Page 22 - GHES-2-4

Global Health Economics and
Sustainability

REVIEW ARTICLE
Trajectory and progress of opioid agonist

therapy programs in the Kyrgyz Republic

Amanda R. Liberman * , Ainura Kurmanalieva 2 , Damira I. Biibosunova 3 ,
1
Natalya Shumskaya , Roman Ivasiy 1 , Daniel J. Bromberg 4,5,6 ,
2
Lynn M. Madden 1,7 , and Frederick L. Altice 1,4,7
1 Section of Infectious Diseases, School of Medicine, Yale University, New Haven, Connecticut,
United States of America
2 AIDS Foundation East-West in the Kyrgyz Republic, Bishkek, Kyrgyzstan Republic
3 Division of Global HIV and TB, CDC, Bishkek, Kyrgyzstan Republic
4 Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New
Haven, Connecticut, United States of America
5 Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg
University, Heidelberg, Germany
6 Department of Psychiatry and Psychotherapy (Campus Charité Mitte), Charité—Universitätsmedizin
Berlin, Berlin, Germany
7 APT Foundation, New Haven, Connecticut, United States of America

Abstract
Academic editor:
Mihajlo Jakovljevic M.D. Ph.D. MAE The incidence and mortality of human immunodeficiency viruses (HIVs) are rising
*Corresponding author: in Eastern Europe and Central Asia (EECA), particularly among people who inject
Amanda Liberman drugs. Opioid agonist therapies (OATs), such as methadone or buprenorphine,
(amanda.liberman@yale.edu)
are the most effective treatments for opioid use disorder and serve as a key HIV-
Citation: Liberman AR, prevention strategy in EECA. OAT uptake across the region, however, has been
Kurmanalieva A, Biibosunova DI,
Shumskaya N, Ivasiy R, limited. The Kyrgyz Republic was the first Central Asian country to initiate OAT and
Bromberg DJ, et al. (2024). remains a pioneer in the region. To understand the progression of OAT scale-up,
Trajectory and progress of opioid all legislations related to drug policies or methadone in the Kyrgyz Republic were
agonist therapy programs in the analyzed from the country’s founding to March 2023 and compared with policies
Kyrgyz Republic. Global Health
Econ Sustain, 2(4):2536. in neighboring countries, particularly Kazakhstan and Tajikistan. Concurrently, local
https://doi.org/10.36922/ghes.2536 news coverage and policy reports were also assessed. OAT has been available in
Received: December 26, 2023 the Kyrgyz Republic since 2001, initially as a pilot project funded by international
donors, and then with gradually increasing state support. Since its inception, the
Accepted: May 10, 2024
methadone program has evolved and influenced neighboring countries in Central
Published Online: September 26, Asia, despite numerous political challenges. The Kyrgyz Republic has expanded
2024 access to methadone, revised clinical protocols, and increased the number of
Copyright: © 2024 Author(s). distribution sites in communities and the carceral system to ensure broader access,
This is an Open Access article aiming for program sustainability. While methadone policies and implementation in
distributed under the terms of the
Creative Commons Attribution the Kyrgyz Republic have advanced earlier and more expansively than in neighboring
License, permitting distribution, countries, some challenges persist. Based on the findings, the suggestions provided
and reproduction in any medium, may support the sustainable scale-up of methadone programs, enabling continued
provided the original work is
properly cited. growth and improvement.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Kyrgyz Republic; Methadone policy; Opioid use disorder; Opioid agonist
regard to jurisdictional claims in
published maps and institutional therapy
affiliations.

Volume 2 Issue 4 (2024) 1 https://doi.org/10.36922/ghes.2536