On the 26th of July 2019, Alliance for Public Health in partnership with local organizations in over twenty cities of Ukraine held an all-Ukrainian awareness raising event dedicated to the World Hepatitis Day observed on July 28 every year. 

During the event, anyone willing had the opportunity to take a free rapid test for hepatitis C virus at mobile ambulatories, get a qualified consultation from doctors and social workers, read information on transmission paths, specifics of the testing, prevention and treatment of viral hepatitis.

In the nearest time, it is planned to test about 3 thousand people for HCV as a part of the all-Ukrainian event. That number includes 500 people to be tested during the central event in Kyiv near the Peoples’ Friendship Arch, close to the newly opened Bicycle-Pedestrian Glass Bridge.  For this purpose, 4 mobile ambulatories staffed with respective medical personnel were working there today. Results of the anonymous rapid testing were available in 10-15 minutes.

According to preliminary results, 18 of 196 tests (9%) proved positive, including 11 persons (6%) who learnt about their problem for the first time! (the information is updated)

Experts estimate that over 300 million people around the world suffer from viral hepatitis, incl. 71 million people with hepatitis C virus (HCV). Every year, more than one million people around the globe die from viral hepatitis. 

Ukraine is among the “leaders” in terms of incidence of hepatitis B and C in Europe.  According to WHO and national experts, 3% to 5% of Ukrainian population (more than 2 million people) are infected with hepatitis C.  90% of the infected are not aware about their condition, as hepatitis virus can live in human body for years, ruining human’s health.

However, in case of timely diagnosing and beginning of treatment, hepatitis C is not a deadly disease. Modern medications allow successful treatment of most patients.

This is why organizers of the event tried to emphasize the importance of spreading reliable information about viral hepatitis (Know!); draw people’s attention to basic prevention measures (Prevent!); and stress the importance of testing for viral hepatitis, as this is vitally important to prevent late stage disease manifestations (Get tested!). The times when treating HCV was extremely expensive and ineffective have passed — new, effective medications are available now (Get treated!).

Several years ago, Alliance for Public Health implemented a program of highly effective HCV treatment with modern direct-acting antivirals. At the time, they were largely unknown in Ukraine.  Their advantage is in being well-tolerated by patients, causing almost no adverse effects and providing very high effect through a three-month treatment course!

“In the last 4 years, under an innovative pilot project of the Alliance, almost 2.2 thousand people from among the most vulnerable populations in 19 oblasts of Ukraine have received services of diagnostics and free treatment of viral hepatitis C with modern drugs. Thanks to that, 98% of patients have completed the full course of treatment and 95% have been cured. Recently, we have provided HCV testing for 1000 inmates of Ukrainian prisons and further diagnostics and treatment for 50 inmates, of whom 49 have also been cured. Unfortunately, it has been three years since Ukraine had a special state program to fight viral hepatitis, but the resources available for the state now allow completely solving the problem”, said Pavlo Skala, Policy and Partnership Director of ICF Alliance for Public Health.

Continuous work to reduce the prices has now made modern medications affordable for Ukrainians.  The Ministry of Health procures drugs at world’s lowest prices. According to the MoH, the largest batch of HCV drugs in the recent years has been procured and is already being distributed to the regions.  In the nearest future, over 7 thousand patients will be able to receive free innovative treatment involving taking pills daily for three months.

Taking a rapid test for viral hepatitis takes 10 minutes and can be done even at home — for that you need to buy a usual rapid test at a pharmacy. Just keep in mind that a positive result of a rapid test for HCV is not the final diagnosis. You need to see a doctor immediately!

“Know! Prevent! Get tested! Get treated!”

National hotline on viral hepatitis: 0-800-50-33-10 

(all calls are toll-free within the borders of Ukraine)

According to expert estimates, more than 2 million Ukrainians are infected with hepatitis C and over 600 thousand – with hepatitis B.             According to official data of the MoH of Ukraine as of 01.01.2019, there are 82 564 persons in Ukraine with HCV and 23 687 with HBV, which is 5.2% and 3.4% of the estimated numbers respectively. This means that the other infected people are unaware of their diagnosis, as in 80% of cases the disease is asymptomatic.

One of priority activities of ICF Alliance for Public Health is fighting the spread of the epidemic of hepatitis C virus in Ukraine and providing diagnostics and treatment of HCV for vulnerable populations.  Since 2015, it has been the support from the Alliance that allowed hundreds of HCV patients to receive modern treatment free of charge, after which the MoH of Ukraine started procuring similar medications with public budget funds.

