Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.

“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.

Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.

At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.

The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.

A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.

The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.

Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.

International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.

If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.

Living in areas with high agricultural pesticide exposure is associated with higher cancer risks, according to a new study that highlights potential health impacts in vulnerable communities. Researchers found that widespread exposure to pesticides in food, water and the environment may increase the likelihood of developing certain cancers.

The study, published in Nature Health, analysed environmental data, cancer registries and biological samples across Peru. It found a strong association between pesticide exposure and cancer risk, marking one of the first large-scale efforts to connect environmental contamination with biological changes linked to the disease.

“This is the first time we have been able to link pesticide exposure, on a national scale, to biological changes suggesting an increased risk of cancer,” said Stéphane Bertani, a molecular biology researcher at the French National Research Institute for Sustainable Development.

The research was conducted in collaboration with several institutions, including the Institut Pasteur, the University of Toulouse and Peru’s National Institute of Neoplastic Diseases. Scientists mapped pesticide dispersion across the country over a six-year period from 2014 to 2019, identifying regions with the highest exposure levels.

The findings showed that people living in these high-risk zones were about 150% more likely to develop cancer. Areas of moderate to high exposure covered more than one-third of Peru’s territory, with contamination spreading up to 30 to 50 kilometres beyond agricultural land due to environmental factors such as wind and terrain.

The study examined data from more than 150,000 cancer patients diagnosed between 2007 and 2020. The highest exposure levels were found in the Andean highlands, where limited rainfall can intensify the accumulation of chemicals. Researchers noted that even pesticides not classified as carcinogenic by the World Health Organization may still contribute to harmful biological changes over time.

Laboratory analysis revealed that pesticide exposure can disrupt cellular processes that help maintain normal function. These disruptions may occur long before cancer develops, potentially increasing vulnerability to other risks such as infections or inflammation.

The study also found that certain cancers were more closely linked to pesticide exposure, particularly epithelial cancers affecting the digestive system, lungs and skin. In Peru, cases of liver cancer were found to overlap with regions of heavy pesticide use, raising questions about environmental factors contributing to the disease.

Researchers said the findings highlight the challenges of tracking pesticide exposure, given its widespread presence in ecosystems. They also warned that communities with limited healthcare access and intensive agricultural activity may face greater risks.

The study calls for stronger regulatory policies and improved monitoring to address environmental health risks. Experts say understanding how pesticide exposure affects human biology could play a key role in preventing cancer and protecting at-risk populations.