post-Soviet Central Asian Countries Research Articles

«Афганский филиал» ИГИЛ как угроза Центральной Азии

The neighborhood with Afghanistan creates many serious security challenges for the post-Soviet states of the Central Asian region. This is not only due to the general turbulence associated with the collapse of the American-backed regime in Kabul and the rise to power of the radical Islamist movement. The growing activity of the local branch of the transnational jihadist network “Islamic State – Khorasan Province” (ISIL, ISIS, IS – the terrorist organization banned in Russia) gives particular urgency to the danger emanating from the Afghan land. The activities of this extremist group are not limited to terrorist attacks against representatives of the current Afghan authorities. The terrorists acting under the banner of ISIS are actively conducting propaganda activities aimed at the population of the post-Soviet countries of Central Asia (primarily Uzbekistan and Tajikistan), recruiting supporters and undermining the socio-political situation. The article examines the main directions of such activities of the supporters of the “Khorasan project” and expresses thoughts on ways to counteract this danger.

The religious situation in Central Asia

Due to communist ideology religious education was not available to Soviet citizens. For a long time, Central Asian countries did not have their own religious educational institutions. After having had their independence and opening of the borders, active interaction of the Central Asian states with the outside world began: many citizens left to receive religious education in Arab countries. During the theological training of young people in foreign Islamic centers, students were imbued with religious views and values ​​alien to the mentality of their people. When they return to their homeland, they begin to promote the ideas of radical Islam. Islamists understand that such activities are prohibited and illegal, they go underground, having unconscious young people involved in the confrontation with the state. Radical religious preachers form a belief in the mass consciousness about the value of Islam as a worldview and social force that can solve all problems. However, the low level of religious literacy of the majority of Muslims, their inability to distinguish true religiosity from religious fanaticism and extremism, contribute to the spread of radical Islamism. As the number of adherents of Islamic extremism increases, their religious and ideological confrontation with the secular state may develop into a phase of armed struggle, into a terrorist underground. The article describes how administration of the republics representing the region has to balance between protecting the citizens from religious extremism and preventing the infringement of the rights and freedoms of law-abiding believers The article examines peculiarities of the religious situation in the post-Soviet countries of Central Asia, describes the legal basis for regulating religious issues,  significance of state concepts and programs. In addition, the article examines peculiarities of religious and theological education in the countries of Central Asia. The article defines the significance of secular principles and the regulation of religious issues in a secular country. Key words: religion, Central Asia, religious organizations, law, religious situation.

Пандемия COVID-19 и международные факторы вакцинной политики постсоветских государств Центральной Азии

The article examines the politics of international supplies of anti-COVID-19 vaccines to the post-Soviet countries of Central Asia. These countries have focused on the diversification of vaccine supplies, in line with their multi-vector foreign policies. Initially, the richest countries in the region, Kazakhstan and Turkmenistan, had an advantage in access to vaccines. However, eventually vaccine supplies from China and then from Western countries (facilitated by such international organizations and programs as UNICEF, Asian Development Bank, and COVAX) started to arrive in the Spring and Summer of 2021. Kazakhstan and Uzbekistan have established their own production of the Russian vaccine, while Uzbekistan also produces a vaccine developed in China. The main conclusion is that the supply of vaccines to the region is determined, first and foremost, by commercial and humanitarian considerations, while geopolitical rivalries among the supplying countries have not played a significant role so far.

Socio-political evolution of Central Asian clans

The article is devoted to the clan organization of the post-Soviet countries of Central Asia. Recently, scientific interest in the stated topic has decreased somewhat, due to the lack of implementation of traditional institutions of Eastern societies and the decline in the influence of the liberal mainstream on the socio-political process in post-Soviet Asia, which, in turn, significantly reduced the thoroughness of criticism of the "non-Western path" of development. The author's perspective on the problem is focused on the identification of traditional institutions, their actualization in the modern political process and variants of their socio-political evolution. The authors offer an expanded understanding of the essence of a clan organization that distributes consolidating loyalty directions both horizontally within blood-related communities and vertically, reproducing the hierarchy of connections from the elite top to the rank-and-file members of associations. The authors consider the growth of social movement, self-awareness and public disillusionment with the attempt to reproduce the Western model of social development to be the main factors that actualize the clan organization in the socio-political process of post-Soviet Asian countries. The dynamically developing socio-political reality of the Asian newly independent States actualizes multidirectional vectors of social integration.

