in Germany and Uzbekistan.
The implementation should be through concrete projects from the subject areas
1. Comparison of health care models in Uzbekistan and Germany;
2. Technology and Innovation;
3. Evidence-based patient care;
4. health policies and political regulations;
5. Financing and Insurance;
6. Cooperation between the pharmaceutical industry and companies from the biotechnology
7. Training, advanced training, advanced training;
8.Telemedicine and digitization take place.
Conference hall in Samarkand, Uzbekistan
Opening event:
The program for the opening event was attached to the draft programm. It featured a number of high-level speakers from the worlds of politics, academia and business, apparently to reflect the event’s benchmark status.
Content program
The programming was in the hands of Dr. Murotova Nigorakhon, Senior Specialist of the
Minister’s Secretariat for International Relations and Investments at the Uzbek Ministry of
Health. She was competently and actively supported by Dr. Khilola Rasulova.
The Uzbek side had previously emphasized the desire to see decision-makers from the
pharmaceutical and medical device industry represented in the German delegation in addition to representatives of academic medicine.
The DUMG-K-A e.V. was responsible for recruiting a group of German speakers who met the requirements of the event. The coordination of content between the German and the Uzbek side took place online between Dr. Murotova and Professors Hahn and Richter.
Despite the short time available, it was possible to put together a German delegation made up of representatives from academic medicine and the German pharmaceutical and medical device industry as well as from the NGO sector, which satisfied the specifications of the draft program.
They were:
The professors Dres. Helmut Hahn, Charité, and Axel Richter, first and second chairman of
the DUMAG-K-A.; Prof. Dr.med. Werner Solbach, former Dean of the Medical Faculty of the State University of Schleswig-Holstein in Kiel; dr medical Kai Joachimsen, Managing
Director of the Federal Association of the German Drug Industry; dr Michael Harder,
Managing Partner of corlife oHG; Martina Unseld, Siemens Healthineers and chairwoman of
the joint health working group of the German Health Alliance and the Committee on Eastern European Economic Relations; dr Alexey Ovchinnikov, BBraun/Aesculap, Health Care Management Central Asia; dr Chris Wetzel, medical consultant; dr Birgit Wetzel, analyst and journalist accredited in Uzbekistan, Rainer Ammende, Munich Clinic Academy Nursing Academy; dr medical Marlies Höck, Acquisition and Infectious Diseases department at MDI Labor Limbach Berlin; dr medical Michael Kramer, Medical Director of the nascent German Medical Center in Tashkent.
Mr. Martin Schorsch, a management consultant based in Uzbekistan and a founding member of DUMG-K-A e.V., fulfilled the function of „Executive Secretary“ with the task of
safeguarding the interests of DUMG-K-A e.V. on site.
The contributions from the Uzbek side were entered into the program by the Uzbek side
independently of the German side.
Meeting with the Minister of Health of the republic of Uzbekistan Prof. Med. Amrillo
Inoyatov with the German delegation
Opening event in Samarkand
Process
The opening event was of high-ranking The Deputy Prime Minister of the Republic of
Uzbekistan, the Minister of Health of the Republic of Uzbekistan, the Uzbek Ambassador in
The Ambassador of the Republic of Uzbekistan to Germany H.E. Nabijon Kasimov
Plenipotentiary Germany (connected online), the German Ambassador Plenipotentiary in
Uzbekistan and representatives of GIZ and KfW as well as the Chairman of the DUMG-K-A.
The German Ambassador to Uzbekistan H.E. Dr. Timo Klinner
Of the 18 contributions by the German speakers:
7 presentations dealt with aspects of cooperation: Hahn (role of NGOs), Birgit Wetzel
(potential for long-term partnerships), Richter (QM in oncology), Nusser (QM for the health
system of Uzbekistan), Boklage (GIZ and RKI in cooperation with Uzbekistan ), Nikitin
(cooperation between TMATF and INTAMT), Unseld (imperative for international
cooperation).
2 lectures: Harder (artificial heart valves), Häring (endoprostheses) dealt with modern
technologies.
Prof. Helmut Hahn, Chairman of the German-Uzbek Medical Society „Koch-Avicenna“
2 lectures: Solbach (medical training) and Joachimsen (relationships between industry and th
medical community) described German conditions.
3 lectures (Höck, Hoffmann, Roth) dealt with the subject of laboratory diagnostics.
1 lecture (Kramer) presented the German Medical Center in Tashkent, which was in the
process of being founded.
1 lecture (Meyer) described the joint project of Uzbekistan with the University of Freiburg on nuclear teratology.
1 lecture (Ammende) dealt with the topic of „care“, which was expressly requested by the
Uzbek side.