Photogallery

On July 15-17, Tbilisi hosts the regional #Advocathon 2019  “Advocacy and HIV”, the first event of this format to be held in Eastern Europe and Central Asia. Eight country teams representing  #SoS_project from Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan and Uzbekistan will get together to develop advocacy plans to ensure the sustainability of HIV services in the EECA region.

The non-standard format of the event will allow to unite the unique experience of representatives of NGOs, governments, the expert community and PLHIV to create innovative solutions to problems in the field of public health financing and HIV-prevention projects in the EECA region.

Sergey Filippovich, Director of the regional  #SoS_project at the Alliance for Public Health: “This is one of the key activities of #SoS_project in the context of budget advocacy building the understanding of the problems we are facing and supporting the public sector to mobilize national resources. To support advocacy efforts of countries we will direct all available resources, including regional information campaign to be launched in autumn. The main goal of the information campaign is to change the format of communication and build a new history of dialogue between the state and the civil sector.”

It should be noted that the teams will consist of representatives of NGOs, associations of HIV-positive people, community-led organizations, key groups representing participating countries, as well as representatives of the public sector.

Dmitry Sherembey, Head of the Coordination Council of the CO “100% Life”: “Here we gathered the leading experts in the field of HIV / AIDS from the EECA region, who do very important work every day. Our work has a human dimension and  very concrete result – the saved lives of patients. The goal of our meeting here is to unite all parties concerned to write a victory plan, a plan that will help us stop the epidemic. And we will not look for patterned and simple solutions, because we are realize clearly for whom we work and the scale of the problems we are facing. And those problems require innovative approaches and  thinking outside the box.”

As the result of their work the teams will present specific budget advocacy projects in the field of HIV financing aimed at strengthening the capacity of the communities and achieving the sustainability of HIV response programs in the countries of the EECA region.

Advocathon is an interdisciplinary workshop event, during which participants specializing in various issues will work in mixed teams to solve problems related to the topic of the event with the direct mentoring and support of leading experts of the region.

The event was organized in the framework of the project “Sustainability of Services for Key Populations in the Eastern Europe and Central Asia Region” (aka #SoS_project), implemented by a consortium of organizations from countries of the EECA region under the leadership of the Alliance for Public Health  in partnership with the charitable organization “100% of Life”, Central Asian Association of People Living with HIV and the Eurasian Key Populations Health Network.

The VII cycle of the international Harm Reduction Academy, founded by the Alliance for Public Health ,takes place In Kyiv, June 1-5. The Academy traditionally brings together participants from around the world, and this time participants are from Kenya, Uganda, Myanmar, the Philippines, South Africa, Belarus and Uzbekistan.

The course of the Harm Reduction Academy brings together the experience and expertise of three continents: Europe, Asia and Africa. And this, definitely, is the very unique course that is relevant to everyone who works in the field of building harm reduction systems and humane drug policies around the world.

“The Harm Reduction Academy is a unique course on a global scale. Participants gain knowledge about the latest innovations, effective interventions, the most effective policy change mechanisms. These are critical knowledge and skills for successful HIV prevention among injecting drug users, a group without which it’s not working effectively to stop the HIV / AIDS epidemic,” – said Andriy Klepikov, executive director of the Alliance for Public Health.

It’s important to note that the Harm Reduction Academy is a global platform for learning and sharing experiences, including training, dialogue and skills building components to accelerate action to defeat AIDS and hepatitis C among people who inject drugs.

As part of the course, students study the theory and practice of harm reduction programs in the form of lectures and in combination with visits to organizations providing harm reduction services in three countries: Ukraine, Kenya and Malaysia. Academy modules include three busy weeks of study in the following areas:

☑️ Harm reduction: principles, components, services.

☑️ Strategic information: monitoring, evaluation, research.

☑️ Policy: environment, resource mobilization, advocacy, community mobilization and empowerment

“Participation in this course has helped me to understand much better how programs are being implemented, and what are the needs of injecting drug users in other countries. We hope that we can optimize our programs with these needs in mind …”, – said Andrew Preston, a participant in the VI cycle of the Academy, from the UK.