Modern practices of obtaining higher education in Kazakhstan

This article is devoted to the analysis of social practices in the field of higher education, formed in post-Soviet Central Asian countries, with specific references to Kazakhstan. Kazakhstan was sig-nificantly affected by the collapse of the Soviet system: breaking ties with many leading former Soviet universities entailed irreversible processes in changing of the entire infrastructure of higher education in the country. Last decades to take place the process of reduction of middle level edu-cation and closure of vocational colleges. These has caused a sharp transition of school graduates to higher education unit, thereby increasing its demand. New opportunities allow studying as well as undergoing internships abroad, tuition fee free education based on the state grant. But there is a differentiation in access to quality higher education and increase of economic barriers to obtain it for children from lower-income families. These differences in access contributed to the formation of «elite» and «mass» universities in the educational space of Kazakhstan and the concentration of youth from lower-income families in non-prestigious educational institutions with low tuition fee. Thereby there is a risk that such situation can increase influence of social background on labour market outcomes (salary and occupational status). In the article the significance of the economic capital in the market of higher education and the social consequences of the choice of “affordable” vocational education are analyzed. Key words: higher education, access to education, economic barriers, high-income families, lower income families, family resource potential.

Russia and Post-Soviet Central Asia: Reciprocal Language Studies in University Curricula and Bilateral Cooperation in this Area

Russia and the post-Soviet countries of Central Asia are close partners, having ties not only in the economy, politics and culture, but also in the field of security. The linguistic aspect of interaction is also of great importance. This article analyzes the presence of the Russian language in the curricula of Central Asian universities, the presence of Central Asian languages in the curricula of Russian universities, and the level of bilateral cooperation in this area. The study is conducted within the framework of the methodological structure of the theory of “soft power” by J. Nye and the concept of “competitive identity of the state” by S. Anholt. The findings of our study present arguments in support of, firstly, the development of an effective strategy to preserve the role of the Russian language as a unifying cultural factor and an instrument of international communication and cooperation, and, secondly, the possibility of preparation specialists in Central Asia in Russia with a good knowledge of regional languages in order to ensure strategic planning, evaluation of joint projects and the study of modern literature.
 Keywords: Russia, Central Asia, cultural cooperation

Leaders, ideas, and norm diffusion in Central Asia and beyond

This article considers how the ideas and worldviews of the first presidents of the post-Soviet Central Asian countries have shaped their states’ identities, and their domestic and foreign policies. It argues that the contested ideas of regionalism in Central Asia were responsible for the rejection, reconstruction, and diffusion of foreign norms within the region and beyond. The ideational norms of the Central Asian states are argued to play a critical role in the creation of new norms— multi-speed and multi-level Eurasian regionalism—and their diffusion into global normative processes. Thus, the Central Asian region, and its contribution to the development of Eurasian normative regionalism, deserves recognition in world politics.

“New Psychiatry” and Traditional Healing in Kyrgyzstan: Attempts to Develop Culturally Sensitive and Community-Based Treatment

Healthcare in post-Soviet Central Asian countries, and mental healthcare in particular, has still preserved many characteristics of the previous Soviet system. In the Kyrgyz Republic, a wide-ranging reform of the healthcare system, which started in the second half of the 1990s, has not included psychiatric services in its priorities. In the face of severe deficiencies in the system, such as an over-institutionalisation of mental healthcare and a lack of adequate financing, a group of local psychiatrists, aware of the standards of contemporary psychiatry, have tried to implement an approach promoting culturally sensitive and community-based treatment of mentally ill patients. They notice a great popularity of traditional healers and their role in local communities, based on a worldview shared with their patients and competence in values and norms of social life. Moreover, these psychiatrists understand that healers’ interventions can be effective in the cases of non-psychotic mental health disorders, and attempt to develop some kind of cooperation with Kyrgyz healers, especially in crisis situations. In this article, grounded in the publications of this group of psychiatrists and my own fieldwork in Bishkek between 2011 and 2013, I discuss these achievements and show how globally promoted ideas and directives of contemporary psychiatry have been adapted to the local conditions.

