Integrating the Sustainable Development Goals into Health Professions Education in Central Asia and the Post-Soviet Space: A Scoping Review

Every year, the world agrees on a set of seventeen goals designed to fix our planet's biggest problems, from ending poverty to protecting the environment. These are the Sustainable Development Goals. One of these goals is specifically about health, but the other sixteen goals—like clean water, clean energy, and climate action—also deeply affect how healthy people are. For decades, the people who train future doctors and nurses have focused almost entirely on treating sickness once it appears. However, a growing number of experts now believe that to truly protect health, medical schools must teach students how to prevent illness by understanding the environment and society. This means training a new kind of health worker who can see how a changing climate or a polluted river makes people sick, and who knows how to fix those root causes.

This shift is happening around the world, but it is moving at very different speeds in different places. A new review of the literature focuses on a vast region that has rarely been studied in this context: the fifteen countries that were once part of the Soviet Union. This area stretches from the Baltic Sea in the north to the mountains of Central Asia in the south. These nations share a common history of medical training that was built on a specific model: teachers lecture, students listen, and the curriculum is divided into strict, separate subjects. The researchers wanted to know if this old system is changing to meet the new global goals, or if the region is being left behind as the rest of the world adapts.

To find the answer, the researchers, led by Sevara Mirkhamidova, did not conduct a new experiment. Instead, they acted as cartographers, mapping every piece of written evidence they could find about this topic in the region. They searched for documents published between 2015 and 2025, looking for anything from official government policies and university reports to scientific studies. They cast a wide net, searching in both English and Russian to ensure they did not miss important local work. They looked for any mention of the Sustainable Development Goals, climate change, or environmental health within medical, nursing, and pharmacy education across all fifteen post-Soviet countries.

The search revealed a landscape that is surprisingly empty. Out of more than a thousand documents found, only forty-two were relevant enough to be included in the final analysis. The most startling discovery was the type of information available. Only four of these forty-two sources were actual scientific studies that measured what students knew or how well they could apply new skills. The vast majority of the documents were simply statements of intent. Universities and governments had written declarations saying they planned to integrate these goals, or they had published policies promising to do so. But when the researchers looked for proof that these promises had turned into real classroom changes or that students had actually learned the material, the evidence was almost entirely missing.

The few countries that did have some data were Russia, Kazakhstan, and Uzbekistan. Together, these three nations accounted for more than seventy percent of all the information found. The other twelve countries, including some of the most vulnerable to climate change in the region, had no documented evidence of any educational activity related to these goals. This created what the author calls an "evidence desert." In nine of the fifteen countries, there was simply no record of any effort to teach future health workers about the link between the environment and human health.

Even in the countries where some activity was recorded, the researchers found a deep divide between what was said and what was done. Universities in Kazakhstan and Uzbekistan had launched programs with names like "SDG Ambassadors," and some Russian medical schools had added new courses on global health. However, these initiatives were often small, optional, or limited to a few students. More importantly, the teaching methods used in these programs often clashed with the goals they were trying to teach. The region's medical education is still heavily based on the old Soviet model, where a teacher stands at the front of a large hall and delivers information to passive students. This style of learning is very different from what is needed to understand complex environmental problems, which require students to work together, solve real-world puzzles, and think critically about systems.

The review identified several major hurdles that are stopping progress. First, there is a shortage of teachers who know enough about the environment to teach it. Most current medical professors were trained in the old system and have never studied climate change or sustainability themselves. Second, the existing medical curriculum is already packed with information about biology and disease, leaving little room to add new topics. Third, many schools, especially in rural areas, lack the basic technology and resources needed for modern, interactive learning. Finally, there are no national rules forcing medical schools to include these topics. Without a requirement from the government, these changes remain optional and easily ignored.

Despite these challenges, the researchers found reasons for hope. In the few places where students were asked about their views, they expressed a strong desire to learn more about these issues. They are a generation that is already aware of climate change and wants to be part of the solution. The review also highlighted a few successful pilot projects, such as a green health initiative in Kazakhstan and new elective courses in Russian universities, which show that change is possible.

The author concludes that the region is at the very beginning of this journey. They propose a five-step plan to move forward. This plan calls for governments to make sustainability a required part of medical training, for universities to train their teachers in these new subjects, and for students to be active partners in redesigning their own education. They also suggest that these countries should work together to share research and partner with international organizations to get the resources they need. The window of opportunity is open, but it will require a significant shift in how these nations think about training their future healers. Without this change, the next generation of doctors and nurses in Central Asia and the post-Soviet space may be ill-equipped to handle the health challenges of a warming world.