“I really liked the innovative and proactive approach to the implementation of interventions, for example, programs that are implemented by peers, self-testing, community-initiated ART programs …”, – said Dr. Samaruddin Samardza Zaza, a participant in the fourth cycle of the Academy, project manager of the Ministry of Health of Afghanistan.

According to the organizers, the diverse international experience of the participants and invited experts allows the students of the course to find optimal solutions for any problematic issues they encounter during the work on harm reduction, in particular when planning programs, communicating with stakeholders, as well as solving organizational and management issues in the context of limited resources.

Founder and organizer of the Harm Reduction Academy: Alliance for Public Health

Technical partner: Alliance Consultancy.

The VII cycle of the Academy is supported by the Fast Track Cities project, PITCH Project in Ukraine (“Partnership for Inspiration, Transformation and Consolidation of HIV Response”), the Global Fund to Fight AIDS, Tuberculosis and Malaria and OSF.

▶️ Find out the latest news about Academy on our Facebook page: Harm Reduction Academy

▶️ You can get more information about the program, feedback from participants and learn how to participate in the next course on website.

Text, foto: Inna Gavrylova

On May 31, 2019, acting mayor of Chisinau Ruslan Codreanu and UNAIDS Regional Director for Eastern Europe and Central Asia Vinay P. Saldanha, signed the Paris Declaration on accelerating action in Large Cities to end the HIV/AIDS epidemic.

Chisinau became the first city in Moldova and the first among the cities of the regional project #SoS_project, which signed the declaration, thereby declaring its active leadership position in the global movement to combat the HIV/AIDS epidemic in major cities around the world. It should be noted that in Moldova annually register about 900 new cases of HIV infection, about 20 percent of which occur in the capital.

In his speech, Ruslan Codreanu noted that this is a historical moment and it will be difficult to achieve the necessary indicators of the strategy 90-90-90, but it is never too late to start making the necessary changes to improve the lives and health of people. “The program’s budget will amount to 1.7 million lei. This money will be spent on information campaigns, prevention, which is important, treatment, care and support. It’s not quite clear where this money will be allocated, but we are counting on social partnership,” – said prime.md acting mayor of Chisinau Ruslan Codreanu.

The city authorities of the capital of Moldova have committed themselves to a significant increase in the coverage of Chisinau residents in the prevention, testing and treatment of HIV infection, with the goal of eliminating the AIDS epidemic and focusing on programs for key groups.

“Chisinau was the first to sign the Paris Declaration in the new regional project “Sustainability of HIV services for key groups in the EECA region” (aka # SoS_project), which covers 14 countries and 24 cities in the Eastern Europe and Central Asia region. The capital of Moldova sets an example to other cities, how to take the initiative in their own hands, applying the best international experience, developing an effective urban strategy, allocating the necessary funding and supporting effective HIV/AIDS activities to improve the health of citizens. This is not the final point, but only the beginning of an effective municipal response to the HIV/AIDS epidemic, where the non-governmental sector, which is very well developed in Moldova, should play a crucial role. Our organization has experience with the association Positive Initiative, which has great expertise in this area. And we are convinced that NGOs must become strategic partners at the municipal level in order to successfully achieve common goals. The Alliance team is ready to provide technical and expert support to the city, ” – said Andriy Klepikov, executive director of the Alliance for Public Health .

The Paris Declaration assumes that the city undertakes to do everything to achieve the indicators 90-90-90 by 2020. This means that 90% of all residents should be tested for HIV, 90% of those infected should receive treatment and 90% of them should have zero viral load (the virus must be completely suppressed). According to the World Health Organization, by 2030 the world will be able to stop the HIV epidemic.

“It is extremely important for us that the Paris Declaration does not become just another declarative statement. It is for this reason that we are working with partners to ensure that in the next 2-3 months the Municipal Program will be approved, in which there will be specific and measurable goals, distributed roles, and, accordingly, budgets. This will be the first confirmation that partners at the municipal level really want and are ready to mobilize in order to achieve the goals of strategy 90-90-90 and save lives ”, – said Ruslan Povega, CEO of the Initiative Positive association. – “Today we have witnessed a manifest political will, which is expressed in the fact that when people want, in a short time they do something that seemed to someone very difficult and impossible. I thank the mayor of the city for a sustainable partnership, for hearing us, understanding the importance of the subject matter and assuring that he will do everything possible so that at the municipal level the situation began to change for the better. I sincerely believe that the Paris Declaration in Chisinau will be successfully implemented. ”

In turn, Vinay P. Saldanha congratulated Chisinau on joining the international initiative and noted that the participants in the declaration “stop the spread of HIV once and for all.”

