Cancer is one of the leading non-communicable diseases (NCDs) in Turkmenistan, alongside cardiovascular disease and diabetes. Though national data is limited, available evidence indicates cancer is a serious and growing health problem. To address it, Turkmenistan is building three specialized cancer treatment centers in Balkanabat, Turkmenabat, and Mary, co-financed by the Islamic Development Bank (IsDB) and the Saudi Fund for Development (SFD).
The Progres team conducted analysis of the country’s cancer burden and the institutions financing its response in the last ten years. We used publicly available sources such as the Ministry of Health and Medical Industry of Turkmenistan, Islamic Development Bank, Saudi Development Fund, World Health Organization (WHO), United Nations Development Program (UNDP), United Nations Population Fund (UNFPA) and International Cancer Control Partnership (ICCP).
There is no information on how much the government spends on cancer prevention, diagnosis and treatment. The Ministry of Health website does not have any information on clinical protocols, cancer data or epidemiological reports. Similarly, public communication and education on cancer diagnosis and treatment is non-existent.
Cancer Trends in Turkmenistan According to International Organizations
From 2014 to 2022, cancer cases rose by 134% in Turkmenistan:
Cancer deaths also increased by 11.4%:
Between 2018 and 2022, the top cancers were breast, stomach, and lung. Over five years, 17,063 people were diagnosed, with more women (10,256) affected than men (6,807).
Figure 1. Most Common Cancer Cases and Mortality for 2018 and 2022 for Turkmenistan
Source: International Cancer Control Partnership (ICCP): Cancer Data for 2018.
Source: World Health Organisation (WHO): Cancer Data for 2022.
Key Factors Contributing to Cancer in Turkmenistan
Population Attributable Fractions (PAFs) estimate the share of cancer cases or deaths caused by specific risk factors:
- 33.9% of melanoma cases (2012): UV exposure;
- 19% of cancer cases (2012): Infections (e.g., HPV, Hepatitis B/C);
- 16.3% of cancer deaths (2017): Tobacco use;
- 10.5% of cancer deaths (2016): Alcohol consumption;
- 2.2% of cancer cases (2012): Obesity;
- 1% of cancer deaths (2017): Occupational carcinogens.
Key Challenges in Cancer Treatment
1. Limited Screening and Early Detection: Cancer screening remains inadequate. In 2016, cancer caused 3,140 of the 15,023 premature NCD deaths (20.9%) while in 2022 cancer deaths reached 4,456. Cervical cancer incidence in 2020 was 15.1 per 100,000 women, with 250 deaths in 2019. Yet, only 50% of women have been screened in the past five years.
2. Limited Treatment Infrastructure: Medical infrastructure in Turkmenistan is still developing. For every 10,000 cancer patients (2020) the number of relevant equipment is as follows for Turkmenistan, Kazakhstan and Russia:
- 27.5 CT scanners in Turkmenistan vs 34.5 in Kazakhstan vs 45 in Russia;
- 20.6 MRI scanners vs 17.7 vs 19.9;
- 12 external beam radiotherapy units vs 13.3 vs 8.1;
- 0 PET or PET/CT scanners vs 0.3 vs 0.5;
- Unknown number of mammograms vs 56.6 vs 50.6.
3. Shortage of Cancer Specialists: Data on cancer treatment specialists is unavailable, likely indicating shortages. There is little to no information on radiation oncologists, medical physicists, radiologists, nuclear medicine physicians and medical and pathology lab scientists.
4. High Cancer Mortality: Though the risk of developing cancer before the age of 75 years in Turkmenistan is relatively low (12.9%), mortality is high. Approximately 65.5% of people diagnosed with cancer in Turkmenistan die from it. This is very high compared to countries like Kazakhstan (57.1%), Russia (49%) or Germany (41.8%).
5. Lack of Preventive Measures: There is low public awareness of cancer risk factors. For example, UV Index levels reach 10 in Dashoguz and 12 in Mary, yet few use protective measures. Alcohol consumption (2.6 liters per person annually) is the third highest in Central Asia while 45.5% of women and 51.1% of men are overweight or obese. A public awareness campaign is needed to educate people about common causes of cancer and how to reduce their risk.
6. Lack of CSOs and Independent Initiatives: Turkmenistan lacks independent civil society organisations (CSOs) working on public health issues including cancer. Turkmenistan’s newly created National Intersectoral Coordination Committee for a “One Health”, which aims to enhance the health of people, animals, and ecosystems, lacks representatives from the CSO sector. Similarly, the limited access to the Internet further exacerbates lack of awareness and engagement, both among health workers and the general public.