Central Asia in Search for its Own Way of Integration

The article deals with perspectives for integration within Central Asian region. The existing experience of integration in the region is perceived as an important factor. Currently the discourse of regional integration is gaining ground in Central Asia. It can be seen by the updates in the foreign policy concepts of most of the post-Soviet Central Asian countries. Another driver of the issue is the growing international activity of Uzbekistan which is due to the new President of the republic elected in 2016. The article defines the context of regional development, challenges which the region face, specific traits of political process. The rationale for integration is linked to economic problems which cannot be solved by each Central Asian country on its own. Construction of any transport and logistical infrastructure in the region as well as tackling security threats determine regional cooperation. Although the researchers give arguments for advantages of integration in the region, Central Asian leaders are still looking for more efficient format of interregional cooperation. This process is not linear with its ups and downs. The article reveals the institutional experience that Central Asia gained over 1990s in search for its own integration project. Today this experience can be treated as an important step to maturity of national governance in the region. But the reason why there is no implementation of integration initiatives discussed in the region earlier is that the current Central Asian political elites are not favorable to any kind of cooperation that will lead in the future to the formation of supranational bodies in the region. They perceive it as a threat to a stable national development. Another factor is a higher commitment of Central Asian countries to cooperate with non-regional economies rather than within the region. In such context a strategy of “bandwagoning” (as it describes S. Walt) will hamper any regional integration project.

Burden of the Cardiovascular Diseases in Central Asia.

Cardiovascular diseases (CVD) are now the number one cause of death in low- and middle-income countries, including those in Central Asia (CA). Low- and middle-income countries (LMICs) bear a disproportionate and growing burden of CVD, which constitutes a challenge to national development. CVD account for more than 43% of cases of disability and 9.0% of cases of temporary disability in many developing countries. The high burden of CVD oftentimes results from insufficient preventive care and a lack of education about the prevention and treatment of these diseases. The rapidly growing burden of CVD and other major non-communicable diseases (NCDs) is a global public health threat, especially in Central Asia. Information on cardiovascular risk factors, including hypertension, diabetes, tobacco use, and alcohol use, is traditionally obtained from studies conducted in Europe and North America, which limits our understanding of these factors in Central Asia. In this review, we collected all published information on CVD in Central Asia from 2000 to 2015, which included the websites of the Ministries of Health, the World Health Organization, PubMed, and other published sources. This narrative review describes CVD burden, stroke incidence, and common CVD risk factors in the five post-Soviet countries of Central Asia (Kazakshstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan).

The Puzzle of India’s Relations with “Central Eurasia”

ABSTRACTIndia’s relations with Afghanistan and the post-Soviet countries of Central Asia have contributed to the growing interest in the country’s rise. By treating them together as “Central Eurasia,” the discourses of Indian foreign policy invoke a contiguous geopolitical locale bound to India by a shared past. Yet, despite the strategic articulation of a manifest Central Eurasian region, the article uncovers a puzzle of bifurcation in India’s foreign policy reflecting distinct operationalizations of India’s cultural capital in its relations with Afghanistan and the Central Asia republics. The comparative analysis indicates that prior historical experience becomes a compelling strategic context for the continuous framing and reframing of the country’s foreign policy space, which reveals India’s shifting perceptions of international order, self-identity, and global roles. India’s interactions in Central Eurasia offer a good illustration of the crossroads that New Delhi’s foreign policy is facing – either keep on proliferating discourses that spin yarns of the international influence of its historical capital or develop proactive diplomatic strategies that deliver the international status that India desires.

Предпосылки для интеграции стран Центральной Азии

This article discusses the prerequisites for the integration of Central Asian countries. At the same time, in the opinion of the authors, for greater convergence of the countries of Central Asia, each of them has its own pros and cons. It describes the pros and cons of closer integration for each of the countries in the region, emphasizing that certain prerequisites for this are available. Plus, the article analyzes the integration of Central Asian countries from a historical point of view, describing the prob- lems that arose on this path in the 1990s. still devoted to describing the similarities and differences of the post-soviet countries of Central Asia, which can both facilitate and hinder normal cooperation. In the conclusion it is claimed that «Kazakhstan can become a» locomotive «of regional economic development and therefore intends to act as a pole of integration of the Central Asian countries and to take an active part in the formation of a dynamic market throughout the region». The article also examines the factors that contribute to the real integration of Central Asian countries. Authors give historical facts confirming the prospects of this process for each country in the region, and also coor- dinate this process with the membership of states in various international and regional organizations. Under the assumptions, we mean those objective conditions and trends that can facilitate or hinder the implementation of a project. This article discusses the prerequisites for the economic integration of the Central Asian countries as a set of objective conditions that imply closer cooperation between the countries of the region in order to solve common problems and ensure the economic development of each of them, as well as the trends in the world economy that have been manifested in recent years and are characterized by increased protectionist moods in the leading economic powers of the world that can exert their influence in the integration processes in the decisions of Central Asia. Factors that could have a negative impact on the integration processes in the region include processes that began in the 1990s with the collapse of the USSR and manifested themselves in various approaches to economic reform and the pace of their implementation, in selected forms of political organization of countries, in national priorities in various spheres of social life, etc. Much will depend on the posi- tions of international organizations interested in the problems of the region and integration groups in which the members are the countries of Central Asia. In conclusion, we believe that the positive prerequisites for economic integration outweigh the negative and the future of the countries of the region objectively linked to integration among themselves and Kazakhstan can be the «locomotive» of economic integration in the region. Key words: integration, positive and negative prerequisites, objective prerequisites, preconditions, preventing integration, Central Asia, countries of the region.