According to Mr. Saldana, the city needs to act at an accelerated pace not only to reach 90-90-90, but it is also extremely important to eliminate discrimination against people living with HIV and key groups, which is a significant barrier. And in this struggle the city is not alone, Chisinau is supported by a team of leaders at the regional and national level who are ready to share their expertise.

The signing of the Paris Declaration was the main and final action of the national campaign “Chase the virus, not the people” in Moldova! (region campaign).

It should be noted that the signing of the Paris Declaration was one of the results of the project “Sustainability of HIV services for key groups in the Eastern Europe and Central Asia region”, which is being implemented in Moldova by the public association Initiative Positive.

At the regional level, a three-year project under a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria is implemented by a consortium: Alliance for Public Health, 100% Life (All-Ukrainian Network of PLWH), The Central Asian Association of People Living with HIV and The Eurasian Health Network of Key People groups, with the participation of national governmental and non-governmental organizations, regional key populations networks , international agencies and organizations, as well as technical partners.

#SoS_project will focus on ensuring the sustainability of services for key populations in 14 countries of Eastern Europe and Central Asia. As a result of the project, by 2021, national funding for HIV/AIDS programs will be increased by $10 million from national, regional and municipal budgets in the countries of the EECA region. It is also planned to ensure $73.4 million savings in the countries budgets through optimised ARV procurement.

Text: Inna Gavrylova

Photos, video: Initiative Positive

Andriy Klepikov, executive director Alliance for Public Health, became the guest of Aibar Sultangaziyev’s unique author’s program “Behind the Scenes of Medicine” on Next TV in Kyrgyzstan.

The theme of the new broadcast was a discussion of “Barriers and opportunities to end the HIV epidemic”.

The program guests talked a lot about the current HIV/AIDS epidemic in the country, how to improve it and what is being done for this, as well as global trends and international partners that provide significant support to Kyrgyzstan in the fight against HIV/AIDS and TB.

So, Andriy Klepikov talked about why the focus of the new regional project “Sustainability of Services for Key Groups in the EECA Region”, which received the laconic name #SoS_project, is aimed at Kyrgyzstan. He spoke about global best practices for ensuring the sustainability of HIV services, which became the basis for #SoS_project; about why the Global Fund’s withdrawal is inevitable and about the importance of ensuring a sustainable transition to state-financed national programs in the next 2-3 years.

Note that the author and host of the TV program is Aybar Sultangaziev, a prominent public figure and director of the Partnership Network Association.

(Text: Inna Gavrylova)

Watch the TV show >>>

#HR19: People before politics!

This was the main message of the 26th International Conference on Harm Reduction (#HR19), which was held from April 28 to May 1 in Porto city (Portugal). The conference is one of the key global platforms in the field of health care, at which top-level harm reduction issues are raised.

This year at #HR19, a number of countries presented their successful experience in implementing harm reduction programs that had a direct impact on improving the public health situation in a particular region and improving the quality of life of people who use drugs, their families and communities.

Participants #HR19 started talking about Ukraine at the opening ceremony of the conference. Ukrainian Andriy Yarovyi, who was illegally detained and convicted in the temporarily uncontrolled territory of the Luhansk region, the so-called “LPR”, was presented with the prestigious international award “Carol and Travis Jenkins Award” (watch video). Note that it is awarded on annually since 2005.

In 2019, Ukraine’s advanced experience was presented in a series of discussions at the 26th International Conference on Harm Reduction.

Andriy Klepikov, Executive Director of the Alliance for Public Health, called on donor governments to allocate funds for the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria. He stressed that these funds play a critical role in stopping the HIV/TB epidemics in the EECA region.

Mr. Klepikov spoke about a working harm reduction program in Ukraine, which had a significant impact on reducing the dynamics of the HIV/AIDS epidemic. The program itself in the country of harm reduction in the country has existed for over 15 years. Initially, it was limited mainly to the exchange of syringes, the distribution of condoms and the holding of groups. Since 2008, with the support of the Global Fund in Ukraine, a substitution therapy program has been introduced. Today, as a successful practice, it is exemplified at expert sites at various levels.

“On the example of Ukraine, we see the effectiveness of preventive programs that are gradually moving from donor to state funding this year. In the process of transition, it is important to keep these programs working, high-quality and efficient, so that they continue to contain the epidemic”, – said Andriy Klepikov.

