azerbaijan – baku, shamakhi, shusha, aghdam, nakhchivan, lahij, ordubad, salyan, lankaran etc. mir-baba mir-abdulla oglu, father of eminent azerbaijani literary man yusif vazir chamanzaminli had a pharmacy in aghdam. 142 kinds of medicines, more than 100 of which were made of herbs, were sold in his pharmacy. chamanzaminli himself, being the son of the pharmacist, described everyday life and practices of azerbaijani healers of the 19th century in his narrative called “the doctor”. such pharmacies were mainly in iranian (southern) azerbaijan. at the beginning of the 20th century, treatment by herbs was enough to spread the method of treatment in azerbaijan. but healers perceived the appearance of new, modern medicines as something strange. “molla nasraddin” – popular azerbaijani magazine of that time, which was of great importance in medicine education, criticized such kinds of remains of the past, ridiculed backwardness of healers-evils of that time, their ignorant treatment of modern knowledge in medicine. for instance, a caricature called “holy bukhara” (painted by azim azimzade) was given in the 20th issue of the magazine (1911). here the image of bukhara emir, doubtfully treating recommendations of the doctor about a new medicine. medicine in azerbaijan democratic republic in 1918, the ministry of health-care led by dr.rafiyev was established in the independent azerbaijan democratic republic. dozens of new pharmacies and hospitals were opened in baku and ganja at that time. azerbaijani students in paris, 1920. many students of azerbaijan democratic republic sent for educating abroad, mainly to germany, saint petersburg, moscow, kiev and other cities, learned medicine there. in 1919, baku state university with a medicine faculty was established in baku. professor v.i.razumovskiy, an eminent surgeon, became its first chairman (until 1920). history of medicine was also taught there. razumovskiy established the first preparatory commission for a short period of time. admission examinations were held in august of the same year and so the first course of students – future doctors – was collected. on august 2, 1922, there were only three azerbaijanis – a.alakbarov, jeyran sultanova, and adliya shahtakhtinskaya-babayeva, who became the doctor of sciences and professor – among the first 29 alumni of medicine faculty. medicine in the azerbaijan ssr after establishment of the soviet power, during the 1920s, pharmacies, where herbs were sold, were closed, and manuscripts written with arabic alphabet were burned. it was a part of the soviet power's policy carried out against islam (mainly in azerbaijan and central asia). building of physiotherapy institute in baku, 1930s. nariman narimanov, who also was a doctor, was the leader of a newly established administration. from 1920 to 1921 aghahuseyn kazimov and then in 1935 mir movsum gadirly were national commissars of health-care in the azerbaijan ssr. in 1930, azerbaijan state medical institute was established and m.n.gadirly was its first rector. eminent scientists and professors such as i.shirokorogov, s.davidenkov, f.ilyin, lev levin, n.ushinkiy, k.malinovskiy and others had a great contribution to the development of the institute. scientists such as m.mirgasimov, m.a.topchubashov, a.m.aliyev, i.m.ismayilzade, and others graduated from this institute, who then brought azerbaijani medical science fame. generally, from 1920 to 1940 hundreds of polyclinics, hospitals and pharmacies were established in azerbaijan. academicians such as mirasadulla mirgasimov and mustafa topchubashov, and professors such as alibey alibeyov, kamil balakishiyev, and others were world-famous scientists and doctors of azerbaijan. medicine in the republic of azerbaijan in the first years of independence, the situation in healthcare was very bad in azerbaijan. the government could keep the healthcare system standing just with the support of international organizations. the necessary medical equipment, lack of medicine was a great problem. a new stage in the development of medicine began after azerbaijan acquired independence. more than 10 laws were established in the sphere of health-care. in march 1998, heydar aliyev, former president of azerbaijan, signed a direction “about establishment of state committee of reforms in the sphere of health-care”. unique state policy was established in the country and the quality of medical service of the population was also improved.as soon as healthcare programs which were included repair and rehabilitation of medical institutions, providing them with equipment, provision and treatment of citizens with free medicines and preparations, diagnostic centers in the regions, in particular coverage of children with all medical services were accepted. today medical centers and modern pharmaceutics industry of azerbaijan is created at a level of world standards. a national plan against illnesses such as hiv/aids and tuberculosis is developed in the country. in 2001, a direction about the celebration of june 17 as a holiday of healthcare employers was signed. in 2004, azerbaijani association of medicine historians which was included in the international union of the history of medicine headquartered in paris, in 2005, was established. the first national conference of the association was held on february 1–2 of the same year in baku. in recent years heydar aliyev foundation has launched a number of projects on the treatment of diabetes, thalassemia, blood donation campaigns, and the protection of maternal and child health. about 870 private medical companies and 2,300 pharmaceutical organizations operate in azerbaijan. the health system in modern azerbaijan includes mainly primary healthcare, outpatient, and inpatient services. in 2012–2013, 11 priority healthcare programs with a total amount of 387.7 million manat were implemented in the country. in 2013 the amount of funds allocated to the healthcare system from the state budget has been increased 11 times compared to 2003. on the basis of this growth, up to 500 healthcare facilities were created or renewed. the range of the most important medicine supply has been increased from 60 to 166. over the past 10 years, the mortality rates have decreased; the natural population grows increased. within the framework of the "health month" disease prevention campaign organized by the ministry of health in december in 2012 under the slogan "for a healthy life” medical institutions that carry out prophylactic examinations have been provided with the necessary equipment and reagents, 3 million patients were checked and treated accordingly. m. topchubashov scientific surgery center carried out open heart surgery for adults and children for the first time in these years. in the republican clinical urology hospital named after m. javadzade kidney transplantation has been started in early 2000. in order to treat patients with chronic renal failure, more than 2,000 patients are receiving hemodialysis sessions