According to the new UNAIDS Global Report on the Global AIDS Epidemic, the world is making significant but dramatically uneven progress, especially in expanding access to antiretroviral therapy. At the same time, the COVID-19 pandemic also had a significant negative impact on the achievements of the countries of Eastern Europe and Central Asia in the fight against HIV/AIDS over the 30 years of the epidemic.
According to the report, Eastern Europe and Central Asia remain one of three regions where the HIV epidemic continues to grow. Therefore, there is an urgent need to scale up HIV services, especially in the Russian Federation.
The report also highlights a large gap between HIV testing and treatment initiation. Only 63%* of people living with HIV who know their HIV-positive status in the region are being treated. And only 41%* of all people living with HIV in the region have suppressed viral load.
The “Seize the Moment” report warns that the HIV response could be slowed down for another 10 years or more if the COVID-19 pandemic seriously disrupts HIV services.
“We cannot say that COVID-19 has become a calm time for the workers of nongovernmental organizations that provide HIV services. On the contrary, the coronavirus has thrown sharper light on health issues in society, and the current period should definitely be a time to take action. Enhanced action in response to HIV. We must work faster, better, and, obviously, for less money, – says Tetiana Deshko, Director of the International Programs Department of the ICF “Alliance for Public Health”, says, – I am sure it is high time to mobilize in order to achieve the key global community goals on AIDS”.
The UNAIDS Global Report emphasizes that it is important for countries to double efforts and act urgently to reach the millions of people still left behind. At the same time, it is worth paying attention to the catalytic regional NGOs that promptly adapted their work in the EECA region in the context of a double challenge to maintain the sustainability of the services provided for people from key populations who badly needed it from the very onset of the coronavirus crisis.
“It is infinitely gratifying that civil society organizations were able not only to continue their work to combat HIV infection, to make the situation safer in order to reduce the risks of COVID-19, but their responses also became responses to the new COVID-19 challenges”, Mrs. Deshko says.
The Alliance for Public Health, UNAIDS and the Asian Association of People Living with HIV have started collecting stories of vibrant, decisive action taken by nongovernmental and government organizations in the EECA region. Today, nearly 60 stories from around the world illustrate this critical work on the interactive online Community Initiatives Map. Any organization or initiative group can send their story, just filling out the form on the website.
Tetiana Deshko also noted that after analyzing the work performed under a double challenge, the Alliance for Public Health team saw that COVID-19 not just complicated the work, but the crisis made them focus on the clearest, most systemic methods of providing HIV care.
“We found out that there are a number of HIV service recommendations following COVID-19, and we should adhere to them after the peak of the pandemic. In particular, we saw that distribution of substitution therapy drugs for injecting drug users, who account for almost half of new HIV cases in our region, was provided at home for long periods, which could both reduce the cost of providing this service and make it more patient-oriented”, Tatyana said. “We saw that distributing the sufficient number of consumables — including syringes, condoms, and tests, for longer periods also helped people to stock up on consumables and practice safer behavior”.
Online work becomes crucial throughout the world. Online counseling on safe behavior, response to crisis situations, introduction of the practice of using test vending machines, syringe vending machines, dispensing antiretroviral medications for a longer period, sending medicines by mail are crucial. According to Tatyana Deshko, all these steps enabled implementing HIV services and reduce the risk of COVID-19. “We must continue them in the future”, she emphasized.
“We tried to monitor the human rights situation using a special database – an online system for documenting, online monitoring and immediate response to violations of the rights of key groups and HIV-positive people (REAct). We worked in 5 countries: Ukraine, Tajikistan, Georgia, Moldova and Kyrgyzstan, where we observed the situation with the rights of key populations. Unfortunately, we have noted many cases of violation of these rights, while more than a hundred cases of violation of rights were recorded in the first 6 months”.
The situation is different in these countries, but it is still the law enforcement agencies who are responsible for the most cases of the key population rights violations, Ms. Deshko notes. The health officials keep the second place. Key populations, people living with HIV, often face cases of humiliation or violence. This is the analysis that is very clearly outlined in the UNAIDS report, showing that the issue of respect for the human rights of key populations is one of the main obstacles in the response to the HIV and COVID-19 epidemic.
We contacted experts from Kyrgyzstan, Moldova and Ukraine, the leaders of NGOs or projects who have recovered from coronavirus infection and asked what needs to be done so that people could cope with HIV and COVID-19. And that’s what they answered.
Aybar Sultangaziev, Chairman of the Partnership Network Association (Kyrgyzstan): “The catastrophic unpreparedness of healthcare systems, lack of supplies of medicines and medical equipment lead to high mortality and disability of the population due to COVID-19. This is happening against the background of hugely inflated public procurement prices, limited funding and a complete lack of forecasts of the situation development. All this is forcing civil society to take the initiative and, in fact, stand up against the storm of the epidemic. Studying the world experience in treatment and the subsequent promotion of improvement of treatment regimens also apparently concerns only the civil sector, while meeting resistance from conservative specialists”.
Yevgeniy Aleksandrovich Goloshchapov, Director of the Advocacy Department, CSO “Positive Initiative” (Moldova): “We have identified two threats: due to problems with supplies, medicines stocks may run out and people will have no treatment, and due to the economic crisis, it is possible that tomorrow there will be no funds to buy medicines. In this situation, NGOs need to develop broad partnerships to ensure continuous access to treatment, as well as for transparency and efficiency in the use of resources“.
Nataliya Nesvat, Chair of the Board of CO “100% Life” branch in Cherkassy (Ukraine): “In parallel with COVID-19, HIV and TB epidemics continue to grow, and in this situation the role of strong NGOs and communities is more important than ever. After all, it is the people affected by HIV and TB who are trapped in the cut-off from necessary services: diagnostics, hospitalization, timely receiving of HIV medications, other medicines and food. But, along with this, NGO workers, more than anyone else, must understand their full responsibility and adhere to all precautions to minimize the risk of COVID-19 infection. Otherwise, access to vital services and, possibly, to the last hope will be lost”.