Kazakhstan Audit Chamber proposes cutting healthcare spending by 140.5 billion tenge

September 21, 2026 at 09:20 AM2 min

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Kazakhstan's Supreme Audit Chamber has proposed reducing planned healthcare spending by 140.5 billion tenge for 2027–2029. Auditors also recommended adding 46 billion tenge for underfunded areas after reviewing 1.57 trillion tenge of the 8.85 trillion tenge transfer program.

Key Facts

The Supreme Audit Chamber proposed cutting 140.5 billion tenge from the republican healthcare budget for 2027–2029.
Auditors found that the Ministry of Health overestimated the attached population by 852,800 person-years, adding 5.59 billion tenge to primary care costs.
The audit identified 88.26 billion tenge in excess drug spending because VAT was applied to 168 of 172 medicines that are exempt from the tax.
The Ministry of Health's request exceeded the single distributor SK-Pharmacia's data by 51.1 billion tenge for 37 drugs.
The audit chamber also recommended adding 46 billion tenge for five essential medicines that were omitted from the budget request.

Audit Findings

The Supreme Audit Chamber reviewed 1.57 trillion tenge of the 8.85 trillion tenge transfer program to the Social Health Insurance Fund for 2027–2029. Auditors found that the Ministry of Health used a population figure 852,800 person-years higher than the attached population register when calculating primary healthcare costs. This overestimation increased primary care spending by 5.59 billion tenge over three years. A similar overestimation in emergency care funding added 6.26 billion tenge in costs. Auditors also flagged a risk of double payment for fourth-category emergency calls, which could be counted in both ambulance and mobile clinic brigade financing.

Drug Spending Discrepancies

The largest finding concerned drug provision, where the budget allocated 660.3 billion tenge over three years. The audit chamber found that 16% VAT was applied to the entire cost of medicines, although 168 of 172 drugs are exempt from this tax. This inflated drug spending by 88.26 billion tenge over three years. A discrepancy between the Ministry of Health's request and SK-Pharmacia's data showed the ministry's stated need for 37 drugs exceeded the distributor's figures by 51.1 billion tenge. Conversely, five essential medicines were omitted from the budget request entirely, with a total need estimated at 46 billion tenge.

Other Overestimations

The audit identified a 1.12 billion tenge overestimation in palliative care spending due to incorrect application of environmental coefficients in Aktobe, Pavlodar, and Turkestan regions. The Supreme Audit Chamber emphasized that the findings do not mean all healthcare spending is inflated. The main concern is the quality of planning and need calculations, which can lead to either excess funding or shortages in specific areas.