The Kazakhstan population was estimated at 15.7 million in 1997. There was a decline during the 1990s, perhaps by as much as 1.4 million between 1992 and 1997, mainly due to out- migration. Nearly 30% of the population is below age 15. The crude death rate per 1,000 in Kazakhstan rose from 7.6 in 1989 to 10.2 in 1997. Health status indices improved from the 1950s but deteriorated from the 1980s. The age standardised male death rate from ischemic heart disease worsened dramatically during the 1990s. Age-adjusted cancer mortality rates are the highest among the Central Asian republics of the former Soviet Union. Kazakhstan also has high notification rates and mortality from pulmonary tuberculosis. Infant mortality (25.3 deaths per 1,000 live births in 1997) is over four times the EU average of 5.7. The possible effects on health status caused by environmental pollution and degradation are major concerns in Kazakhstan. Something like 50% of the population live below the poverty line.²⁵

In Kazakhstan, the WHO World Health Report (2006) indicates a life expectancy at birth of
56 years for males; 67 years for females (Table 4). Healthy life expectancy is 52.6 years for males; 59.3 years for females.²⁶

Table 4: Population life expectancy at birth, Commonwealth of Independent States (plus Mongolia) (2004)

Source: WHO World Health Report 2006

The adult mortality rate²⁷ in 2004 is reported as 424/1000 population for males and 187/1000 for females. ²⁸

In 2006, UNAIDS reports:

‘The epidemics in Eastern Europe and Central Asia continue to grow and are affecting ever-larger parts of societies in this region. The number of people living with HIV in this region reached an estimated 1.6 million in 2005 - an increase of almost twenty-fold in less than ten years. AIDS claimed almost twice as many lives in 2005, compared with 2003, and killed an estimated 62,000 adults and children. Some 270,000 people were newly infected with HIV in the past year. The overwhelming majority of people living with HIV in this region are young; 75% of the reported infections between 2000 and 2004 were in people younger than 30 years (in Western Europe, the corresponding figure was 33%).’ ²⁹

UNAIDS also specifically highlight the increase in HIV infections in Kazakhstan:

‘By the end of 2004, Kazakhstan had reported a cumulative total of 4696 HIV cases; it had also reported that 231 of these individuals had developed AIDS, including 188 who had died. Among the HIV cases for which the mode of transmission was known, about 84% were infected through injecting drug use. For the year 2004, the Kazakh authorities reported 699 new HIV cases, 79 new AIDS cases and 67 AIDS deaths. The most affected age group is 20-29 years old (54.3%). The great majority of the infected population are male, as only 207 women are known to be HIV positive. One hundred and one children are known to have been born to HIV-positive mothers; six of them are HIV-positive. The two most affected oblasts (regions) in Kazakhstan are Karaganda and Pavlodar (northern cities close to the Russian border), which account for about 70% of the reported cases. In addition, Almaty, and the trading city Shymkent have high rates of infection. Preliminary results of sentinel surveillance in select populations show that HIV prevalence in Karaganda is about 5%, in 2% Uralsk 2% and 0.3% in Almaty. The most vulnerable groups in Kazakhstan are IDUs, sex workers and prisoners (1227 PLWHA are in national penitentiaries). The country is located on a main drug-trafficking route, which facilitates drug use. Despite the seemingly large number of 45,000 officially registered IDUs, a study conducted in 1998-2002 indicates that the actual number may exceed 250,000. According to national estimates, 3% of the population inject drugs, which would make the number of IDUs 450,000. The involvement of women and children in drug use and trafficking is likely to increase HIV prevalence in these groups. The estimated number of female sex workers is 20,000-50,000, of whom 30% are IDUs. Data from STI clinics show that 75% of female sex workers have at least one STI, while 5% of prisoners in temporary detention have syphilis. Some available data suggest that HIV prevalence in sex workers was 0.5% at the end of 2001, while National HIV/AIDS Centre data suggests that at least 1% are HIV positive.’³⁰