Techniques to improve the HIV cascade were presented at separate sessions.

Testing innovations and experience in organizing assisted self-testing for HIV in Ukraine were presented by Tatyana Salyuk, director of the METIDA project of the Alliance for Public Health.

Konstantin Dumchev, scientific director of the Ukrainian Institute of Public Health Policy, spoke about adherence to ART and reducing the viral load among HIV patients in Ukraine who use drugs.

A separate leitmotif emphasized the role of cities in improving people’s health. At the session on the role of cities in local drug policy, there were examples from Ukraine to strengthen funding for harm reduction programs in cities, drug testing, and work with city police.

They also told in Porto about the first Ukrainian harm reduction office in the EECA region, which opened in December 2018 on the basis of the regional narcological dispensary in Sumy (Ukraine).

The effectiveness of such cabinets has been scientifically proven for a long time, and this is the first space of this kind in the countries of Eastern Europe and Central Asia, which exists through local funding. The additional funds provided by the Public Health Alliance and the International Renaissance Foundation were needed only to launch the project, including repairs and equipment for the premises. For official work of the cabinet a special package of documents was prepared. The organization and opening of the cabinet was coordinated by the harm reduction activist, the head of the Freezone organization, Alexey Zagrebelny.

Tatiana Deshko, Head of the International Programs Department of the Alliance for Public Health, told about the success of urban initiatives on HIV / TB in EECA cities and, in particular, the program in Odessa.

Tetiana Deshko at the Harm Reduction International Conference 2019 in Porto, Portugal. ©Jared Krauss/HRI

Two years ago, within the framework of the regional public health alliance project “Accelerated response to the HIV/TB epidemic among key populations in Eastern Europe and Central Asia”, the Odessa Municipality joined the global initiative of the Track Track Cities, aimed at overcoming the HIV/AIDS epidemic by 2030.

The joint work of the Alliance, the Odessa Municipality, NGOs partner and representatives of key groups led to an increase of 50% in the number of patients receiving ARV therapy. For comparison, in Kyiv, which is also the city of the initiative of Fast Track Cities, over the same period, progress was 43%, and even less all over Ukraine – only 37%.

27,378 representatives of key groups were covered with HIV prevention services, of whom 17,430 were people who inject drugs (84% of the estimated number). Mortality due to HIV in Odessa decreased by 19% from 117 people in 2017 to 95 people in 2018.

“It is extremely important that the funds allocated in 2018 work in harm reduction programs in Odessa. The distribution of syringes for the program’s funds through pharmacies has already begun. We are waiting for the most important decisions on social contracting, which will allow the program funds to be directed to the low-threshold services of the city’s NGOs”, – Tatiana Deshko noted.

They spoke at the 26th International Conference Porto and about the Ukrainian project on harm reduction for young people who are experimenting, Drugstore. Representatives of the Elton John AIDS Foundation spoke about the project, talked about it at a press conference, and participants in HR19 discussed Drugstore on the sidelines.

Video broadcasts of the conference sessions can be viewed here.

Text: Inna Gavrylova

This week on 29^th of April Alliance for Public Health has attended and presented comments on the interactive multi-stakeholders hearing on Universal Health Coverage at the United Nations Headquarters in New York, United States. This meeting was the preparatory process for the UN general assembly high-level meeting on universal health coverage on 23 September 2019 in New York, with the overall theme: Universal Health Coverage: Moving Together to Build a Healthier World. The President of the General Assembly, with the support of the World Health Organization and UHC2030, has convened the interactive multi-stakeholder hearing as part of the preparatory process for UN HLM. Permanent representative of Japan is the friend of UHC and Thailand and Georgia was the co-facilitators of the event.

The hearing took place from 10:00 to 18:00, in the General Assembly Hall at the UN Headquarters in New York. The discussion was focus on core themes around UHC, noting that UHC is a catalyst for social-economic development and a key contributor to equity, social justice and inclusive economic growth. Nearly 600 stakeholder’s representation from all over the world participated the hearing. In consultation with global CSO’s UHC2030 have submitted following key asks during the hearing and can be found here. Zahedul Islam, Director of Treatment, Procurement and Supply Management of APH has taken part in the interactive discussion and provided comments on

• How to bring about actionable commitments from the member states during the HLM and ensure its implementation
• Should CCM mandates be expanded to include UHC in the country level where all multi-stakeholder partners are involved
• Should UHC integrate traditional medicine and other non-traditional medical practices while creating a UHC basic service package
• How to leverage parliamentary platform to progress UHC agenda with policy makers in the country level

The outcome of the hearing will be published within the next few weeks and inform the preparation of the zero-draft political declaration on UHC that will be negotiated by Member States. APH is proud to be part of this multi-stakeholder hearing and UN high-level meeting process.

