Compass Centre in Kharkiv, Ukraine: when Policeman Becomes an Uncle

img_0039

Authors: Janine Wildschut, Olesya Kravchuk, AFEW International

“I come here often,” Senior Inspector of the Juvenile Prevention Department of National Police of Kharkiv region, Ukraine, Andrii Stadnik is sitting by the table in the centre Compass of Kharkiv City Charitable Foundation Blago. He is smiling and pointing at the table. “Look, here I even have my own cup to drink from…”

Andrii Stadnik started to work in police in 1998. He says he is very happy with his job now. In Compass he meets many children who are grateful for not being send to prison, and he likes to be able to help them. The regulars of the centre even call him uncle Andrii, and this shows very good relations between people in the Ukrainian culture.

18 years old Oleksandr (Sasha) is sitting in front of Andrii, at the same table. Sasha is one of the main characters in the film that was made about the centre Compass a few years ago. Once he was detained by Andrii Stadnik and stayed under police control for some time. Now, after the client management program at Compass, Olexandr is doing much better. He even found a job as a security guard. “Now I somehow feel as Andrii’s colleague,” Sasha smiles.

“The criminal juvenile cases decreased tremendously last years, due to the approach when juvenile police is collaborating with a youth centre that offers client management. These alternative supporting ways are more constructive and more effective,” Senior Inspector of the Juvenile Prevention Department is telling us. “Previously there were 2000 cases per year, and now it is 362. The formulas of substances that circulate on the streets change so fast that young people can often not be prosecuted, but by giving youth an option and an alternative for other options, young people have less problems and also cause less problems for the society they live in.”

img_0036There are 492.000 children in the region in total. 897 families are under juvenile department control in Kharkiv region in Ukraine. The Juvenile Police checks these families, sees how they are doing, and if there are cases of child abuse, financial problems, and so on. Kharkiv Juvenile police is also inviting colleagues from other smaller cities or villages, and teaches them how to work with the Centre Compass. Through this cooperation they found out that young people from the region have difficulties with coming to the Centre since Kharkiv is too far for them. That is why now once a week a social worker of the Centre travels to the villages to counsel young people in need there.

Kharkiv City Charitable Foundation Blago has a long history of working with key populations, including people who use drugs, sex workers, men having sex with men and street children. The organisation started to work with adolescents using drugs since 2012 within the framework of “Bridging the Gaps: Health and Rights of Key Populations” project, through ICF “AIDS Foundation East-West” (AFEW-Ukraine.) Bridging the Gaps project supported the opening of the centre Compass that specifically serves vulnerable adolescents and young people, focusing on youth using drugs. The centre offers psychological counseling services, medical help, testing for HIV, hepatitis B and C. It is a daycare facility with social workers, psychologists and medical workers. The centre is providing case management services to youth using drugs, and also works with youth in prisons, and vocational schools.

Improving Outcomes for People Living with HIV

2136950249_b3e5f6a6fa_bThis is a call to action for European governments, international organisations, patient organisations, and the wider health community to align on a new HIV policy agenda that addresses the crucial unmet needs of people living with HIV (PLHIV) – to ensure they can live longer in good health, and participate fully in society and the economy.

Current HIV policy frameworks rightly focus on prevention, diagnosis and effective treatment (viral suppression), but do not go beyond this to address other health and social challenges faced by PLHIV. In Europe, where viral suppression should increasingly be the norm, it is vital that policy makers and healthcare providers recognize these challenges and respond.

An integrated approach is needed to improve:

  • Health outcomes – by addressing the increased risk that PLHIV will develop other medical problems (co-morbidities) – including mental health issues.
  • Social outcomes – in particular by combating stigma and discrimination, and ensuring that PLHIV are able to secure and retain employment and housing.

Effective action to improve outcomes, and reduce the health burden and costs associated with HIV, can bring meaningful economic benefits and reduce demands on European healthcare systems.

We call on the EU and Member States to:

1. Revisit the Dublin Declaration on Partnership to Fight HIV/AIDS, and ensure that its monitoring adopts a ‘life-long’ approach to the health and social inclusion of PLHIV.

2. Identify and agree on policy indicators necessary to monitor and assess country performance in improving health and social outcomes for PLHIV.

