On September 27, 2021, from 09.30 to 12.30 a Round table “Accelerating the response to the HIV / AIDS epidemic in Osh city” will be held in Osh city (Kyrgyzstan).
The Kyrgyz Republic, along with other UN members, joined and is implementing the “Political Declaration on HIV and AIDS: On the Fast-Track to Accelerate the Fight against HIV and to End the AIDS Epidemic by 2030”.
The event organized with the support of the Alliance for Public Health and the Regional Project “Sustainability of Services for Key Populations in the Eastern Europe and Central Asia Regions” (#SoS_project) and will be attended by invited guests who will share their experiences and strategies in relation to COVID, drug policy, as well as harm reduction to health and society against HIV, tuberculosis and social disintegration.
On the Round table will be presented data the implementation of the city’s HIV program and state social contracting in Osh city. The event will host participants from international organizations, deputies of the сity, Kenesh of Osh city, representatives of law enforcement agencies, heads of medical institutions, local offices, non-governmental organizations.
Among the speakers:
Almaz Mambetov, Mayor of Osh city
Jakob Huber, Senior Partner Licit
Andriy Klepikov, Alliance for Public Health
Ravshan Mazhitov Director of the Plus Center Foundation
Aibar Sultangaziev, Partnership Network Association
Akylbek Mamaseyitov Head of the Internal Affairs Department of Osh city
Gulgaky Mamasalieva, Director of Interbilim Osh
As well as other representatives of departments, international and non-governmental organizations.
On September 14, 2021 Alliance for Public Health, within the Sustainability of Services for Key Populations in EECA regional project (SoS_project) in collaboration with IAS – the International AIDS Society will launch Regional Dialogue on Progressive Approaches to HIV Diagnostics and Treatment in Eastern Europe and Central Asia (EECA) and Balkan countries.
This Dialogue is organized for the civil society representatives and governments who are involved into the AIDS response, as well as researchers, community, activists and policy makers from both regions with the aimto demonstrate operational research (OR) results, focusing on lessons learned and recommendations for implementing similar interventions in other countries in the region. Also, the participants will get ad hoc data on assess the situation in the region with the implementation of the latest recommended approaches to diagnosis and treatment, with an emphasis on the interventions that have been piloted within the ORs, identifying key action points/next steps/road maps for the countries of the region to improve the situation and achieve results on the implementation of interventions, as well as possibility to improve corresponding exchange of experience – information and technical support.
Languages: English and Russian (simultaneous translation will be provided)
We are pleased to announce that The International Charitable Foundation “Alliance for Public Health” is organizing a competition for the media “Drug Addiction vs. Drug Policy: problems and solutions in Ukraine” for the second year in a row. We invite the journalists of national and regional mass media to take part in the competition for the best journalistic materials on the drug policy and protection of the rights of people who use drugs/patients on substitution maintenance therapy (SMT). The activities will include visits to the regions of Ukraine and training events for the journalists.
The application can be submitted by the authors/editors or editorial teams who have published (or aired) their news/articles/videos/posts fromJanuary 1st to November 12th, 2021.
The All-Ukrainian competition for the media was created to inform the people of Ukraine about modern prevention and treatment techniques for people who use drugs with an emphasis on the peculiarities of introduction and expansion of SMT in medical institutions, increasing access for people who use drugs to comprehensive services of the national program on HIV/AIDS and hepatitis C prevention, tuberculosis, problems of observance of the human rights.
The urgency of reforming and liberalization of the national repressive drug policy of Ukraine, as well as the decriminalization for people who use drugs on practical successful examples of such work in Ukraine and effective practices of developed countries, are the priority tasks of the competition.
The jury, which will include well-known Ukrainian editors and journalists, as well as public activists and representatives of the Alliance, will determine one winner in each of the following categories:
Television and radio
Printing press
Online edition
Blogging
The winners of the journalist competition will receive diplomas and incentive prizes. In addition, this competition provides individual awards for initiative materials, such as a series of texts/articles/videos/posts, the creation of special projects, the collaboration of several editions, and so on.
