Uzbek President Shavkat Mirziyoyev has signed a decree that significantly changes the role of the private sector in the country’s healthcare system. The document allows private clinics to participate in the state medical insurance system, introduces large-scale tax and customs incentives, creates a new investment infrastructure, and gradually transfers part of state functions to private and semi-state corporate structures.
The decree — No. UP-74 “On measures for additional support of the private sector in healthcare” dated May 5, 2026 — entered into force on May 7, 2026 (the full text in Russian is attached below). One of its key goals is to increase the private sector’s share in medical services to 30% by 2030.
Private clinics to treat patients using state funds
Starting July 1, 2026, non-state medical organizations will be allowed to provide medical services in all areas using state budget funds under the state medical insurance system and on the basis of a license.
The document introduces unified base reimbursement rates for treatment costs in both public and private medical institutions. This means the government will pay for patient treatment at the same rates regardless of the clinic’s ownership structure.
At the same time, the current practice of distributing budget funds among specific medical institutions will be abolished. Instead, financing will be allocated according to disease categories.
The authorities are also simplifying access to state-funded contracts for private clinics. Medical organizations that have passed national or international accreditation will no longer need to obtain approval from a Health Ministry expert commission when signing contracts with the State Medical Insurance Fund.
Private sector to be allowed to perform organ transplants
One of the most sensitive changes is the decision to allow private clinics to perform human organ and tissue transplant operations.
From May 1, 2027, such procedures may be carried out by non-state medical organizations that have passed national or international accreditation.
At the same time, the state will maintain strict oversight. Transplant activity will be classified as a “high-risk” area under the risk analysis system. Clinics will be required to regularly submit data on donors and patients to the Health Ministry.
The ministry has been instructed to develop separate requirements for molecular genetic testing, lists of mandatory analyses, and a rehabilitation system for transplant patients. The decree separately establishes liability for private clinics in cases of harm to patients’ life and health.
A new investment structure is being created in healthcare
The decree creates a new system for managing investments in healthcare.
The Agency for Pharmaceutical Industry Development will be renamed the Agency for the Development of Medicine and the Pharmaceutical Industry. It will receive powers related to attracting investors, supporting public-private partnership projects, and integrating the private sector into the healthcare system.
A joint-stock company, “Health Invest,” as well as a Medical Organizations Development Fund, will be established under the agency. At the initial stage, the fund will receive $10 million from Uzbekistan’s Fund for Reconstruction and Development on a non-repayable basis.
The new structure will be responsible for forming investment packages, supporting projects, and managing transferred medical institutions.
In practice, the decree creates a separate quasi-state system for managing medical assets and investments.
Four state medical centers to be transferred under external management
By the end of 2026, several major state medical institutions will be transferred to the management of “Health Invest” on a pilot basis:
- Jizzakh Regional Multidisciplinary Medical Center;
- National Children’s Medical Center;
- National Medical Center;
- Multidisciplinary Medical Center LLC.
The transfer will include the institutions’ land and property complexes.
In addition, the Health Ministry, the Agency, and the Ministry of Economy and Finance must develop a strategy by April 2027 to improve the efficiency of state medical institutions. Proposed mechanisms include supervisory boards, KPI-based management evaluation, and greater private sector involvement through public-private partnerships.
Government launches preferential lending for private medicine
To develop high-tech clinics outside regional centers and in border districts, NBU (National Bank of Uzbekistan) opens a $200 million preferential credit line.
Entrepreneurs will be able to obtain loans of up to $10 million for up to 10 years, including a three-year grace period.
Projects will also be eligible for partial interest rate compensation through the Entrepreneurship Development Company.
In return, clinics must obtain national or international accreditation within three years after establishing their operations.
Authorities introduce tax and customs incentives
The decree provides a range of benefits for medical businesses and foreign specialists.
Until May 1, 2029, foreign doctors, consultants, managers, and technical specialists will pay a social tax rate of 1%.
Employers will also be allowed to deduct voluntary health insurance expenses for employees and their family members from the taxable base — up to 10 million soums per person annually.
From June 1, 2026 to June 1, 2029, the following will be exempt from import customs duties:
- medical equipment;
- components and spare parts;
- consumable materials;
- specialized category “A” medical vehicles.
Licensing and quality control to be tightened
Despite market liberalization, the decree simultaneously expands state oversight powers.
The amendments introduce new provisions on inspections of compliance with licensing requirements in medical and pharmaceutical activities, as well as quality control over medical services.
At the same time, a more targeted sanctions mechanism is being introduced: licenses may be suspended only for the medical specialization where violations are identified, rather than for the clinic’s entire activity.
Separate changes concern healthcare digitalization. State information systems must be integrated with the State Medical Insurance Fund, including electronic referrals and electronic prescriptions.
Reform was discussed days before the decree was signed
Several days before the decree was published, on May 1, 2026, Shavkat Mirziyoyev reviewed a presentation on healthcare system development and expanding private sector participation.
At the presentation, the authorities publicly outlined the scale of the planned changes and the problems that had accumulated in the sector. According to figures presented there, the number of private clinics in Uzbekistan grew from 3,200 in 2016 to an expected 8,700 by the end of 2026. The number of private medicine specialties increased from 39 to 116, while the number of beds rose from 16,000 to 57,000. Officials forecast that the private sector’s share of the country’s total hospital bed capacity will reach 31%.
At the same time, the presentation highlighted problems in sector regulation, including insufficient quality control, outdated licensing requirements, the absence of a unified electronic database for private clinics, and weak support for investment projects.
Many of the measures later included in the decree were first presented during that meeting: allowing private clinics to provide services funded by the state budget, permitting accredited non-state organizations to conduct transplants, tightening licensing procedures, introducing remote electronic oversight, and creating a new investment structure around the Agency for the Development of Medicine and the Pharmaceutical Industry and the company “Health Invest.”
Officials also announced that all state medical institutions would be required to obtain mandatory licenses by the end of 2030. According to the plan, 55 national-level institutions must be licensed by April 2027, 413 regional organizations by the end of 2028, and more than 3,000 district and city medical institutions by the end of 2030.
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