Famous social activist Andrii Yarovyi, who was illegally detained and convicted in the temporarily uncontrolled territory of the Luhansk region, the so-called “LNR”, was presented with a prestigious international award.
On April 28 at the opening ceremony of the #HR19: 26 International Conference on Harm Reduction in Porto (Portugal) was announced the award of the authoritative international award “Carol and Travis Jenkins Award” to Andrii Yarovyi as a victim of daring human rights violations related to illegal imprisonment for the storage of legally obtained medical drug replacement therapy.

Andrii Yarovyi could not personally receive the award, he handed the appeal, which was read during the presentation of the award.
In the letter, Andrii thanked for acknowledging his contribution to the protection of the rights of people who use drugs and the development of harm reduction programs. In his letter, he noted that he was convinced of the achievement of goals. “The most important thing is to believe. To believe and not to stop, ”wrote Yarovaya.
The “Carol and Travis Jenkins Award” has been awarded at the International Conference on Drug Related Harm Reduction since 2005. The purpose of the event is to recognize the contribution of communities or individuals in the field of harm reduction from drug use, health care and human rights.
Learn more about Andrii Yarovyi.

Text: Inna Gavrylova

On April 3, a working meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria countries of the Eastern Europe and Central Asia region (EECA Constituency) was held in Dushanbe (Tajikistan) with representatives of the Ministries of Health and the National Coordination Councils of the five Central Asian countries: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan.

Professor Natalia Nizova, Deputy Member of the Board of the Global Fund from the EECA electoral group, said that the focus of the meeting was on enhancing the participation of representatives of the public sector of Central Asian countries in the electoral group.

“The EECA Constituency is one of the seven Governors of the electoral groups in the Global Fund, whose leading members are representatives of state structures delegated by countries. It was important for us to hold a meeting on the territory of one of the countries of Central Asia – a region that is currently characterized by a rapid increase in new cases of HIV and tuberculosis, – said Professor Nataliya Nizova. – The objectives of the meeting were to provide additional information on the opportunities that, through participation in the Constituency, are opened up for the countries of Central Asia as well as in discussions with representatives of the regional offices of UNAIDS and WHO on the consolidation of available resources in the region for the successful preparation of countries for the transition period. The Constituency meeting was been prepared for more than a year with the assistance and support of the Ministry of Health of Tajikistan, which allowed the participation of both members of the delegation of the Global Fund electoral group and invited participants”.

During the meeting, Pulod Jamolov, Executive Director of SPIN Plus (Tajikistan) and a member of the regional team #SoS_project presented a three-year project strategy with the support of the Global Fund “Sustainability of Services for Key Groups in the EECA Region” (#SoS_project).

“The multi-country #SoS_project has a complementary structure design and clearly defined goals. In the whole EECA region, we plan to attract more than $10 million in prevention programs for key groups. And this is extremely important in the context of the transition to state financing. WHO representatives who attended the meeting expressed interest in the project strategy. I think, we will continue the new dialogue with WHO on the project implementation at other regional and country sites,” – Pulod Jamolov said.

“A regional project is another resource for Central Asian countries that cannot be implemented without the active involvement of Ministries of Health, CCM teams and an understanding of the prospects that are opened up for each country and region as a whole,” – noted Professor Nataliya Nizova.

From the speech of Natalia Nizova at the launch #SoS_project meeting (Kiev, Ukraine, March 26, 2019)

#SoS_project will focus on ensuring the sustainability of services for key populations in 14 countries of Eastern Europe and Central Asia. As a result of the project, by 2021, national funding for HIV/AIDS programs will be increased by $10 million from national, regional and municipal budgets in the countries of the EECA region. It is also planned to ensure $73.4 million savings in the countries budgets through optimised ARV procurement.

The implementation of the three-year project will be coordinated by the Alliance for Public Health, in a consortium with the 100% Life (All-Ukrainian Network of PLWH), the Central Asian HIV’ Association and the Eurasian Key Populations Health Network, with the participation of national governmental and non-governmental organizations, regional key populations networks , international agencies and organizations, as well as technical partners.