Requirements for competitive works:
Texts/articles/videos/posts can be prepared in any language of national minorities with a translation into Ukrainian or Russian.
Publications should reflect Ukrainian realities and, preferably, contain references to the best world practices, demonstrate the real state of affairs with an emphasis on ways to solve these problems.
The jury will give preference to well-reasoned texts/articles/videos/posts, which prove the need to expand the access of people who use drugs to substitution maintenance therapy and promote their decriminalization on the examples of the best world practices. The focus should be on countering organized drug trafficking, not on stigma or discrimination against people who use drugs.
The publications may also cover certain aspects, such as women who use drugs and its taboos in Ukrainian society, changes in the drug scene and adolescent addiction with an emphasis on synthetic drugs, and so on.
All materials submitted by media representatives must be original and free of plagiarism.
One author (editorial team) can submit an unlimited number of works to the competition.
he best materials will be published on the information resources of the ICF “Alliance for Public Health”, so when applying to the competition, the authors automatically allow such publications.
The Second All-Ukrainian competition for the media “Drug Addiction vs. Drug Policy: problems and solutions in Ukraine” is part of the project “Accelerating Progress in Reducing the Burden of Tuberculosis and HIV in Ukraine” implemented by ICF “Alliance for Public Health” with the support of The Global Fund to Fight AIDS, Tuberculosis and Malaria.
We invite you to join the #Open_dialogue on preparation Regional funding proposal under the Global Fund’s COVID-19 Response Mechanism (C19RM), EECA and SEE countries.
The dialogue will take place at ZOOM on May 21, 2021 from 11:00 to 13:00 Kyiv time (EEST/UTC +3).
The program of the event includes a presentation of the concept and a 1.5-hour discussion of priorities for communities of key groups in the region and PLHIV.
All interested organizations, representatives of key groups, activists and experts are invited to participate. Everyone will have the opportunity to take part in the discussion.
To participate in the Open Dialogue, fill out the registration form: https://cutt.ly/IbKnARi
All registered will be sent the program of the event and a link to zoom to participate.
On April 22, Medical Patent Pool (MPP) announced that it signed sublicence agreements with pharmaceutical companies Hetero and Viatris (through its subsidiary Mylan), to manufacture and supply dolutegravir (DTG) and DTG-based regimen to Azerbaijan, Belarus, Kazakhstan and Malaysia.
Sergey Filippovich, director of #SoS_project at the Alliance for Public Health: “In the countries of Eastern Europe and Central Asia, the region with the greatest HIV treatment deficit and limited resources, this is a real breakthrough. Now even more people will be able to receive the latest innovative treatment and significantly improve the quality of their health. In this example of cooperation, we see that through joint efforts, access to effective ART will be expanded. And our work with the partners of the regional project to build the sustainability of HIV services continues. ”
In late 2020, ViiV Healthcare (the manufacturer of the delusional drug) and MPP signed a licensing agreement for these four countries, aimed at expanding access to generics of dolutegravir and ensuring a lower cost of the drug.
“We are delighted that more people living with HIV in the four countries will soon be able to access DTG-based regimens, especially TLD (tenofovir disoproxil fumarate/lamivudine/dolutegravir), the first-line regimen recommended by the World Health Organization (WHO), which will now be available in these countries in a single pill,” says Charles Gore, Executive Director of MPP.
An official press release from MPP indicates that Hetero and Viatris (through its subsidiary Mylan) were selected following a rigorous and impartial selection process. They are longstanding partners of the Medical Patent Pool and have a proven track record of developing, manufacturing and supplying essential medicines to countries around the world, including low- and middle-income countries. “As Hetero and Mylan have already received approvals for DTG and TLD from the U.S. Food and Drug Administration and WHO prequalification, they will be able to supply these much-needed products rapidly to the four countries. A third generic manufacturer is in the process of being selected.”
On April 27, 2021, from 11:00 to 12:30 (CEST, UTC +2 or from 12:00 to 13:30 EEST, UTC +3), an online discussion will be held “The Balkans’ response to COVID-19: experience of #SoS_project partners”.
