Abstract / Summary
Background: /Objectives: Strengthening public administration of epidemiological surveillance is a policy priority for the Republic of Kazakhstan amid globalization, the emergence of new pathogens, cross-border importation of quarantinable infections, and the high economic cost of recurrent epidemics. This study analyzed Kazakhstan’s sanitary-epidemiological legislation and evaluated the effectiveness of the public administration of its infectious disease surveillance system.
Methods: We conducted a comparative analysis of current and repealed Kazakhstani legal acts against the World Health Organization International Health Regulations (2005), benchmarked against United States and Australian border-health law; a descriptive analysis of national infectious disease incidence per 100,000 population (2022–2024); and a multivariable ordinary least squares regression on a cross-sectional comparator sample of 12 countries (Kazakhstan, 10 Organisation for Economic Co-operation and Development [OECD] member countries, and Romania, an OECD accession candidate; 2023–2024) relating log-transformed 2024 measles incidence to 2023 second-dose (MCV2) measles vaccination coverage and the 2023 World Bank Government Effectiveness index.
Results: The legal analysis identified substantial gaps, including the absence of a statutory definition of epidemiological surveillance and of public health emergency criteria, and fragmented regulation of border sanitary control. Vaccine-preventable disease incidence rose sharply in 2023–2024 despite consistently high (98.8%) average official first-dose (MCV1) measles vaccination coverage. The regression model explained 68.3% of cross-country variance in measles incidence (R² = 0.683; F(2,9) = 9.70; p = 0.006); government effectiveness was a significant predictor (B = −2.79; p = 0.007), whereas second-dose (MCV2) vaccination coverage was not (B = −0.03; p = 0.667).
Conclusions: In the full-sample conventional OLS model, government effectiveness was associated with measles incidence whereas MCV2 coverage was not; however, this pattern was sensitive to the exclusion of Kazakhstan and to robust standard-error estimation, and should therefore be considered exploratory and hypothesis-generating rather than a confirmed determinant, given the small sample (n = 12). Kazakhstan should prioritize closing identified regulatory gaps and strengthening surveillance governance, informed by consolidated border-health models such as those of the United States and Australia.