The development of PPP, which is one of the most effective tools for implementing infrastructure projects through the attraction of extrabudgetary financing and the quality management of the private sector, is becoming relevant in the framework of the state policy of the Government of the Republic of Kazakhstan.

In accordance with Article 27 of the Law of the Republic of Kazakhstan "On Public-Private Partnership", the state bodies participate in public-private partnerships, including by granting rights to use state-owned property for the purposes of implementing PPP Projects.

State bodies participate in the PPP Project in the form of providing state support measures in accordance with the legislation of the Republic of Kazakhstan, including by ensuring the consumption of a certain amount of goods, works and services produced during the implementation of the PPP project.

The state partner involves the Private Partner to execute the PPP project and as sources of cost recovery and revenue generation there are following opportunities:

- compensation of investment costs;

- compensation of operating costs.

Thus, in order to implement the project "Modernization of Health Facilities in Pavlodar Region with equipment for anesthesiology, resuscitation and intensive care departments", Diagal Limited Partnership acted as a private partner, which signed the Public Private Partnership Contract for installation and maintenance of 72 pieces of medical equipment (26 anesthetic respiratory apparatus and 46 ventilators) manufactured by Drägerwerk AG & Co. KGaA (Germany) at 12 Health Facilities of Pavlodar Region.

The main economic benefits to put this PPP project in practice are as follows:

- simultaneous provision of high-tech medical equipment;

-guarantee to provide the required spare parts as per manufacturer's prices;

- 5 years warranty maintenance of 72 units by qualified specialists.

The project executed as per PPP scheme has the following advantages in comparison with other possible project implementation schemes(budget financing, state loan and others):

Advantages for the Public Partner:

- improvement of the medical services quality;

-increase in the level of equipment with high-tech medical equipment;

- reduction of such a socially significant indicator as mortality.v

Advantages for the Private Partner:

- Opportunity to expand and diversify his/her business;

- Reimbursement of investment and operating expenses by the Public Partner.

Today, Diagal LLP has successfully supplied and installed 72 pieces of medical equipment in 12 medical organizations in the Pavlodar region. In March, all medical equipment was transferred to state property by the Private partner. The warranty service phase has started and will last until the end of 2022.

GLOVAATSKAYA Inna Vladimirovna, the chief parttime anesthesiologist-resuscitator of UZ of the Pavlodar region.

The anesthesiology and resuscitation services are front-line in medicine. The intensive care unit serves the patients in severe state, whose functions of one or several organs are decompensated or lost: lungs, heart, kidneys, etc. Treatment of these patients requires the replacement of these organs with special equipment: devices for artificial lung ventilation, hemodialysis and artificial blood circulation. There are new safe ventilator devices that allow to carry out lung ventilation for a long time without harm to the patient. The old apparatus, when used, caused a lot of complications and delayed the recovery process. As the chief specialist of the region in terms of my background, I travel to all districts and hospitals of the city for consultations of serious patients, I can say that even the Anesthesiology, reanimation and intensive treatment department of large hospitals in the Pavlodar region are not fully equipped. Until now, there was a deficit of even the most necessary equipment – ventilators, NDAs and monitors. The deficit in this equipment averaged 50%. In 2017, 72 NDAs and ventilators were purchased for hospitals thanks to the existing PPP program, with the support of the Head of the Pavlodar region, the Department of Healthcare. This allowed almost completely to meet the need for hospitals in the missing equipment. For example, 11 similar devices were delivered to the city hospital No. 1. The choice Dräger (Germany) equipment is explained by high reliability, durability, compliance with modern requirements and good maintenance. In Kazakhstan, Diagal (Astana) is a distributor of Dräger Medical GmbH (Germany)."Diagal" company not only installs the equipment, but renders services at all stages of maintenance from installation to emergency repair, and fulfills our requests for hardware maintenance in a short time possible. All equipment presented bythis companybelongs to the latest developments in the field of medical technology. Thanks to the company, a 3-day training master class was held by Furmanchuk D.P the specialist from the Republic of Belarus, freelance consultant of the Dräger representative office, candidate of medical sciences. On the basis of the cardiological center, more than 70 anesthetists-resuscitators doctors from the Pavlodar region were trained.