This is the second in a series of events to discuss the COVID-19 response in EECA and SEE countries. The main goal is to share experiences to improve the regional response to the pandemic.
The first online discussion took place on April 7, 2021 with the presentation of research reports on the impact of COVID-19 on HIV and tuberculosis programs. More than 120 people from 15 countries took part in the event. To view the reports, go to the Alliance for Public Health library >>>
Event agenda:
11:00-11:05 – Opening remarks
11:05-11:20 – Andrej Senih, Executive Director of Stronger Together (North Macedonia) Maintaining essential HIV services and introducing new ones in Covid-19 time
11:20-11:35 – Aida Kurtovic, LLB, MA, Executive Director of the Health Partnership (Bosnia and Herzegovina) Innovation in COVID-19 response
11:35-11:50 –- Goran_Radisavljević, CEO, Timok Youth Center (Serbia) COVID-19 case detection and vaccination – implementation strategy and challenges
11:50-12:05 – Sanja Šišović, program director of NGO CAZAS (Montenegro) Access to HIV prevention, testing and treatment during COVID 19 epidemic
12: 05-12: 20 – Dr. Fifa Rahman, principal researcher of the Matahari Global Solutions (United Kingdom) Results of the study on the impact of COVID-19 on the sustainability of HIV and TB services (accent on Balkan)
12: 20-12: 30 – Q&A session.
On April 14, 2021, from 15:10-16:00 (EEST, UTC +3) or 14:10-15:00 (CEST, UTC +2) , a side event will be held during the 64th session of the UN Commission on Narcotics: “Critical situation with rights violation of women using drugs in Eastern Europe and Central Asia: immediate action required”.
Description:
1. Presentation of cases regarding violation of rights and violence against women who use drugs collected through the REAct database in 5 EECA countries (Georgia, Kyrgyzstan, Moldova, Tajikistan, Ukraine). Alliance for Public Health
2. Regional overview of problems and recommendations for organizing services for women who use drugs and violence. EHRA, in cooperation with UNFPA
3. Assessment of problems by the community of women who use drugs and women living with HIV. Eurasian Women`s Network on AIDS
4. Police response: the experience of the Ukrainian system “Polina”. National Police of Ukraine
5. Community responses. The WINGS project (Kyrgyzstan) See Agenda>>>
We at the Alliance care about the safety of our partners who are #AlwaysAtFrontLine and of clients of HIV prevention projects!
Considering another upsurge in COVID-19 incidence and another lockdown all over the country, Alliance for Public Health has made an urgent procurement: 4 mln medical masks, 47 thousand litres of a disinfectant, and 300 thousand pairs of gloves (for the total amount of around UAH 12 mln)!
A significant part of the goods is already on the way to our partner organizations, and we expect that it will fill their need for 2021 — for protecting both personnel and clients coming to receive HIV prevention, testing and confirmation services — thus enabling uninterrupted provision of all the services regardless of the difficult epidemiologic circumstances in the country.
All the procured personal protective equipment have passed state sanitary-epidemiologic examination and received necessary certificates of conformity. Let us take care of our health and of the health of others!
In order to honor World TB Day, which is commemorated annually on March 24, the Alliance for Public Health is calling upon MPs, government officials, public authorities, doctors, scientists, international partners, and civil society to pay particular attention to people affected by tuberculosis (TB) against the backdrop of the spreading COVID-19 pandemic. Time is running out is the slogan that has brought together organizations and activists this year in an effort to focus attention on the commitments made by countries to eliminate TB.
“Do we allow the possibility that the situation with COVID-19 may be here to stay or even get worse over the next 10-20 years? No! The entire world has mobilized to make sure the answer here is a resounding ‘No’! And what about TB? The COVID-19 pandemic has taught humanity how to take concerted action, and we see and know what works and what does not. We need the prioritized policies, the resources, modern treatments, a focus on human needs, and the effective engagement of communities and civil society. Let’s not settle for half measures every year!” points out Andriy Klepikov, the Executive Director of the Alliance for Public Health.
