Study on Economic Partnership Projects in Developing Countries in FY2016 Study on Reinforcement Project of Blood Service in the Republic of Uzbekistan February 2017 Prepared for: Ministry of Economy, Trade and Industry Prepared by: Shimizu Corporation Reproduction Prohibited Ministry of Economy, Trade and Industry Prepared by: Study on Economic Partnership Projects in Developing Countries in FY2016 Shimiz Cotporation February 2017 Study on Reinforcement Project of Blood Service in the Republic of Uzbekistan Preface This report summarizes the results of the “FY2016 Project for Promotion of Overseas Deployment of High-Quality Infrastructure Systems (Investigation of Yen-Loan-Financed Private-Sector Infrastructure Project Formation),” which was entrusted to Shimizu Corporation by the Ministry of Economy, Trade and Industry (METI). This study “Republic of Uzbekistan: Study on Reinforcement Project of Blood Service in the Republic of Uzbekistan” was conducted to verify the feasibility of a project aiming to improve Uzbekistan’s blood services by developing a new plasma product factory in its capital, Tashkent City, upgrading test equipment of blood centers located in 4 major cities, including Tashkent City, and providing operational support and technology support for those facilities at a cost of approx. 8.05 billion JPY. We hope that this report will help the above project to be realized and serve as a reference for the stakeholders in Japan. February 2017 Shimizu Corporation Project Map Project sites across the country (1) (2) (5) (10) (4) (3) (7) (9) (6) (8) (11) (12) 100 km Provincial Blood Station (1) Nukus Provincial Blood Station Karakalpakstan Nukus City (2) Urgench Provincial Blood Station Khorezm Urgench City (3) Fergana Provincial Blood Station Ferghana City (4) Andizhan Provincial Blood Station Andijan City (5) Namangan Provincial Blood Station Namangan City (6) Bukhara Provincial Blood Station Bukhara City (7) Navoi Provincial Blood Station Navoiy City (8) Samarkand Provincial Blood Station Samarkand City (9) Jizzax Provincial Blood Station Djizakh City (10) SyrDarya Provincial Blood Station Syrdarya City (11) Kalush Provincial Blood Station Kashkadarya Karshi City (12) Termez Provincial Blood Station Surkhandarya Termez City Gray-shaded stations (1, 4, and 8) are target sites of the project. Source: A map image from Google Maps was modified by the study team Project sites across Tashkent Province (2) (6) Tashkent (3) (4) (5) (1) 2 km (7) Chirchik Tashkent 5 km Plasma product factory Within the premise of the Republican Blood (1) Existing plasma product factory Transfusion Center in Tashkent City Blood transfusion stations in Tashkent Province (1) Republican Blood Transfusion Center (2) Blood transfusion station in the 2-clinic of Tashkent Medical Academy (3) Blood transfusion station in the 3-clinic of Tashkent Medical Academy Tashkent City (4) Blood transfusion station in the Republican Scientific Center of Surgery (5) Blood transfusion station in the Republican Scientific Center of Emergency (6) PNN Blood Product Center (7) Chirchik Chirchik Blood Transfusion Station The gray-shaded station (1) is a target site of the project. Source: A map image from Google Maps was modified by the study team Abbreviations Abb. Complete designations B/C Benefit per Cost BCP Business Continuity Plan CLEIA Chemiluminesent Enzyme Immunoassay EIA Environmental Impact Assessment ELISA Enzyme-Linked ImmunoSorbent Assay E/N Exchange of Notes FIRR Financial Internal Rate of Return F/S Feasibility Study GDP Gross Domestic Product GMP Good Manufacturing Practice HBV Hepatitis B Virus HCV Hepatitis C Virus HIV Human Immunodeficiency Virus IU International Unit JB Japan Blood Products Organization JBIC Japan Bank for International Cooperation JETRO Japan External Trade Organization JICA Japan International Cooperation Agency JPY Japanese Yen L/A Loan Agreement ME Medical Equipment METI Ministry of Economy, Trade and Industry MOH Ministry of Health NAT Nucleic acid Amplification Test NPV Net Present Value ODA Official Development Assistance QA Quality Assurance QC Quality Control SanPiN Sanitary Norms and Regulations STEP Special Terms for Economic Partnership USD United States Dollar UPS Uninterruptible Power Supply WHO World Health Organization Contents Preface Project Map Abbreviations Contents Executive Summary Chapter 1 Overview of the Host Country and Sector (1) Economic and Financial Circumstances of the Counterpart Country ............................................ 1-1 1) General Background of Uzbekistan ........................................................................................ 1-1 2) Uzbek Economic and Financial Circumstances ..................................................................... 1-2 (2) Overview of Project Target Sector ................................................................................................. 1-6 1) Overview of Blood Services in Uzbekistan ............................................................................ 1-7 2) Status of blood donation ......................................................................................................... 1-9 3) Status of plasma derivative production ................................................................................ 1-10 4) Conditions of Major Institutes ............................................................................................... 1-11 5) Issues Related to Blood Services .......................................................................................... 1-16 6) Overview and Comparison of Current Status of Blood Services in Japan ........................... 1-17 (3) Conditions of Target Areas ........................................................................................................ 1-21 Chapter 2 Study Methodology (1) Study Details .................................................................................................................................. 2-1 1) Study Items ............................................................................................................................. 2-1 2) Study Targets .......................................................................................................................... 2-2 (2) Study Methodology and Organization ........................................................................................... 2-2 1) Study Methodology ................................................................................................................ 2-2 2) Study Organization ................................................................................................................. 2-3 (3) Study Schedule ............................................................................................................................... 2-5 1) Overall Schedule .................................................................................................................... 2-5 2) Field Studies ........................................................................................................................... 2-5 Chapter 3 Justification, Objectives and Technical Feasibility of the Project (1) Project Background and Significance ............................................................................................ 3-1 1) Project Background ................................................................................................................ 3-1 2) Project Significance ................................................................................................................ 3-1 (2) Basic Policies and the Determination of Project Details ................................................................ 3-3 (3) Project Overview........................................................................................................................... 3-4 1) Improvement of blood services: securing of raw material plasma required for production of sufficient blood products .................................................................................. 3-4 2) Improvement of blood services: increased blood safety ......................................................... 3-5 3) Increase of safe and secure plasma derivatives production .................................................... 3-6 4) Operational Support for Human Resource Development, Training and Equipment Maintenance etc. ................................................................................................................... 3-10 5) Project Cost Estimate ............................................................................................................ 3-11 (4) Necessary Evaluation of the Project ............................................................................................ 3-12 1) Demand Forecast .................................................................................................................. 3-12 2) Consideration of Division of Roles for Implementing of the Project ................................... 3-12 3) Evaluation of Technological Practices for Plasma Derivative Production ........................... 3-12 4) Acquisition of Approval and Licenses Required for Plasma Product Factory Construction 3-13 Chapter 4 Evaluation of Environmental and Social Impacts (1) Analysis of Current Environmental and Social Situations ............................................................. 4-1 1) Current Status of the Land for a New Plasma Product Factory .............................................