KAZHBAEV Bakhtiyar Amangeldinovich, director of Diagal LLP.

Diagal LLP is an authorized distributor of medical equipment Drägerwerk AG & Co. KGaA (Germany) and its authorized service center with the right of service and technical support in the territory of the Republic of Kazakhstan.

The main profile of our company is equipping the departments of anesthesiology, resuscitation and intensive care, as well as departments of neonatology, emergency and urgent medical care with medical equipment manufactured by Drägerwerk AG &Co.KGaA.

Drägerwerk AG & Co. KGaAis the world's largest manufacturer of medical equipment for anesthesiology, resuscitation and neonatology, occupying leading positions in the manufacture of anesthesia, respiratory apparatus, artificial lung ventilation, patient monitoring systems and equipment for neonatology, medical consoles or architectural systems along with hospital centralized supply chain with medical gases.

The whole equipment manufactured by  Drägerwerk AG & Co. KGaA, represented by us in the market of Kazakhstan, belongs to the latest developments in the field of medical technology, in other words – to the category of HiTech products. Therefore, Diagal LLP is aimed at introduction and supply the medical and preventive and diagnostic medical institutions of the Republic of Kazakhstan with new technologies by implementing modern high-quality medical equipment, providing integrated solutions for equipping and monitoring systems that include indication, storage and transfer of data and qualified assistance in staff training through the training seminars, master classes, providing full information about the equipment and its operation.

The main principle of Diagal LLP is satisfaction and consumer confidence based on personal and collective responsibility, high qualification of employees, rational management, reliability and quality of the equipment supplied, and providing quality warranty and after-sales service. It should be noted that the service department of Diagal LLP consists of qualified service engineers who annually attend training at the manufacturer  Drägerwerk AG & Co. KGaA.

The fruits of Diagal LLP for today are fruitful cooperation, successful and kind relations, reliable partnership with many medical institutions of the republican, regional and city level.

One of the important factors is the stable financial state of the company. Timely planning of inflation and currency risks allowed the company to withstand the devaluation period in the country and keep the customers and not to disrupt the contractual obligations.

To date, the company fully covers its production costs and is financially sustainable. These are the exact criteria that enabled our company to successfully prove itself as an investor within the framework of the public-private partnership project in the Pavlodar region.

What is the reason behind for our decision to take part in an investment project based on the principles of public-private partnership?

Obviously, the very process of making any investment decision is never easy. And besides,this mechanism of interaction with the statewas new for us. And only with a clear understanding of who will be our partner, what legislative base in this area, what are the risks and responsibilities of all parties, we decided to act as a private partner in the project of the Health Department of Pavlodar region called "Modernization of Health facilities of Pavlodar region with equipment for the anesthesiology, resuscitation and intensive care departments".

Thus, in October 2017, the Public-Private Partnership Agreement was signed for the project "Modernization of Health facilities in Pavlodar region with equipment for anesthesiology, resuscitation and intensive care departments", according to which in January 2018 Diagal LLP, acting as a private partner in the private financial initiative supplied 26 anesthesia breathing apparatus and 46 ventilators manufactured by Drägerwerk AG & Co. KGaA (Germany) for twelve subordinate organizations of the Public Health Administration of Pavlodar region as well astraining of medical personnel at sites. And already in early March, we successfully passed and completed the procedure for transferring medical equipment to the state ownership holders (medical organizations of the Pavlodar region). At the moment, the PPP project is at the 5 years warranty service stage since the date of commissioning of medical equipment.

The main goal of our participation in the PPP project is to provide the public healthcare system of the Republic of Kazakhstan with medical equipment of the highest level so that the medicine really works to improve the quality of life of patients.

In particular, the PPP project with the Public Health Department of the Pavlodar region is aimed at improving the quality of equipment for anesthesiology, resuscitation and intensive care units of medical institutions in the region equipped with modern and innovative equipment for providing timely emergency medical care, including influencing the decline in lethal outcomes of newborns and parturient women as well as the patients who need emergency resuscitation assistance.