During this past year of living with the COVID-19 pandemic, we have witnessed unprecedented safety and security measures, as well as quarantine restrictions imposed by Ukraine and other countries. We had to find modern and effective approaches to doing our work in the new conditions, which have already demonstrated their efficacy. These include active TB case finding among new vulnerable populations, the widespread introduction of video directly observed therapy for TB patients, and strengthening patient support to maintain adherence to treatment.
Civil society, which has traditionally played a key role in combating TB and has been actively involved throughout the process of TB service delivery, has become a link between the health care system and people affected by TB under COVID-19-related quarantine restrictions. During this difficult period, civil society proved to be a cornerstone of TB diagnosis and continuing care.
Thus, the efforts of the Alliance and its partner organizations have made it possible to maintain the effectiveness of TB treatment at the pre-pandemic level. A sufficient amount of anti-tuberculosis drugs was purchased and delivered to patients. Additionally, at the request of the representatives of the regional TB service, necessary medical equipment was purchased; medical and social workers were provided with personal protective equipment; partners in the regions provided with SARS-CoV-2 antigen rapid test kits.
To facilitate successful treatment outcomes, patients were linked to medical and psycho-social support in 8 regions. This strategy led to TB recovery rates being 91.3% for patients with drug-susceptible TB and 82.4% for patients with drug-resistant TB.
In addition, the Alliance and its partner NGOs continued with their active efforts to identify TB cases among vulnerable populations through screening surveys for TB-like symptoms and using a results-based funding approach. Thus, in 24 regions, nearly 104,000 people from most-at-risk groups were screened, of which more than 97% with a positive screening result were linked to diagnostic services.
A new grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria for 2021-2023 provides for the expanded scope of activities intended to detect new TB cases among most-at-risk groups, including children and residents of areas along the demarcation line in the government-controlled areas of the Donetsk and Luhansk regions. Efforts to support the mental health of people with TB are also underway to help them successfully complete treatment. In a bid for further improving patient rights, a gender-sensitive algorithm is currently being developed for healthcare professionals to counsel TB patients and strengthen patient rights protection in collaboration with TBPeople Ukraine, a charitable organization of TB patients.
The Alliance is continuing its policy-making activity and efforts towards advancing TB political commitments. Thus, on March 17, 2021, at the initiative of the inter-factional parliamentary group called The Parliamentary Platform To Fight TB, which is supported by the Alliance, the Committee hearings on measures for combating TB during the pandemic caused by the SARS-CoV-2 coronavirus were organized and held. However, in order to contain the negative impact of the COVID-19 pandemic on the TB sector, multiple pressing issues need to be addressed as soon as possible. Thus, given the overall decrease in the number of TB cases identified over the last year, which is likely to lead to a spike in the number of complicated cases and an increase in TB-related deaths in the near future, we would like to stress the need for more attention and vigilance on the part of healthcare workers towards TB signs and symptoms. Among the issues that need to be addressed as soon as possible is the development and approval of a plan for the transition from donor to public funding.
We hope that next year these and other challenges will be overcome through our joint efforts.
The Alliance, as always, is ready for undertaking large-scale and decisive action in the fight against TB, and we feel deeply grateful to our partners and donors, civil society and key communities, professional and governmental organizations for the fruitful cooperation in overcoming the TB epidemic in Ukraine!
The Economist Intelligence Unit and the Alliance for Public Health presented a report based on the study “Drug Policies in Eastern Europe and Central Asia: the Economic, Health and Social Impact” in Belarus, Kazakhstan, Kyrgyzstan and Russia. It is the first such study in the region, where researchers analyzed a number of possible scenarios and were able to get impressive findings.
The study points out that reinvesting the total amount of €12.34 bln saved from decriminalizing drug use in the four study countries (Belarus – 431 mln, Kazakhstan – 773 mln, Kyrgyzstan – 38 mln, Russia – 11.1 bln) into scaling up antiretroviral therapy and opioid agonist treatment programs could help to effectively curb the HIV/AIDS epidemic in 20 years for no added cost.