Security threats and challenges in the post-soviet Central Asia: religion-based extremism on case study of ISIS

Nowadays the post-Soviet Central Asian countries face a broad range of security challenges and threats. Some of them are systemic in nature, while others occur sporadically. Many challenges and threats are coming from the outside the region, but the countries’ internal situation and background including historical, economic, social and political aspects. The reaction in the countries on religious-based radicalism and movements like ISIS is an ambiguous. The range and level of the threats and challenges depends on various reasons and different in all Central Asian countries. But the case of ISIS is very unprecedented and needs to be under the special analysis through the political and socio-economic dimension in all states. The different ways of development chosen by Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan and different background including borders, political systems, the role of religion and social stability defines the reflection to the threat in different way. Tajilistan and Uzbekistan are in high risk zone. The existing regional and extra regional organizations as CSTO and SCO are important in terms of security strengthening in Central Asia. Analyzing the general social, economic and religion climate picture in terms of absorbing or reflecting religious based extremism and ISIS the real power to stop it can be both effective inter-governmental cooperation and coordination with strong civil society support. Keywords: security, Central Asia, extremism, ISIS;

Security threats and challenges in the post-soviet Central Asia: religion-based extremism on case study of ISIS

Nowadays the post-Soviet Central Asian countries face a broad range of security challenges and threats. Some of them are systemic in nature, while others occur sporadically. Many challenges and threats are coming from the outside the region, but the countries’ internal situation and background including historical, economic, social and political aspects. The reaction in the countries on religious-based radicalism and movements like ISIS is an ambiguous.  The range and level of the threats and challenges depends on various reasons and different in all Central Asian countries. But the case of ISIS is very unprecedented and needs to be under the special analysis through the political and socio-economic dimension in all states. The different ways of development chosen by Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan and different background including borders, political systems, the role of religion and social stability defines the reflection to the threat in different way. Tajilistan and Uzbekistan are in high risk zone. The existing regional and extra regional organizations as CSTO and SCO are important in terms of security strengthening in Central Asia. Analyzing the general social, economic and religion climate picture in terms of absorbing or reflecting religious based extremism and ISIS the real power to stop it can be both effective inter-governmental cooperation and coordination with strong civil society support.   Keywords: security, Central Asia, extremism, ISIS;

Security threats and challenges in the post-soviet Central Asia: religion-based extremism on case study of ISIS

Nowadays the post-Soviet Central Asian countries face a broad range of security challenges and threats. Some of them are systemic in nature, while others occur sporadically. Many challenges and threats are coming from the outside the region, but the countries’ internal situation and background including historical, economic, social and political aspects. The reaction in the countries on religious-based radicalism and movements like ISIS is an ambiguous. The range and level of the threats and challenges depends on various reasons and different in all Central Asian countries. But the case of ISIS is very unprecedented and needs to be under the special analysis through the political and socio-economic dimension in all states. The different ways of development chosen by Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan and different background including borders, political systems, the role of religion and social stability defines the reflection to the threat in different way. Tajilistan and Uzbekistan are in high risk zone. The existing regional and extra regional organizations as CSTO and SCO are important in terms of security strengthening in Central Asia. Analyzing the general social, economic and religion climate picture in terms of absorbing or reflecting religious based extremism and ISIS the real power to stop it can be both effective inter-governmental cooperation and coordination with strong civil society support. Keywords: security, Central Asia, extremism, ISIS;