3. Adopt in 2017 an integrated EU Policy Framework on HIV/AIDS, viral hepatitis and TB – thereby extending the focus of the EU Action Plan on HIV/AIDS, which comes to an end in 2016.

Background

Whilst important progress has been made in the global response to HIV/AIDS, with the European Union (EU) playing an instrumental role, the European region – and in particular Eastern Europe – now has the fastest growing HIV epidemic globally. 29,992 people were diagnosed with HIV in the EU/EEA in 2014. At the same time, PLHIV are living longer, which has created new challenges relating to the prevention, treatment, and management of co-morbidities.

With the EU Action Plan on HIV/AIDS expiring at the end of 2016, and the Dublin Declaration on Partnership to fight HIV/AIDS now more than a decade old, European governments and the EU institutions have an opportunity to make progress on their political commitment to fighting both the transmission of HIV, as well as its health and social impacts – including the Sustainable Development Goals (SDGs).

Continuing challenges include the strengthening of prevention programmes, reducing late diagnoses, ensuring equity and universality of access, and the social consequences of HIV that stem from stigma and discrimination. Governments and health systems must respond to the fact that PLHIV are living longer. We must ensure that PLHIV remain in good health as they grow older, and can lead successful, productive and rewarding lives. This aspiration should motivate the HIV response in all European countries – not only those that already perform well in relation to the UNAIDS targets for diagnosis, treatment and viral suppression.

The Beyond Viral Suppression Initiative

The Beyond Viral Suppression initiative arises out of a shared recognition among leading HIV experts that there are crucially important issues relating to the health and social inclusion of PLHIV that have to date received insufficient attention from policy makers and healthcare providers, and which must now form part of our HIV response.

In an era when ageing populations and health system sustainability are central challenges for all European countries, the initiative will also aim to inform debates about cost-effective strategies for co-morbidity prevention and management, whilst ensuring patient-centered healthcare delivery. Our recommendations should therefore be of high relevance both to policy makers and the wider health community.

The steering group is co-chaired by: Nikos Dedes, the Founder of Positive Voice (the Greek association for PLHIV) and a Board member of the European AIDS Treatment Group (EATG); Professor Jane Anderson of Homerton University Hospital NHS Foundation Trust in London; and Professor Jeffrey Lazarus of ISGlobal, Hospital Clínic at the University of Barcelona, and CHIP, Rigshospitalet, University of Copenhagen. The initiative is enabled by sponsorship provided by Gilead Sciences and ViiV Healthcare.

The initiative is developing a performance assessment of HIV services ‘beyond viral suppression’ – focusing on: access to appropriate health services; health outcomes – co-morbidity and co-infection prevention, and health-related quality of life; and social outcomes.

A research team supported by a study group of leading academics will seek to identify the policy indicators necessary to assess countries’ performance at improving health and social outcomes ‘beyond viral suppression’. Our aim is thereby to complement the work of other initiatives focusing on HIV prevention, diagnosis, and access to high quality treatment and care.

Today We Celebrate 15 Years of AFEW!

15yearsafew_logo_proposal2Dear AFEW supporters and partners!

Today is a very important day for AFEW International. We are honouring World AIDS Day 2016, and also celebrating the 15th anniversary of our organisation. We are very grateful that we have spent these wonderful 15 years with your support and appreciation, and we would like to thank you for this!

We know that 15 years of our work would be not possible without you. We understand that together with you we are working towards a healthy future of our region. We realize the potential and current issues of Eastern Europe and Central Asia, and we are confident that we will be able to overcome them together with you. Thank you for being with us throughout our successes and challenges!

Having a leading position with expertise in HIV, TB and other related public health concerns in Eastern Europe and Central-Asia, AFEW will continue fighting stigma and discrimination, upholding the human rights, and improving the access to and quality of health services for key populations at risk for HIV, TB and viral hepatitis. This is still so much needed as the region where we work is still experiencing HIV growth, faces increased incidence of MDR-TB and has a high prevalence of Hepatitis C. Our activities help to change the future of the region and contribute to a healthy and comfortable life of people!

Thank you for being with us!

Happy World AIDS day and happy AFEW anniversary!

Sincerely,

AFEW International

UNAIDS Regional Director for Eastern Europe & Central Asia Address

wad2016_day_hp_2_jpg1 December 2016, UNAIDS — Dear colleagues!

