Reports on the implementation of state programs in the healthcare sector in 2023

The Parliamentary Committee on Social Policy and Healthcare listened to reports from the Government on the implementation of state target programs in the field of health and social policy in 2023.

6 state-centered programs have been adopted and operate in the field of prevention and treatment of various diseases in Pridnestrovie.

Information events, rapid testing for HIV, and medicines for therapy were purchased in the republic people living with HIV infection as part of the implementation of the state target program “Prevention of HIV/AIDS infection and sexually transmitted infections (STIs) in the Pridnestrovian Moldavian Republic for 2020–2024”. 2428 patients with HIV/AIDS infection are registered at the dispensary, almost all of them receive APB therapy in our republic. Almost 35 thousand people were examined, 132 cases were registered (28.4 per 100 thousand population) with an established diagnosis of HIV infection, including one child in 2023. The diagnosis of AIDS was established in 31 patients. The Ministry of Health notes that the highest incidence of HIV is in Rybnitsa, Slobodzeya and Dubossary districts. This suggests that the rate of spread of HIV infection among the rural population will continue to grow, which in the near future, in epidemiological terms, must be assessed as an unfavorable factor. The Republican Dispensary for the Prevention and Treatment of HIV/AIDS and Chronic Viral Hepatitis received equipment, medicines and furniture in the form of sponsorship from abroad in addition to government funding.

The state program for the prevention and treatment of viral hepatitis B and C, as well as the State Program for the prevention and treatment of HIV/AIDS infection, ends at the end of 2024. The State Program for the Prevention of Viral Hepatitis is new, it was adopted in 2021. A large number of studies are being carried out to identify patients with hepatitis B and C as part of the new state program. 2214 patients were identified, of which 862 were with chronic viral hepatitis B, 1352 were with chronic hepatitis C. 1.5 received treatment during 2022 and 2023 thousands of people. Budgeted funding was spent on developing laboratory diagnostics and screening services for viral hepatitis B and C, organizing a state register of patients with viral hepatitis B and C and providing their treatment, and improving the qualifications of medical staff.

The main goal of the state program for immunization of the population is to improve the epidemiological situation regarding infections controlled by means of specific prevention. Vaccination against 11 infections is being carried out; vaccines and syringes were purchased with funds allocated from the budget, transportation and quality control were carried out, about 400 thousand rubles were spent on medical and hygienic education of the population in Pridnestrovie. The Ministry of Health notes in the report that in Pridnestrovie in 2023, no cases of rubella, measles, diphtheria, or polio were registered. 4 cases of mumps, 49 cases of whooping cough, and 221 cases of tuberculosis were recorded. Overall, the incidence of vaccine-preventable diseases remains low, the report said.

This is not the first year that a state target program for the prevention of tuberculosis has been operating in the republic. Various types of laboratory research are carried out, the purchase of necessary materials and equipment for laboratories and departments within its framework. The cost estimate “Treatment, diagnostic and preventive measures at all stages of management of tuberculosis patients” made it possible to fully carry out tuberculin diagnostics in all cities and regions of the republic, provided reagents, reagents and consumables for conducting bacteriological and clinical studies, the report of the Ministry of Health notes. The Global Fund to Fight AIDS, Tuberculosis and Malaria provides great assistance to Pridnestrovian phthisiatricians. For example, through humanitarian aid from the Global Fund for the treatment of tuberculosis patients, over the 12 months of 2023, second-line anti-tuberculosis drugs were supplied according to the “DOTS-plus strategy” in the amount of more than 2.5 million rubles. However, the epidemiological situation with tuberculosis in Pridnestrovie continues to be epidemic. 254 people were registered for the first time over the 12 months of 2023. The incidence of tuberculosis among children and adolescents has increased significantly - 50 and 11 cases, respectively (in 2022 - 8 and 5 cases, respectively). The leaders in incidence among children and adolescents were the Slobodzeya district, the cities of Bendery and Tiraspol.

The main activities are defined in the state target program “Oncology: improving cancer care for the population of the Pridnestrovian Moldavian Republic,” the implementation of which will increase the level of detection of cancer patients in the first stages of the disease and will contribute to the high-quality provision of specialized medical care. Surgical and symptomatic treatment, chemotherapy, and laboratory tests were financed from the budget as part of the program. The report notes that external factors negatively affected the import of medical and pharmaceutical products, which in turn negatively affected the timely provision of medicines to inpatients and outpatients in general, and this category in particular in 2023. 4 types of medicines were not purchased in this regard.

1822 people were registered, of which 1034 were with stages I-II of the disease in 2023. 58456 citizens consulted oncologists at clinics, dispensaries and advisory departments last year. It is noted that mammography examinations among women are carried out on the orders of doctors, although not to the planned extent. 2589 mammography examinations were carried out free of charge in 2023, and breast cancer pathology was diagnosed in 112 women.

Another new state target program for the republic, “Prevention and treatment of cardiovascular diseases in the Pridnestrovian Moldavian Republic,” continues to work effectively. The state program is aimed at reducing the level of premature mortality from cardiovascular diseases (by correcting behavioral risk factors, reducing arterial hypertension, diabetes, obesity, while using basic drug treatment, counseling and the use of modern technologies.

Electrocardiographs were purchased for a number of medical institutions, diagnostic devices and tests, medications, and stenting was used for 233 people as part of the state program during 2023.

The high level of morbidity and mortality from cardiovascular diseases is due to a high percentage (more than 20%) of elderly citizens, as well as an unhealthy lifestyle (smoking, drinking alcohol, physical inactivity, unbalanced diet, obesity, psycho-emotional stress, diabetes) and rare treatment for medical help. Therefore, the state target program provides for the identification and monitoring of risk factors for the development of cardiovascular diseases. In particular, all citizens over 40 years of age are required to determine their lipid profile at the outpatient and inpatient stages of medical care. 33164 such studies were carried out in 2023, pathologies were identified in 14582 citizens.

The Committee on Social Policy and Health has prepared draft resolutions on the approval of reports on the implementation of 6 state target programs in the field of healthcare in 2023 and plans to submit them for discussion by the Supreme Council of the Pridnestrovian Moldavian Republic in the near future.