7. Increase in Medical Tourism: Given the shortcomings of the healthcare system in Turkmenistan, an increasing number of Turkmen nationals and foreign residents seek medical care overseas. For example, 85% of medical tourists to Iran are from Iraq, Afghanistan, and Turkmenistan. Moreover, the US Department of State warns its nationals traveling to Turkmenistan that medical care is limited, many basic supplies are scarce, and even routine procedures may require travel abroad while invasive treatments carry serious health risks. Meanwhile, 72% of the total health expenditure is paid out of the pocket of Turkmen citizens leading to major barriers to universal access to health.
8. Limited national cancer control plans: The ICCP assesses comprehensiveness of national cancer control plans on 13 cancer control domains. On their plan review index Turkmenistan scored 15.70 out of 100, compared to Kazakhstan which scored 28.70. The below spider chart compares Turkmenistan to Kazakhstan and Russia on these domains. In particular, Turkmenistan scores low on: prevention (0.0), palliative and supportive care (0.0), research (0.0), emergency preparedness (0.0), health equity and special populations (5.0), health workforce (6.7) and treatment (9.5).
Source: ICCP 2023.
International Institutions Supporting Cancer Treatment
Based on the publicly available information, below are the key international institutions supporting cancer treatment in Turkmenistan.
Islamic Development Bank (IsDB) approved a US$156.3 million loan to build oncology hospitals in Turkmenabat and Balkanabat (150 beds each), and for project oversight and capacity-building. The exact financing terms from the Islamic Development Bank (IsDB) and the Saudi Fund for Development (SFD) are not publicly available. However, the IsDB tender documents mention three financing modes – installment sale, loan, and grant – which relying on how the IsDB funding works might mean the following:
- Installment sale: IsDB likely purchases medical equipment and resells it to Turkmenistan at a pre-agreed markup, to be repaid in installments. Ownership transfers upon delivery.
- Loan: In line with Islamic finance principles, the loan is interest-free, but includes a service fee of 0.75%-2.00% per year to cover administrative costs. Repayment is typically over 20 years, including a 5-year grace period.
- Grant: Grants are usually reserved for Least Developed Member Countries (LDMCs), so awarding one to Turkmenistan – an upper-middle-income country – is notable. The grant likely supports technical assistance and capacity-building.
All IsDB funding requires anti-corruption and anti-fraud safeguards. These provisions are written into project agreements, and the IsDB retains the right to audit all parties involved.
Saudi Fund for Development (SFD) approved a US$80 million concessional loan to build a 200-bed hospital in Mary. While exact loan terms aren’t public, SFD loans are known to be highly concessional – offering 1–2% interest rates, repayment periods of up to 50 years, and a grant element of 35–59%, making them among the most generous globally. Loans must fund economically or socially viable projects and typically cover only part of the total cost, with the remainder financed from other sources. Disbursed and repaid in Saudi Riyals, loans come with legal and financial protections, including tax and currency immunity and safeguards for SFD assets. Borrowers like Turkmenistan may be required to provide collateral, and there’s often a preference for using Saudi-made products.
United Nations Development Programme (UNDP): Since 2021, UNDP has implemented a $92 million, government-funded project to improve non-communicable diseases care. Recent deliveries included $641,490 worth of cancer drugs like Trastuzumab, Hydroxyurea, and Nilotinib. Around 60 oncology and hematology drugs are supplied annually. However, statistics, monitoring, implementation, impact reports and distribution plan for medicine and equipment are not publicly available. By 2030, Turkmenistan aims to reduce mortality from noncommunicable diseases (NCD), including cancer, by one third. According to UNDP, despite the fair progress in reducing NCD mortality, “acceleration is required to reach target level 19%”.
UNFPA and UNICEF: In 2016, Turkmenistan introduced the Human Papillomavirus (HPV) vaccine, a virus that causes cervical cancer. The project was financed by the government and vaccines procured by UNICEF. Vaccination is free for 9-year-old girls and boys. However, statistics, monitoring, implementation and impact reports are not publicly available.
International Atomic Energy Agency (IAEA): The IAEA is advising on nuclear medicine for a new 500-bed International Oncology Center in Ashgabat. The center will provide diagnosis, treatment, rehabilitation, and medical training. However, statistics, monitoring, implementation and impact reports are not publicly available.
Overall, Turkmenistan is making important strides to improve cancer care through investments and international cooperation. Yet, greater focus and efforts are needed on early detection, screening, outreach, data collection, capacity-building, accessibility of universal health care and prevention to reduce the growing cancer burden.
