Cancer Control in Kazakhstan: HE Dr. Zainab Shinkafi Bagudu Interviews Dr. Dilyara Kaidarova

Join us for the premiere episode of our new interview series “United Against Cancer with HE Dr. Zainab Shinkafi Bagudu” on OncoDaily. In this episode, Dr. Zainab Shinkafi Bagudu interviews Dr. Dilyara Kaidarova, Chairman of the Board of the Kazakh Institute of Oncology and Radiology (KazIOR) and President of the Kazakhstan Cancer Society (KazCS). Discover insights into the innovative cancer control strategies being implemented in Kazakhstan and learn about Dr. Kaidarova’s remarkable journey in the field of oncology.

Dilyara Kaidarova is the President of the XIII Congress of Oncologists and Radiologists of CIS and Eurasia, Chairman of the Board of JSC “Kazakh Research Institute of Oncology and Radiology” and Chief Oncologist of the Ministry of Health of the Republic of Kazakhstan. She is also the President of the Association of Oncologists of the Republic of Kazakhstan.

Her Excellency Dr. Zainab Shinkafi-Bagudu is a global cancer advocate, a pediatrician, a UICC Board Member, a Founder of the Medicaid Cancer Foundation, and the Chairperson of First Ladies Against Cancer (FLAC). Dr Bagudu is working with the state ministries of health, education, and women affairs to implement programs to sustainably improve menstrual hygiene, girl-child education, economic empowerment of women, and put an end to gender-based violence. Zainab Shinkafi-Bagudu is a member of the Editorial Board of OncoDaily.

Zainab Shinkafi Bagudu: Hi everyone, this is our OncoDaily interview for today and we’re United Against Cancer. We want to, today we’re going to speak to Professor Dilyara and then we’ll get to the crux of the matter.

As always, my name is Zainab Shinkafi-Bagudu, a global cancer advocate and very keen to connect with all the people that are involved in cancer across the world so that together we will be united. Doctor, please tell us a little bit about yourself. Introduce yourself, your name and your current position as well as other positions that are relevant to your work in cancer control.

Dilyara Kaidarova: Hello Zainab, I am very glad to see you again. Yes, I know you for many years and I know that you are a very strong woman in the elimination of cervical cancer in Africa. I am Dilyara Kaidarova, I am inside gynecology, oncoginecology surgeon, but now my position is director of National Cancer Institute in our country.

It is one of the main institutes in our country and president of associations of oncology associations of our country. I am a professor, PhD, surgeon, more than 30 years I am working only in oncology healthcare system. I was resident in our, I am studying in our university, Almaty, it is our city, capital city, Almaty government medical institute and then all my life I am working in treating patients in oncology health system.

Now I work with all patients, not only with gynecology patients, our institute treating patients from all countries. Kazakhstan is a very huge country, approximately 3 million square meters. Our localizations in Central Asia and more than 20 million populations we have in our country.

Zainab Shinkafi Bagudu: Thank you. Thank you for that very concise introduction. As you know, we were in Kazakhstan some years ago for the World Cancer Leaders Summit of the Union for International Cancer Control, the UICC, and it was indeed a very interesting one.

A lot of political advocacy, political will and governmental involvement at the time. You’ve described your distinguished career and the work that you do in gyneoncology and your involvement in the health system of Kazakhstan. From the time of the World Cancer Leaders Summit to now, would you say that the impact of having the highlights on the country, how has it been?

The effect of having such a large global meeting in the country, has it helped to improve or is it just the same? Did it bring more focus to oncology in your region?

Dilyara Kaidarova: Yes. I think many problems we have in oncology healthcare system in our country. Of course, financial problems.
Patients haven’t access to new drugs. Patients haven’t access to new radiation therapy equipment. Our country is very huge and we decided to build new oncology centers in each oblasc because it is more than 1,000 kilometers between one city to another city.

We talked with our president. Of course, if the president is involved in situations with cancer problems, for us it is very like our president because he said for us to create a cancer control plan in our country and to realize all our problems in our country, to build new cancer centers, to buy new equipment, not only for radiation therapy Linux, but to build new operating rooms with new equipment for endoscopy surgeon for new devices and to create new clinical protocols for our patients, for chemotherapy, for radiations.

We worked with ESMO, with WHO and they helped us three years ago to create new protocols, clinical protocols with NCSK.

And now in our country, we have new protocols. Now in our country, patients have access, free access, all our treating for patients, cancer treating is free for patients. And they have access for all cancers, yes.

For 44 targets therapy and three immunotherapy. And of course, I don’t know how many for all chemo is free for patients. Now, what is very, yes, good support for us, but the problems is, was problems with new radiation therapy equipments.
And now in that year, we changed in six region, uh, all equipments. And now we have a new Linux. And in our institute, in our institute, we have four new Linux for treatment and the two Thomas therapy.

And now in our capital, started building for proton therapy, proton therapy. Yes. And, but of course, but we have problems with child cancer.

Of course, we have only two only two centers in our country and problems with lymphoma for transplantations. Now it is very big problem. Yes.

Uh, yes. Bone marrow transplanted. And now we started in our institute to build new, uh, new building there for, uh, our hematology patients for, for adults.

And then they decided to build new hematology center in capital of our country. Yes. We have problems, but to realize all this plan, we need five years and we started from that year, from 2024.
And we hope that we will do it. It was fine. The finance will be every year for us.
Everything is finance. Yes.

Zainab Shinkafi Bagudu: It’s a not true. Your population is 18 million, 20 million, 20 million, 20 million. Yes.
Okay. Yes. Okay.

