Belarus

As with many former Soviet bloc countries, Belarus' healthcare is in a state of transition from a centralized communist system to a more mixed system. Despite having the fifth highest number of doctors per 1000 people in the world, the capital investment of the public sector has been inadequate and this has led to outdated equipment and under-funded hospitals. Furthermore, unrealistic demands on the universal health care system have encouraged the practice of making 'under-the-table' payments to ensure quicker treatment, undermining equity.

Belarus is still feeling the ramifications of the Chernobyl crisis in 1986, which has put considerable health strain on populations living in areas with high levels of background radiation.

In 2006 the government introduced restrictions into the retail pharmacy sector, stipulated minimum floor areas and public entrances. This has lead to a decline in the number of pharmacies.

Access to innovative therapies is low due to a low per-capita spending on medicines, combined with a nationalistic policy designed to promote the interests of the local industry, and limited or no reimbursement for drugs not on the essential medicines list. The importing of medicine is also impeded by high tariffs (5-15%) and a further 18% VAT charge. Vaccines as well, usually exempt from tariffs, are taxed at approximately 7%.

However, drug quality is improving in the country as the government now insists on bioequivalence testing for all tendered pharmaceuticals.