Text: Inna Gavrylova

14 countries of EECA and Balkan regions will be able to save more than $ 73.4 million thanks to optimized procurement of antiretroviral drugs and optimization of treatment regimens.

These funds will allow reallocation of funding and expansion of treatment programs and services for key populations in countries. This was announced by Andriy Klepikov, Executive Director of the Alliance for Public Health during the presentation of the regional project “Sustainability of Services for Key Groups in the EECA Region”, which was shortly named #SoS_project.

“The enormous savings at the regional level are very well and in details calculated,” – emphasized Andriy Klepikov. – “This is not a figure from the ceiling. Behind it, there are strategic calculations, analytics, which is confirmed at the level of each country as well as on regional level. There are some specific calculations that have already been transformed into a commitment format in some countries, because in all countries these applications were approved by the CCM – the national coordination mechanisms for HIV/AIDS”.

To achieve the expected savings, the project will develop strategies for optimizing the cost of ART regimens, which will lead to a decrease in the average cost of first-line ART. Advocacy activities will also be carried out aimed at reducing prices for ARVs and using savings to finance the needs of prevention and care services for the Key Groups and PLHIV. In addition, work to optimize clinical guidelines for ART, a list of drugs in accordance with WHO guidelines is planned, as well as advocacy to include countries in voluntary licensing and registration of generic manufacturers.

The regional project “Sustainability of Services for Key Groups in the EECA Region” is the largest and most comprehensive regional project of the Global Fund to Fight AIDS, Tuberculosis and Malaria in Eastern Europe and Central Asia. It brings together 14 countries of the EECA region and southeastern Europe and the 23 cities with the highest burden of prevalence of HIV/AIDS.

“Unfortunately, we cannot work at the same time everywhere,” – says the executive director of the Alliance for Public Health. – “Therefore, we have chosen 23 cities with the largest number of HIV-cases. This is a reasoned choice when, effectively working in cities, you can influence the effective response of the HIV/AIDS epidemic and at the state level”.

The main goals of the project are to increase the financial sustainability and effectiveness of HIV programs, remove the most significant barriers to accessing prevention and care services for PLHIV, and increase the effectiveness and accessibility of HIV services delivery models for key populations.

To achieve these goals, the Global Fund provided financial support in the amount of $ 13 million. Andriy Klepikov said that almost half of these funds ($ 5.6 million) will go to the advocacy of the reduction of prices for ARV drugs and optimization of procurement mechanisms.  Another quarter of the project budget ($ 3.2 million) is planned for budget advocacy. $ 1.6 million is provided for the removal of legal barriers, the same amount for project management. Another $ 1 million will go to operational research.

The #SoS_project team will actively cooperate with all those who can provide, and/or affect the necessary changes, both from civil society and government agencies. It is also planned to interact with recipients of country GF grants to achieve common goals and successful experience in introducing innovations in some countries of the region will be extended to other states. All actions to introduce innovations will be accompanied by operational research, which will become the evidence-based research for launching new initiatives.

“The idea is not only to throw in some initiatives, but simultaneously with such interventions to launch operational research, which will help identify and prove their effectiveness,” explained Andriy Klepikov. – “It worked, in particular, in Ukraine. But we would not want other countries to take it on faith. In each country for advocacy, before the Ministry of Health will start funding, it is important to get a serious evidence base, which is collected through operational research”.

According to the plans, budget advocacy within the project will consist of the following elements: development/updating of the functional mechanisms of public procurement of prevention and care services and support services from NGOs; increasing the capacity of NGOs and government representatives on budget advocacy, reallocation of financial resources, relations with government structures; support for the development of national social contracting guidelines; advocacy for the adoption of municipal programs and funding related activities.

Moreover, as part of the project, it is planned to attract $ 10.250 million in prevention programs for key groups from savings made through the project.

The implementation of the three-year The Global Fund project will be coordinated by the Alliance for Public Health, in a consortium with the 100% Life (All-Ukrainian Network of PLWH), the Central Asian HIV’ Association and the Eurasian Key Populations Health Network, with the participation of national governmental and non-governmental organizations, regional key populations networks , international agencies and organizations, as well as technical partners.

Text: Inna Gavrylova

Foto: Julia Nikolenko