Keeping Pakistan as a Balancer While Courting Indian Friendship

Andrew Small's analysis of recent developments in Sino-Pakistan relations in his book The China-Pakistan Axis: Asia's New Geopolitics is insightful and persuasive. Small's central thesis, as I understand it, is that around 2013 China significantly shifted its policy for managing its vital relationship with Pakistan. Motivated both by the metastasis of Islamic extremism across the region and by deepening understanding of the impact that a possible India-Pakistan nuclear war would have on that spreading extremist cancer, China set aside its earlier policy of noninterference in Pakistan's affairs. It began urging Pakistan's leaders to rein in extremist groups, not only those mucking around in China's Xinjiang region (which Beijing had long warned Islamabad against), but even within Pakistan and Afghanistan. Beijing recognized the diminishing utility of secret side deals worked out with extremist groups in years past. Such deals simply did not work as well with the generation of extremist leaders-a conclusion attested to by the more frequent attacks in Xinjiang and on Chinese interests in Pakistan. Beijing also signaled to Islamabad that its support for Pakistan in a future confrontation with India would be conditioned by Pakistan's role in provoking that confrontation. This shorter leash was an attempt to dissuade elements in the fragmenting Pakistani state from again condoning terrorist attacks on India that threatened to trigger Indian retaliation and thence an India-Pakistan war that could further destabilize the entire region.This approach expanded diplomatic common ground with the United States in countering the spread of Islamic extremism and the disintegration of the Pakistani state. Derivatively, Beijing attempted to mediate a search for political accommodation in Afghanistan and adopted a more relaxed view toward the U.S. military presence there. Lord, make them [the Americans] leave, but not yet, became the Chinese mantra, Small suggests.Scholars will need to test Small's thesis of a major shiftin China's Pakistan policy through further primary research. But at a minimum, the book's clear, thoughtful, and empirically substantiated argument has advanced our knowledge of an important issue. Small posits two primary factors driving the shiftin China's Pakistan policy: (1) greater fragmentation of the Pakistani state and use of Pakistani territory as a base for Islamist operations, and (2) a rethinking of the implications of a possible India-Pakistan nuclear war.Regarding the first factor, the growing frequency of violent protests in both Xinjiang and major Chinese cities outside Xinjiang, combined with extremist attacks on Chinese citizens in Pakistan (e.g., construction crews refurbishing the Karakorum Highway, academics conducting research, or women operating massage parlors) indicated to Beijing that China's traditional reliance on Pakistan's military and political elites to minimize such incidents was simply no longer effective. The generation of extreme Islamist leaders is more ideological and less pragmatic than the older generation, with whom a deal might stick. The collapse of states such as Syria, Iraq, and Libya, together with the looming U.S. withdrawal from Afghanistan and the prospect of renewed civil war there, caused China to give much greater emphasis to internal security concerns arising out of its deeply rooted Uighur problem. In short, these concerns increasingly influenced China's management of its all-weather relationship with Pakistan. The spread of terrorist movements in the post-Soviet countries of Central Asia also threatened to undermine the ambitious transport-building programs of the new Silk Road designed to draw those lands into China's economic sphere and foster stability through faster economic growth.Regarding the nuclear factor, Small persuasively argues that, starting with the Kargil confrontation of 1999, Beijing recalculated the region-wide destabilizing effects of a nuclear exchange between India and Pakistan. …

Mapping abandoned agricultural land in Kyzyl-Orda, Kazakhstan using satellite remote sensing

In many regions worldwide, cropland abandonment is growing, which has strong and known environmental and socio-economic consequences. Yet, spatially explicit information on the spatial pattern of abandonment is sparse, particularly in post-Soviet countries of Central Asia. When thriving reaching for key Millennium Development Goals such as food security and poverty reduction, the issue of cropland abandonment is critical and therefore must be monitored and limited, or land use transformed into an alternative one. Central Asia experienced large changes of its agricultural system after the collapse of the Soviet Union in 1991. Land degradation, which started already before independence, and cropland abandonment is growing in extent, but their spatial pattern remains ill-understood. The objective of this study was to map and analyse agricultural land use in the irrigated areas of Kyzyl-Orda, southern Kazakhstan, Central Asia. For mapping land use and identifying abandoned agricultural land, an object-based classification approach was applied. Random forest (RF) and support vector machines (SVM) algorithms permitted classifying Landsat and RapidEye data from 2009 to 2014. Overlaying these maps with information about irrigated land parcels, installed during the Soviet period, allowed indicating abandoned fields. Fusing the results of the two approaches, RF and SVM, resulted in classification accuracies of up to 97%. This was statistically significantly higher than with RF or SVM alone. Through the analysis of the land use trajectories, abandoned agricultural fields and a clear indication of abandoned land were identified on almost 50% of all fields in Kyzyl-Orda with an accuracy of approximately 80%. The outputs of this study may provide valuable information for planners, policy- and decision-makers to support better-informed decision-making like reducing possible environmental impacts of land abandonment, or identifying areas for sustainable intensification or re-cultivation.