It would, in its turn, make a significant impact on the control over the epidemic in Eastern Europe and Central Asia (EECA) in general, with the following forecasted rates of averted HIV infections: Belarus – 64%, Kazakhstan – 84%, Kyrgyzstan – 69%, Russia – 58%. The study findings are very timely, and the recommendations offered make the case for using such new approaches as the UNAIDS 2020 targets within the 90-90-90 strategy have not been achieved yet in Belarus, Kazakhstan, Kyrgyzstan or Russia. “The previous UNAIDS target to halve HIV among PWID by 2015 was missed by a huge 80%. Continuing on this trajectory will mean also missing the more ambitious target to end AIDS by 2030,” states the report.
The study results clearly show the need to revise the drug policy approaches in the focus countries, but the progress in this direction remains slow, said Dr. Chrissy Bishop, Senior Analyst for Health Policy and Clinical Evidence at the Economist Intelligence Unit. In this context it is important to point out the cost effectiveness of decriminalization approaches. Putting people who inject drugs in jails not only costs a lot to the national budgets, but also leads to the increasing number of new HIV cases.
The report also underlines that because of competing needs, public health interventions for HIV have been low on policymakers’ priority lists, with the allocation of domestic funds to scaling-up HIV prevention programs falling short of demand. Authors of the study think that the national governments should reconsider their approaches because criminalizing the lifestyle of PWID does not make sense as those people are drug dependent and need medical and social support.
“What is striking about these findings is that the savings can be achieved and the HIV infections can be averted in the countries following a shift in resources from criminalization to ART and harm reduction,” underlined Dr. Bishop.
“This report has a tremendous potential to be the basis of our future efforts and it is crucial that the Global Fund is ready to support them. For the EECA countries it is very significant and can serve as a strong incentive to work even more to stop the HIV/AIDS epidemic, using all the possible arguments to advocate for the elimination of repressive drug policies,” pointed out Andriy Klepikov, Executive Director of the Alliance for Public Health.
Decriminalization of drug use saves resources and allows people to live longer lives
Today, Eastern Europe and Central Asia is the only region in the world with catastrophic dynamics of the HIV/AIDS epidemic growth. Thus, since 2010 the number of new HIV cases grew by 72%, while mortality increased by 24%. PWID account for 48% of the new HIV cases in the region. According to 2017 data, only in Russia there are 1,881 mln of people who use drugs.
Drug policies in the EECA countries are quite similar and are first of all characterized with prevailing punitive measures, while public health measures aimed at prevention, rehabilitation, treatment and access to the controlled use of drugs still have lower priority for the national governments.
The main victims of such an approach are PWUD, who first of all are people with a chronic illness who need medical and social support. Instead, PWUD become hostage to the existing approach as the key efforts of the law enforcement agencies are aimed at them and not at the organized drug dealers staying in the shadow.
Authors of the study show that decriminalization and reinvestment of the saved resources in the health sector to support harm reduction programs will lead to the total life years gained by PWID from 17.8 thousand to 2.6 mln in the study countries.
It should be noted that one of the key recommendations presented in the report is addressing stigma and discrimination. “Stigma and discriminatory attitudes towards vulnerable populations need to be stopped. Stigma-reducing workshops which educate the health and law enforcement sector on HIV prevention is a simple yet scarce solution in EECA. The importance of counselling, supporting positive mental health, addressing homelessness, preventing overdose and providing access to sexual and reproductive health services should be central to these educative workshops. Long term solutions require consistent and robust data collection on violence, discrimination and stigma, alongside actively using tools of influence such as shadow and alternative reporting to UN human rights treaty bodies”, states the report.
Catalyzing change
During the online presentation of the study results, international experts, law enforcers, researchers, CSO representatives and health professionals from the focus countries shared their comments. Participants from 20 countries of the world watched the online discussion live.
