Frontiers in public health · 2026
Public health diplomacy in Central Asia: a scoping review.
СтатьяScoping ReviewСистематический обзорНазвание и аннотация: Перевод в очереди
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Joshi Ashish, Sharma Nishtha, Jha Niharika, Cruz Jonas, Mukashev Nurzhan, Nazarzoda Khuseyn, Saliev Sukhrob, Sharshenova Ainash A, Sarria-Santamera Antonio
Аннотация
BACKGROUND: Central Asia comprising Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan, confronts a complex array of health challenges shaped by the post-Soviet transition, including fragmented health systems, a dual burden of communicable and non-communicable diseases, environmental degradation, healthcare inequality, and competing geopolitical influences. Public health diplomacy has emerged as a critical instrument for addressing these transnational challenges.
OBJECTIVES: This scoping review aimed to map and synthesize the existing evidence to examine the role of public health diplomacy in strengthening health governance and regional and international health cooperation.
METHODS: Following the Arksey and O'Malley scoping review framework, this paper used a systematic search of PubMed, and Google Scholar. Studies published between 2000 and 2025 addressing health diplomacy, health governance, cross-border cooperation, or health system reform in Central Asia were included. Data was extracted using a standardized charting form and synthesized through descriptive and narrative thematic analysis.
RESULTS: Seventeen studies met the inclusion criteria. Kazakhstan was the most extensively studied country (n = 4), followed by Uzbekistan (n = 2), Kyrgyzstan (n = 1), and Tajikistan (n = 1). No country-specific study addressed Turkmenistan. Key findings revealed: (i) all five countries continue to navigate the post-Soviet health transition with uneven progress toward UHC; (ii) significant intra-national healthcare inequalities persist, particularly in Kazakhstan's rural areas; (iii) environmental health threats including transboundary water pollution, industrial contamination, and household air pollution, demand coordinated diplomatic responses; (iv) the European Union uses health as a soft-power instrument, while China's Belt and Road Initiative and the SCO represent expanding but under-evaluated platforms for health cooperation; (v) Russia's influence persists through institutional legacies and migrant health governance; (vi) centralized, top-down health communication hinders public trust across the region; and (vii) no health diplomacy training program exists for Central Asia. The strongest SDG 3 alignment was with target 3.8 UHC, while maternal mortality, child health, and substance abuse targets remained unexamined through a PHD lens.
CONCLUSION: Public health diplomacy has significant potential to strengthen health governance and regional cooperation in Central Asia. Advancing this agenda requires stronger regional collaboration, context-specific capacity building, greater evidence generation, and systematic evaluation.
OBJECTIVES: This scoping review aimed to map and synthesize the existing evidence to examine the role of public health diplomacy in strengthening health governance and regional and international health cooperation.
METHODS: Following the Arksey and O'Malley scoping review framework, this paper used a systematic search of PubMed, and Google Scholar. Studies published between 2000 and 2025 addressing health diplomacy, health governance, cross-border cooperation, or health system reform in Central Asia were included. Data was extracted using a standardized charting form and synthesized through descriptive and narrative thematic analysis.
RESULTS: Seventeen studies met the inclusion criteria. Kazakhstan was the most extensively studied country (n = 4), followed by Uzbekistan (n = 2), Kyrgyzstan (n = 1), and Tajikistan (n = 1). No country-specific study addressed Turkmenistan. Key findings revealed: (i) all five countries continue to navigate the post-Soviet health transition with uneven progress toward UHC; (ii) significant intra-national healthcare inequalities persist, particularly in Kazakhstan's rural areas; (iii) environmental health threats including transboundary water pollution, industrial contamination, and household air pollution, demand coordinated diplomatic responses; (iv) the European Union uses health as a soft-power instrument, while China's Belt and Road Initiative and the SCO represent expanding but under-evaluated platforms for health cooperation; (v) Russia's influence persists through institutional legacies and migrant health governance; (vi) centralized, top-down health communication hinders public trust across the region; and (vii) no health diplomacy training program exists for Central Asia. The strongest SDG 3 alignment was with target 3.8 UHC, while maternal mortality, child health, and substance abuse targets remained unexamined through a PHD lens.
CONCLUSION: Public health diplomacy has significant potential to strengthen health governance and regional cooperation in Central Asia. Advancing this agenda requires stronger regional collaboration, context-specific capacity building, greater evidence generation, and systematic evaluation.