On the occasion of World AIDS Day, 1 December 2016, on behalf of the UNAIDS Regional Office for Eastern Europe and Central Asia, I am pleased to share some important updates on the new UNAIDS global report and key events and initiatives in the HIV response in our region.

This week UNAIDS launched our new global report ‘Get on the Fast-Track: The life-cycle approach to HIV’ showing that countries are getting on the Fast-Track, with an additional one million people accessing treatment globally in just six months (January to June 2016). By June 2016, approximately 18.2 million [16.1 million–19.0 million] people living with HIV had access to the life-saving treatment, including 910 000 children – double the number five years earlier. If these efforts are sustained and increased, the world will be on track to achieve the target of 30 million people on treatment by 2020. Please see the full report here.

On 3 November 2016, Ministries of Health from 12 countries of Eastern Europe and Central Asia adopted the Minsk Statement on ‘HIV and Tuberculosis: Treatment for All’, calling for expanded and rapidly scaled-up access to affordable, quality-assured medicines for HIV and TB. Please see more information about the meeting and the adopted Statement here.

The Government of Ukraine has announced that in 2017 it will double funding from the national budget for HIV and TB treatment, and fully finance the national opioid substitution therapy programme for people who inject drugs – a key population in Ukraine that is at higher risk of HIV infection. Please see more information here.

The first National AIDS Conference in Kazakhstan ‘HIV: Yesterday, Today, Tomorrow’ was held in Almaty on 12-13 October 2016. Over 170 representatives of government, academia, health sector and civil society groups from different regions of Kazakhstan joined the event and discussed the importance of measures to be taken to put Kazakhstan on the Fast-Track. Please see more information here.

On the occasion of the International Day of Youth, a series of activities were organized by the Youth Foundation of Armenia to raise awareness among young people about healthy lifestyles and HIV prevention. One of the main events was a concert in Yerevan on 17 November 2016, attended by over 10.000 youth. Information about HIV testing and prevention was shared through social videos, leaflets and other materials throughout the day.

In Tajikistan, the Minister of Health called for people to know their HIV status during the first ever public event on HIV prevention in Dushanbe. The event, in support of the ‘Hands up for #HIVprevention’ campaign, united more than 500 representatives of the Government of Tajikistan, health professionals, celebrities and young people. Please see more information here.

In the Russian Federation, the next phase of the national campaign ‘#StopHIVAIDS’ will be launched on 28 November in Moscow, under the leadership of Svetlana Medvedeva’s Foundation for Social and Cultural Initiatives. As part of this campaign, a series of activities will take place across Russia from 28 November to 4 December, including open lectures in schools, vocational schools and universities. The campaign will feature the Russian Minister of Health, Veronika Skvortsova, Minister of Education, Olga Vasilieva, Minister of Communications and Mass Media, Nikolai Nikiforov, the Head of Rospotrebnadzor, Anna Popova, and various non-governmental organizations. Please see more information about the campaign here.

22Please join the UNAIDS World AIDS Day Hands Up for #HIVprevention campaign. The campaign is focused on different aspects of HIV prevention, offering space for people to express their views on what they think needs to be done to strengthen HIV prevention efforts. You can upload your photo/video on the special campaign event page on Facebook or Twitter. Thank you for helping us in raising awareness and reaching wider audiences. We encourage you to join the campaign!

I would like to end this letter with a video message by Michel Sidibé, UNAIDS Executive Director on the occasion of World AIDS Day 2016.

Sincerely,

Vinay P. Saldanha
UNAIDS Regional Director for Eastern Europe & Central Asia

AFEW Tajikistan is Opening HIV Rapid Testing Point

qurghonteppa_2010_02HIV voluntary counselling and rapid testing point will be opened on December 1, 2016 in Qurghonteppa, Tajikistan. Testing point will be situated in the representative office of RPO AFEW Tajikistan in Khatlon region.

Official opening ceremony of the HIV voluntary counselling and rapid testing point is supported by the Administration on public health and social protection of population of the Hukumat of Khatlon region and the Regional AIDS Center. During the opening, 25 representatives of governmental, international and public organizations will learn about experience of the RPO AFEW Tajikistan in introduction of HIV voluntary counselling and rapid testing service.

The activity is conducted within the “Bridging the Gaps: Health and rights of key populations -2.0” – program funded by the Ministry of Foreign Affairs of the Netherlands.

