This technical desk review provides a comprehensive assessment of the factors influencing the delivery of pre-exposure prophylaxis (PrEP) in the Republic of Kazakhstan. Based on an analysis of national legal acts, ministerial orders, clinical protocols, and programme reports, it outlines the country’s progress in integrating PrEP into the national HIV prevention framework.
The review identifies key facilitators of PrEP implementation, including strong political commitment, the inclusion of PrEP in the Guaranteed Volume of Free Medical Care (GVFMC), and the development of standardised clinical guidelines. At the same time, it highlights persistent barriers such as fragmented service delivery, limited collaboration with community-based organisations, and stigma among healthcare providers.
Among Kazakhstan’s major achievements are the integration of PrEP into the state-funded healthcare system, the adoption of a national clinical protocol (Order No. ҚР ДСМ-180/2023), and the inclusion of PrEP medicines on the list of reimbursed pharmaceuticals (Order No. ҚР ДСМ-75/2021). Nevertheless, PrEP coverage remains uneven across regions, with services largely concentrated in major urban centres such as Almaty, Astana, and Shymkent. Rural populations, migrants, and some key population groups continue to face barriers related to geographic access, stigma, and low levels of awareness.
The review concludes with targeted policy recommendations aimed at strengthening coordination, decentralising PrEP services, building healthcare provider capacity, and leveraging digital innovations. By consolidating its regulatory achievements and addressing remaining implementation gaps, Kazakhstan is well positioned to become a regional leader in biomedical HIV prevention.
The publication was created by ECOM and published within the framework of the regional project “Sustainability of services for key populations in Eastern Europe and Central Asia (EECA) — #iSoS: Empowering and Innovations”, implemented by a consortium of organizations under management of the ICF “Alliance for Public Health”, with the financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Viewpoints presented herein are solely those of its authors and may not coincide with the views or opinions of the Alliance for Public Health and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