1 lecture (Ovchinnikov) Contribution of industry (BBraun/Aesculap min to improve the
health of the population.
Prof. Axel Richter, Germany, and Director Mirzagalib Nigmatovich Tillyashaikov MD, Medical
Center of Oncology and Radiology in Tashkent
The Uzbek side was represented with a total of 22 presentations:
3 lectures (Khadraliev, Sverdlov,Akulich) dealt with digitization
1 lecture (Parpieva): Progress in the fight against tuberculosis
1 lecture (Kurbonov): Cluster formation in a regional hospital
1 lecture (Razikova) : Transformation in the field of allergology
1 lecture (Turaev ) :Prospects at the endocrinological service
1 lecture (Kodirov): Improvements in drug supply
1 lecture (Murod): Damage to health caused by the drying up of the Aral Sea and successes
in improvement
1 lecture (Sidikov): Typification of universities
1 lecture Irismetov: Uzbek-German cooperation
1 lecture (Ruzibaev) Cooperation with German organizations
1 lecture (Akhmetova): Cooperation in paediatrics
1 lecture (Bobir)(1 lecture): Cooperation in paediatrics
1 lecture (Tillyashaikov) Cooperation in oncology
1 lecture (Izzhanov): Teaching
1 lecture (cup): training, teaching
1 lecture (Mamasoatov): Transplantology
1 lecture (Alikhanova) Lifestyles
1 lecture (Tukhtalov) Transformation
1 lecture (Islamov) Hematology
1 lecture (Heineking) Paediatrics.
Signing LOIs:
A specially set up program item served to sign letters of intent (LOIs) for cooperation
between German and Uzbek officials and interested institutions.
Interviews with the Minister of Health:
A separate item on the agenda were interviews with the Minister of Health, which he
conducted with selected congress participants as part of the event. Those invited were asked about their impressions and asked to make suggestions for improvement.
Satellite Events
05/23/2023: Visit to the Republican Specialized Medical Center of Phthisiology and
Pulmonology (Head: Prof. Nargizza Nusratovna, Chief Phthisiologist of the Republic of
Uzbekistan. This center has been working together with the German Reference Center TB in
Gauting (Dr. Hoffmann) for years. As far as can be seen, the most important conditions for
successfully combating TB are met here (molecular diagnostics, DOTS therapy, etc.)
Visit to the National Children’s Medical Center (Head: Prof. Maksud A, Saidov)
05/24/23: Visit to the Republican Center for Emergency Medical Care (Head: Prof. D.A.
Alimov)
05/25/23: Visit to the Republican Specialized Scientific and Practical Medical Center of
Oncology and Radiology in Tashkent (Head: Prof. Dr. Mirzagalib Nigmatovich Tillyashaikov)
Visit to the Ministry of Health of the Republic of Uzbekistan and personal reception by the
Minister of Health, Prof. Dr. Inoyatov Amrillo Shodievich;
05/25/23: Masterclass in Oncology Surgery at the Republican Specialized Scientific-Practical Medical Center of Oncology and Radiology in Tashkent (Director: Mirzagalib Nigmatovich Tillyashaikov MD). .Live surgeries: Minimally invasive resections of colorectal cancer, demonstrations and discussion with Prof. Dr. Axel Richter
Gala Dinner
This took place on 26.5. at the personal invitation of the Minister. The desire to make the stay of the guests from abroad as pleasant as possible culminated in the gala dinner on the evening of the congress day with dance performances and musical accompaniment, which prevented the desire or the possibility of conversations from arising in the first place.
Summary and Outlook
The Uzbek side had prepared the program with great care and in a highly professional
manner. This refers both to the error-free use of the English language and to the concrete
formulation of the specifications and goals, which can be used to carry out an evaluation
(what was achieved, what was not achieved?), and thus corresponded to international
conventions. A follow-up event was envisaged for the next year. At the Uzbek Embassy in
Berlin, an employee was specifically tasked with the further development of German-Uzbek
relations in the healthcare sector. Hospitality/human support was extremely cordial. This
included the uninterrupted accompaniment of the guests from the time they were picked up at the airport/train station to the farewell by employees of the Ministry and from colleagues.
Visits to leading medical centers in the run-up to the event on May 23rd and 24th in Tashkent revealed that these centers have a high standard of technical equipment and equipment; the buildings also meet international standards.
Experiences with the master class in oncology (Richter/Tillyashaikov) showed that work was done “at eye level” and there were no differences in quality in medical practice. A strong personal, but also institutional partnership was built up, which should serve as a model for further projects. Overall, the event can be considered a good success. This showed the great interest in the fact that an unexpectedly large number of participants (650) took part in the opening. A sensible start was made and should form the basis for a continuation/intensification. Cooperation and harmonization in healthcare are a generational project!