in 27 centers and are provided with appropriate medications. measures have been taken to improve the quality of medical services provided to mothers and children. if the infant mortality rate in the country was 16.7 in 2003. in 2013 this figure was 10.8. the maternal mortality ratio decreased from 18.5 to 14.9, compared to 2003. according to the law "on education", the training of physicians in the country is carried out through residency, accepted in the medical education system of most countries of the world. in 2012 about 500 doctors were admitted to residency in various specialties passing through the state commission on student admission. besides, in 2009–2012, 451 doctors and midwives have been trained in private and state clinics in foreign countries for 3–6 months. refresher training sessions were organized in baku with the participation of specialists from different countries and 1363 participants have gained practical knowledge in these training sessions. since 2003, 12 relevant decisions have been established to increase the salaries of medical workers. within the framework of the "electronic azerbaijan" state program "citizen's electronic health card" has been launched. there are currently about 10 registrars of various diseases, a single registry of cadres, an electronic surveillance system of infectious diseases, drug circulation, a dispatching service of an emergency medical station, and others. the ministry of health has provided 38 e-services. the "electronic services" section has been created on the official website of the ministry and there are 11 electronic services. the ministry of health cooperates with about 40 countries. in addition, the sanitation and epidemiological service development program for 2015-2020 has been developed, which took appropriate measures to prevent infectious diseases. an action plan covering 2013–2020 on combating non-infectious diseases (such as tobacco smoking, obesity, physical activity, alcohol use disorder, etc.) and national action plan on early prevention and treatment of childhood disorders (2014-2020) have been implemented. in 2009, a new approach was introduced which seeks to define the number and type of staff needed in the system based on demographic criteria. in july 2009, the government issued a new law on education. within the framework of the law on education the ministry of health had to prepare a draft law on medical education by october 2009. the azerbaijan medical university is the only provider of undergraduate medical education in the country. several unlicensed private medical schools operated in the late 1990s and early 2000s, but they all were closed by the ministry of education by 2005. in 2013 about 1020 medical students are enrolled annually in 8 departments. the department of human resources, education and science of ministry of health, organizing the planning of health staff, provides data on vacancies in health facilities. in accordance with data on vacancies the ministry of health asks the azerbaijan medical university to provide them with medical staff. the university sends graduates to the relevant specialty internships. the planning of nursing and midlevel healthcare personnel also follows the same process. since february 1, 2008 governmental medical institutions show a gratuitous medical aid to population, by a direction signed by ogtay shirinov, a minister of health-hare of azerbaijan. in november, 2009, azerbaijani doctors performed the first operation in heart for prevention of arrhythmia. 43 new hospitals and diagnostic centers, 46 outpatient polyclinics, 4 restoration centers for disabled persons and 12 diagnostics and health centers were put into operation during the last years. 30 medical institutions and 5 polyclinics are to be constructed in 2013. indicators of longevity and birth rate have improved because of the development of the medicine in the country. medical training there are eight nursing schools in azerbaijan which closely cooperate with the ministry of health. being a nurse does not require higher education. candidates may become a nurse by graduating from a nurse training school. graduated nurses are presented with vocational diplomas. in 2008, the total annual admission to all nursing schools was 1950. postdiploma education for nurses is provided through three nursing schools located in baku, ganja and mingechevir. depending on the specialty, refresher trainings are required every five years. the course duration is from five days to two months. in 2008, approximately 2200 nurses completed these trainings. physicians should participate in refresher trainings every five years that organized by the azerbaijan physicians’ advancement institute. in 2008, more than 2700 physicians attended various refresher trainings organized by institute. at the same time international organizations such as unicef, unfpa, who, usaid, etc. also organized and funded various trainings on maternal child care, primary care and emergency medicine, family planning and reproductive health, primary care and public health, and others. the trainings lasted from 22 months to 30 months depending on specialty profile. sanitary-epidemiological service public health services are provided by different agencies, including the sanitary-epidemiological service, public health and reforms center of the ministry of health, the national hiv/aids center and other structures. the sanitary epidemiological service defines sanitary and hygienic norms and regulations include drinking water, sanitation, living and workspace hygiene, food hygiene such as production, distribution, storage, sale and handling of food products, occupational and environmental hygiene, and radiation hygiene. the activity of the service also include control over state sanitary surveillance and epidemiological investigation, social-hygienic monitoring, preventing and eliminating infectious and parasitic diseases and food poisoning, planning sanitary-hygienic and anti-epidemic activities, reviewing the sanitary-epidemiological situation, controlling quality of environment, physical development of and morbidity among the population, implementing programs on health of the population. the sanitary epidemiological service consists of two structures: sanitary epidemiological surveillance inspection service and hygiene and epidemiology center. the first one controls the activity of the specialized hygiene and epidemiology centers as well as carries out implementation of state sanitary surveillance. hygiene and epidemiology center provides organizational-methodological supervision in about 83 district and city. the center is responsible for the hygiene and epidemiology of water transport. pharmaceutical sector since 2006 pharmaceutical sector operates actively. this sector is adjusted on the laws on pharmaceutical activity and products, circulation of narcotics, psychotropic substances and their precursors, establishment and activity of a pharmacy, analytical