That’s that’s noted. Um, so that’s, so now you, sorry, go on. I think you have shed some of the strategies that, you have used to improve the healthcare system, uh, particularly when it comes to oncology that you’ve shared with us, um, the fact that you have free access for patients or patients, and then you have six, Linux six new Linux in the last, few years that have come up as well as, um, targeted and immunotherapy drugs available.

Chemotherapy is also available. And that is, uh, what would you say about the preventative measures that have been taken for early detection? How do you, I know you work on the every woman study for ovarian cancer.

For instance, you are one of the co-authors and PIs in that study. Um, so what, and one of the issues that we have with ovarian cancer is late detection. So what’s, what measures are in place, for early for prevention and early detection of cancer is your civil society active, or is it all government driven?

Dilyara Kaidarova: Yes. In our country, we have government, prevention program, three screening. We have, it is free for our citizens for breast cancer from 40 to 70 for women, for cervical cancer from 30 to 70 and for colorectal cancer for women and men’s from 50 to 70.

It is all free for citizens who have insurance, government insurance. Since 2018, our government, they created new social insurance fund for all citizens. And we need to pay every year, each citizens, they need to pay for this fund.
But of course, more than 3 million people in our countries, they didn’t pay for this insurance and they haven’t access to screening.

That is problem. And now I talked with our new minister of health said we need to change because of course it is easy to prevent cancers and, and it was not so cheaper than, than, uh, than treat, to treat this cancer.

And we showed for them, and now they want to change maybe their strategy, uh, because government, all people, they need to pay, but for child, for old, older, uh, populations, it is free, all free, but who is worked, they need to pay for that insurance.

Zainab Shinkafi Bagudu: Yeah. So is it just workers, people that have working or you can pay even if you don’t have, what happens to the unemployed? Are they covered by the health insurance?
Because health financing is very important, uh, around the world for all, all low middle income countries, particularly because of the COVID pandemic.

Financing health has become a very big issue and we health insurance and universal health coverage, of course, is one of the major ways in which we can achieve good health for all if we’re able to. So does the health insurance system, does it allow people that are not in the non-formal sector?

That is if you are not employed, by government, if you’re in the private sector, you pay into that insurance or is there side-by-side private insurance and government insurance?

Dilyara Kaidarova: No, we have our government insurance.

Zainab Shinkafi Bagudu: Necessary.

Dilyara Kaidarova: Necessary. That we have our necessary government there, insurance for all citizens. Uh, it is, they need to pay every, who is not in the, uh, in not government system worker, they need to pay every year $50.
It is not so huge. Only $50 and you can receive all, you have access to all, to CT, to MRI, if you have problems, but, um, no, people don’t understand. That’s everybody.

That is that, that is cheaper. But of course we have private, uh, sector, say private insurance, but it is only for who want, but if you will pay for government, it is not so huge amount of money, but 3 million, they didn’t pay for that. And they haven’t access to this.

And, we talked with our prime minister about that. They need to change this politics in our healthcare system. Um for, but after that, we created, new, new strategy in our polyclinics.
If patients come to polyclinics with diagnosis, with diagnosis of pre-cancer, pre-cancer, not breast, pre-cancer, pre-cancer, pre-cancer lesion.

And our GP, they need to put them in green corridor and during 30 days in polyclinics, they need to put diagnosis or not. And this is our new strategy system. Yes.
Because before cancer, they need to pay for CT, for MRI. And somebody say, we haven’t money for this. We haven’t access for that.
And that is why we started to do this green corridor for that patients, for that citizens. Yes. And now we started.
Yes. And it will be free for patient, for patient with pre-cancer and many, many. Yes.
It’s free for them.

Zainab Shinkafi Bagudu: Very interesting. That’s good because we can talk about prevention. We tell patients go on screen, go on screen.
If we don’t provide for them what to do after, then it is a problem. So if we tell them screen and we’re going to put you in the green corridor, it’s good. So that they have, they have, um, hope that something will happen to me after I will get, I will be taken care of by the system.

So I think a lot of what we have, uh, you’ve highlighted the importance of cancer control. Your work has been highlighted and helped and made easier by the political will and support that you have received from the government. And it has helped you a lot in reaching the citizens and making generally cancer better.

Is there any question you would like to, or anything more you would like to say?

Dilyara Kaidarova: Yes. I want to add about our, our… Is there anything more?
It’s fine. Yes. I want to add about our, um, work with elimination of cervical cancer.
We have screen, but…

Zainab Shinkafi Bagudu: So tell us about your cervical cancer elimination program.

Dilyara Kaidarova: Yes, of course. In our country, problems that during these 10 years, the cervical cancer are increasing and the mortality is stable. And, we, before we haven’t our vaccination program.

And last year we talked with our minister of health and they decided to, uh, introduce in calendar in calendar of, calendar vaccinations, this, HPV vaccine. Oh, it was 10 years, my work with all government was jeopardized with, I don’t know. We did many round tables.

We did… I hear you. I have double H from ER, from all, I don’t know where many round tables with IGCS, with UACC.
And since 2024, yes, 2024, yes, we, uh, they bought this HPV vaccine and, we will start our vaccination program for girls in September.

Zainab Shinkafi Bagudu: Congratulations. Yes, it is.

Dilyara Kaidarova: Congratulations. I’m crying and spell for all them because young, young woman died every day, two, two woman died in our country every day from cervical cancer, from cervical cervical cancer. Yes.

Zainab Shinkafi Bagudu: I hear you. I have similar story. But when you get there, it’s worth it.
We had a long journey, a lot of advocacy, like you mentioned, uh, similar partners and, uh, it will start last year, 2023. Today we have vaccinated 12 million girls with HPV vaccine in the short time. So now a lot of work.

So it’s very, very, very fulfilling. And I, you are there already. Once you have a date is just to start.
When you start, it’s, it’s over. You have the number. So congratulations.
Well done. Thank you for sharing that with us.