In detail
Dr. Harder writes
Scientific cooperation
The DUMG K-A is a society that also promotes scientific exchange. This includes topics such as
a. Organization of congresses, meetings in Uzbekistan and Germany.
b. It is important to find formats for future events that colleagues in Central Asia and
Europe will find equally enriching.
c. Funding of concrete, joint, scientific projects that need to be identified:
This includes voting on possible funding from the federal government and the EU
and, if necessary, the Uzbek government, which could be used.
Medical cooperation
Help with medical care. In particular, it is about the transfer of knowledge through training in Germany and Uzbekistan.
Advice on medical care
This area seems to me to be the most active field at the moment, e.g. Dr. Hofmann
(tuberculosis, Synlab), Prof. Richter (oncology), Dr. Höck (infections), Prof. Leyh (heart
surgery at the University of Würzburg) and can be intensified in many other areas.
Economic cooperation
This includes, for example, doctors who work in Uzbek hospitals etc work e.g. the TIMC,
or cooperation with German hospital societies: The need for action seems to have been
recognized and funded for a long time, so that no “start-up funding” is required.
If German goods and services are brought to Uzbekistan, numerous questions about
import, customs regulations and marketability (what are the admission requirements,
registration …) have to be clarified. There is a German Foreign Trade Chamber in
Tashkent, but it is ostensibly “sparsely” staffed. This AHK is an important building block
for an economic representation in Uzbekistan. The German Embassy should be able to
provide information on how resilient this AHK. In this process, the DUMG sees itself as a
platform for bringing participants into contact.
Prof. Solbach writes:
My task was to explore common interests in the field of training and further education, as
well as interesting research questions.
In conversations with colleagues, the high quality standard of patient care that is practiced
under the possibilities of limited public resources became clear.
Topics such as laboratory diagnostics and safety and adequacy of drug supply were also
discussed.
There was great interest in subjecting the existing patient data to a scientific evaluation in the spirit of continuous quality improvement. In other words, the data treasures deserve to be unearthed.
The consistently very good to excellent equipment was impressive.
At the Health Forum in Samarkand on May 26th, the will to cooperate in the academic sector in the areas of training and further education, but also in research, became very clear again in many discussions.
Continuing education stays for clinically active physicians. The call for scholarships could
provide motivation here.
FURTHER DEVELOPMENTS:
− Joint training and information events, e.g. B. on the use of antibiotics (possibly via
online forums)
− Structured collection and evaluation of patient data with the aim of publication
(e.g. results of the breast cancer screening program)
− Establishment of new or consolidation of existing university partnerships.
− On this basis, there would be access to a wide range of funding opportunities from
the Federal Republic of Germany (e.g. Ministry of Education and Research,
Ministry of Health, Ministry for Economic Cooperation, German Research
Foundation, German Academic Exchange Service DAAD)
− In the medium term, a joint doctorate could become possible.
− Cooperation of selected academies of science.
However, the focus of the Academy of Sciences of the Republic of Uzbekistan is on natural
science subjects. There are institutes for nuclear, geo and thermal physics, as well as for
bioorganic chemistry and polymer chemistry. Biomedical research activities are not strong.
The establishment of a coordination office on the Uzbek and German sides would be desirable for the definition of the detailed goals, the setting of priorities and the bundling of activities. On the German side, the tasks could possibly be transferred to existing structures (e.g. DAAD).
In summary, it became very clear that there is a strong motivation on the working level in the field of biomedicine and biotechnology from both the Uzbek and German sides to expand and deepen cooperation.
The political will required for implementation was provided by the Minister of Health of the
Republic of Uzbekistan, Dr. Amrillo Inoyatov and the Ambassador of the Federal Republic of
Germany, Dr. Tilo Klinner, impressively documented.
Concrete project proposals
Creation of a central microbiological
laboratory for all state hospitals and medical
practices in Tashkent, including a training
center for laboratory staff (Höck’s proposal)
Nosocomial infections are the most common complications of medical applications. Device-
associated infections such as device-associated pneumonia and sepsis as well as postoperative wound infections are the top priority. To this end, a 10-point infection prevention program should be implemented in all hospitals and medical practices in Uzkekistan. The treatment of infectious diseases is based on the clinical diagnosis and knowledge of the causative pathogen in order to carry out a therapy tailored to the patient. Microbiological diagnostics are of great importance, since the best possible therapy can only be carried out if the causative pathogen is known. For this it is necessary to establish a microbiological central laboratory equipped with a high level of technical know-how.