The Study on the Women’s Status & Role in Post-Soviet Central Asian Countries

The Study on the Women’s Status & Role in Post-Soviet Central Asian Countries

Post-Soviet Central Asia: A summary of the drug situation

BackgroundThe paper aims to provide a snapshot of the drug situation in Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan using the EU methodology of “harmonised indicators of drug epidemiology.” MethodsMost of the data reported here were gathered and analysed within the framework of the EU-funded CADAP project in 2012. Together with members of CADAP national teams, we conducted extraction from the databases of national institutions in the field of (public) health and law enforcement, issued formal requests for the provision of specific information to national governmental authorities, and obtained national grey literature in Russian. In specific cases, we leaned on the expert opinions of the national experts, gathered by means of simple online questionnaires or focus group. In the rather scarce cases where peer-reviewed sources on the specific topics exist, it is used for comparisons and discussion. ResultsAll the post-Soviet Central Asian countries lack information on drug use in the general population. School surveys are relatively well developed in Kazakhstan, and Kyrgyzstan benefited from an international survey project on health in schools organised by private donors in 2009. For Tajikistan and Uzbekistan, the most recent available data on drug use in the school population are from 2006 and as such are of little relevance. Problem drug use is widespread in Central Asia and estimates of its prevalence are available for all four countries. All the post-Soviet Central Asian countries use a rather outdated system of narcological registers as the only source of data on drug users who are treated (and those investigated by the police), which was inherited from Soviet times. The availability of treatment is very low in all the countries reported on here except Kyrgyzstan; opioid substitution treatment (OST) was introduced first in Kyrgyzstan; Kazakhstan and Tajikistan are piloting their OST programmes but the coverage is extremely low, and in Uzbekistan the OST pilot programme has been abolished. HIV and hepatitis C virus (HCV) infections are concentrated in injecting drug users (IDUs) in Central Asia, with the situation in Kazakhstan having stabilised; HIV is on the increase among Kyrgyz IDUs. The sharp decrease in HIV and VHC seroprevalence among IDUs in Uzbekistan and Tajikistan still awaits an explanation. The system for monitoring of fatal drug overdoses needs substantial improvement in all the countries reported on here. Overall mortality studies of drug users registered in the narcological registers were performed in Uzbekistan, Kazakhstan, and Tajikistan; the highest excess mortality among registered drug users was found in Uzbekistan, and in all three countries, it was substantially higher for women than men. The seizures of illegal drugs are by far the highest in Kazakhstan; however, wild-growing cannabis represents 90% of these seizures. Uzbekistan was the country with the highest number of drug arrests. In Kazakhstan, after the decriminalisation of drug use in 2011, the number of reported drug-related offences dropped to below 50% of the figure for the previous year. ConclusionThe drug situation monitoring system in the four post-Soviet countries of Central Asia still needs substantial improvement. However, in its current state it is already able to generate evidence that is useful for the planning of effective national and regional drug policies, which would be of the utmost importance in the forthcoming years of the withdrawal of the International Security Assistance Force from Afghanistan.

Mortality of registered drug users in Central Asia

BackgroundWithin the fifth phase of the Central Asia Drug Action Programme (CADAP) covering five post-Soviet Central Asian countries, an analysis of the mortality of drug users was performed. The results for Kazakhstan and Uzbekistan are presented in detail in this paper since results from Kyrgyzstan and Tajikistan are not considered valid and Turkmenistan did not provide data at all. MethodsA system of registration of all users of illegal drugs known to the health and/or law enforcement authorities (“narcological registers”) exists in Central Asian countries inherited from the system of Soviet “narcology”. According to the legal norms, the death of a registered person should be recorded. We conducted indirect standardisation of crude mortality rates and computed the standardised mortality ratio (SMR) comparing observed number of deaths with expected number of deaths according to age and gender specific mortality rates in the general population of the same country. ResultsThe results show excess mortality in registered drug users, particularly in registered females, in Uzbekistan (the latest available SMR for all those registered is 7.4; the SMR in females is 16.3) and Kazakhstan (4.0 and 12.9). The excess mortality is highest among young adults (18–34) in all the studies. ConclusionTaking into account the limited quality and reliability of the data – first of all, the likely under-reporting of deaths in the narcological registers – the crude mortality rate among registered drug users is quite high when compared to EU countries. The SMR in total is comparably lower as a result of the high background mortality in the general population. This excess mortality is preventable and should be targeted by the national drug policies. Specifically, the programmes should target registered and unregistered female drug users.