When discussing the study report, speakers agreed that the presented findings are striking and can be used to advocate for the elimination of repressive approaches in drug policies of the EECA countries. However, they pointed out that rapid change should not be expected.
Michel Kazatchkine, member of the Global Commission on Drug Policy, when commenting on the report, assured that this document with an economic justification of the alternative approaches to drug policies can be used by the UN agencies and national CSOs to advocate for change in the countries. The report clearly shows how modelling can be a significant supportive tool to plan and develop government policies in the long-term perspective. Results of the modeling studies are part of the evidence base, and this is an important consideration both for individual countries and for the region as a whole. Professor Kazatchkine underlined that it is very important that the future policies should be based on cost effectiveness and human rights, especially in Russia, where there is a very strong political and ideologic opposition to transition to safer approaches to HIV prevention in PWID using opioid agonist therapy.
It should be noted that “as OAT is not available in Russia, scaling up needle and syringe programs (NSP) is an alternative solution which would be cheaper than scaling up OAT and ART. It would cost on average €46.5m per year to get 60% coverage of PWID and avert around 14,000 HIV infections per year. What is striking about these findings are the savings and HIV infections averted following such a simple shift in resources from criminalization to harm reduction approaches, something governments cannot ignore,” states the report.
Aleksander Kwasniewski, member of the Global Commission on Drug Policy, gave the example of Switzerland. In the early 1990s, the country had the highest HIV prevalence among PWID, similar to what is happening in the EECA region today. The number of people injecting drugs was growing, they were marginalized by society and harassed by police. Despite having sufficient financial means, the Swiss government decided then to stop using repressive methods, but to initiate a massive scale up of harm reduction services. A large spectrum of treatment and support options was offered to people who use drugs, from rehabilitation to lifetime maintenance, to address the transmission of HIV and other infections. The results were rapid and astonishing. The HIV rate among people who inject drugs fell from 30% in 1993 to under 2% in 2009, while the number of overdoses decreased by 62%. The challenging situation that Switzerland had 20-30 years ago is now repeated in the EECA region, and we can address those challenges in a similar way, by revising the repressive drug policies and reinvesting resources in HIV treatment and harm reduction programs.
According to Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, study on the EECA drug policies can really catalyze the change. Mr. Sands underlined that now it is a very important time to be talking about the HIV epidemic, especially while the top topics for discussion is still COVID-19 and vaccines. Those are the realities that the world is facing. However, it is crucial to speak about the effective measures to fight HIV/AIDS for people to remember that there are other health crises and that actually COVID-19 is making them much worse. We need to get people to think differently. “We can’t afford to do things, which were ineffective or served as barriers to making progress, now is the time to say – that didn’t work,” said Mr. Sands. He also pointed out that there is still a crisis with HIV/AIDS plus the situation is aggravated with COVID-19. It is clear that governments are facing a lot of challenges, but they cannot ignore the alarming dynamics of the HIV epidemic, especially if this issue can be addressed at no added cost as clearly shown by the study findings presented by The Economist.
“This report has a tremendous potential to be the basis of our future efforts. It is very important,” said Andriy Klepikov to wrap up the online discussion “Drug Policies in Belarus, Kazakhstan, Kyrgyzstan and Russia: Presenting the Report by The Economist.” “I would like to point out that this report is something new. We have been talking about decriminalization for many years now. However, in this study we were not raising the question of decriminalization, we asked an open question: “Where can the money come from, if there is no money?” The Economist offered a clear answer to this question. In 20 years, about €12 billion can be saved in four countries with introducing humane drug policies based on human rights and reinvested in ART and harm reduction programs, which will be cost effective. Further advocacy should be based on those arguments. It is only a start of a broad discussion. There are good practices in the countries and we need to strengthen knowledge sharing. We invite representatives of all the stakeholders to join the dialogue and discuss the details of the advocacy strategy to be implemented in the countries. Millions of lives are at stake and now we know for sure the answer to the question how countries can bring the dynamics of new HIV cases under control and achieve 90-90-90 targets without allocating additional resources.”