Such a microbiological laboratory could e.g. B. supply all state hospitals and medical practices in Tashkent. It could also play an important role as a training center for
laboratory staff.
Dr. Marlies Höck
Building a community of professionals interested in Uzbekistan in Germany#
From a local point of view, the deficits could best be remedied by concrete projects. The
simplest measure are personal exchange projects in as large a number as possible. In this way, it must be possible to build up a sufficiently large number of people interested in cooperation in both partner countries. This is especially true for the German side because of the little knowledge about Uzbekistan. Conversely, a group of young, future-oriented members of Uzbekistan’s intellectual elite should be built up who are seriously trying to complete an educational stay in Germany. The hurdles are high here: language skills, technical deficits, training deficits make many applicants fail when applying to official bodies (DAAD, Humboldt Foundation, others), which leads to demotivation. Previously acquired knowledge of the German system (school exchange, student exchange and job shadowing) could have an awareness-raising effect here. The role of unbureaucratically working non-governmental organizations (Rotary, DUMGKA, etc.) should have a positive effect here, since their requirements are lower and thus make it possible to get to know the partner country for the first time. In addition, the activities of the DUMG K-A should be formally coordinated with the responsible ministries. Contacts to parties and organizations are established.
Oncology flagship project:
Improving the quality of oncological care in Uzbekistan.
The concrete project: expansion of the oncological center in Tashkent into a so-called
„lighthouse“. There, both structures and equipment should be in accordance with German and European standards. We want to establish a close cooperation. Since a new building for the oncological center is planned, the structures could be developed accordingly so that further training events, seminars and workshops (for Central Asia) can take place there for the oncological care of Uzbekistan. There would be many opportunities to cooperate with German industry (Siemens, Aesculap, etc.). The companies mentioned have corresponding academy structures that could be used very well for international events with experts from Germany.
In this context, we act as an intermediary between the Ministry of Health, German university
clinics and interested German companies in order to enable equipment that meets modern
standards at the best possible conditions.
Air rescue:
A visit to the Republican Center for Emergency Medical Care revealed that there is no air
ambulance anywhere in Uzbekistan. This means a significant loss of human life simply
because of the transport routes to the nearest hospital. The explanation given was that civilian use of aircraft of any kind is prohibited by law. The sole competence lies with the military.
Free availability (no prescription required) of antibiotics:
In numerous discussions on this topic, it turned out that in Uzbekistan all antibiotics are freely available without a prescription. This leads to the well-known phenomenon of resistance development. Whether this can be remedied seems questionable because of the variety of business interests that oppose a prescription requirement.
Internal “brain drain”:
During the talks, it became clear that this brain drain stands in the way of the development of health care that benefits all sections of the population. It is about the observation that young, competent medical graduates from the university are enticed away by well-paying hospitals, since the salaries there are many times higher than the state salaries. As a result, there is a „two-class medicine“ with the well-known consequences.
Import of medical technology and pharmaceuticals:
It was repeatedly criticized that there were difficulties with the import of high-quality
products from the pharmaceutical and medical device industry. This is a point where our
colleagues from the industrial sector should comment.
Scientific collaboration:
According to various preliminary talks with the DAAD, there seems to be a considerable need for development in the field of medical-biological research. There is still a lack of concrete
cooperation projects.
Cooperation in teaching:
Translation of German textbooks (Herold: Internal Medicine) and Suerbaum et al.
Medical microbiology and infectiology:
According to the publisher, both books may be translated against payment of a license
fee.Prof. At the meeting on June 23, 2023, Hahn handed over a copy of each of the books
mentioned to the embassy secretary Hasanov from the Uzbek embassy.
Thanks to:
The German delegation thanks our Uzbek hosts for their kind and generous hospitality. This
thanks goes especially to the Uzbek Minister of Health, Excellency Professor Dr. medical
Amrillo Inoyatov, and the Head of the Secretariat for International Affairs and Investments at
the Ministry of Health, Dr. medical Nigorakhon Murotova, PHD, MBA, and their staff,
especially Ms. Khilola Rasulova and all others who contributed to the great success of the
conference.
We would also like to thank all the speakers from the German and Uzbek side as well as the
heads of the medical institutions who contributed to the success of the event with their
contributions.
Our special thanks go to Mr. Martin Schorsch as the „Executive Secretary“ for the fact that he competently and confidently clarified and solved all logistical details for us both during the preparation time and during the course of the conference.
For the DUMG K-A e. v.:
Prof. Dr. medical Helmut Hahn (Chairman) Prof. Dr. medical Axel Richter (2nd Chairman)