HIV voluntary counselling and rapid testing point is located at 9 Lokhuti Street, Qurghoonteppa, Representative office of RPO AFEW Tajikistanin Khatlon region.

 

AFEW Director is the Chair of TB/HIV Working Group

ankeAFEW executive director Anke van Dam became the chair of Wolfheze Working Group on TB/HIV collaborative activities. The group will document and promote the best models and identify research priorities of integrated TB/HIV care in the European region. Members of the group will also identify barriers in TB/HIV services and collaboration.

“I am very honoured to be part of the group,” – Anke says. – “AFEW is implementing integrated HIV/TB activities in the EECA region for quite some years now. I will bring this experience into the group, and hope to contribute to collecting best models. There is still so much to gain in improving the care and health of people living with both HIV and TB.”

Wolfheze TB/HIV Working Group started a year ago in The Hague, The Netherlands. There, Wolfheze and WHO National TB Programme Managers’ meeting participants discussed the need for strengthening TB/HIV collaborative activities in the context of the WHO End TB Strategy. They agreed to create a Working Group on TB/HIV collaborative activities taking into account specific challenges and opportunities in the WHO European region.

24 Participants from 11 Countries Come to the Training in Bishkek

bishkek-640-3214524 participants will take part in the community-based participatory research training that will take place in Bishkek, Kyrgyzstan, on 8, 9 and 10 November 2016. Participants come from the following countries: Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Ukraine and Uzbekistan.

There was a great interest for this training, we received more than 200 applications. Those organizations that were not selected to attend the training will be able to access all the information online. The online e-learning course that will be available from February 2017 onwards.

Those who were not selected for the first training can still be eligible for the next training and/or the call for proposals for the research grant. The next calls for applications will be announced via Facebook and on our website.

Online application for Community-Based Research training

The-main-square-of-Bishkek675AFEW (International) is organising a community-based research programme. The programme consists of several trainings and a small grants fund for community-based research projects. The programme is meant for communities in Eastern Europe and Central Asia (EECA) and is aimed to result in the submission of abstracts for the International AIDS Conference 2018, which will be held in Amsterdam.

Please find herewith the link for the application here. If you have more questions about the application, please email us at research@AFEW.nl.

The training will take place in Bishkek, Kyrgyzstan, on 8, 9 and 10 November 2016. This training is the first step in a community-based research programme.

We are looking for motivated participants from the EECA region with a keen interest, some experience, and familiarity with community-based research. We foresee to invite two participants per organisation: one decision maker and one research implementer. The training is free of charge.

Following the training, you will be able to access online training modules to further shape your research skills. On a later level, training participants are expected to fill in an application form for the community-based research fund. This call will be released towards the end of 2016.

We are now accepting applications to attend the training. The deadline for application is Friday 9 September 2016.

Poster 200x150 1op10

AFEW Cooperates in Co-infection Prevention and Harm Reduction EU project

HA-REACT-logoAFEW became the collaborative partner of the Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT) that addresses existing gaps in the prevention of HIV and other co-infections, especially tuberculosis and viral hepatitis, among people who inject drugs. This three-year project was launched in late 2015 with core funding from the European Union, and is being implemented by 23 partners in 18 EU Member States. Twelve collaborating partners are contributing additional expertise, among them the European Centre for Disease Prevention and Control and the European Monitoring Centre for Drugs and Drug Addiction.

“Collaboration with HA-REACT is important for AFEW because we would like to explore how we can use the tools developed by HA-REACT for countries in our EECA region,” – AFEW executive director Anke van Dam says.

HA-REACT focuses particularly on the EU member states where there are obvious gaps in effective and evidence-informed interventions, or where such interventions are not being implemented at a sufficient level. HA-REACT also encourages the implementation of comprehensive harm reduction programmes at sufficient scale in all EU member states as an essential strategy for improving the prevention and treatment of HIV, TB and viral hepatitis.

Starting Methadone after 18 Years of Using Drugs   

IMG_269244 years old Makhmad asked for support of the social workers of “Bridging the Gaps” program implemented in Qurghoonteppa city in Tajikistan after he experienced 18 years of injecting drugs and had several ineffective attempts of stopping using them. He was seeking for some assistance in his drugs dependence treatment.

“I have heard about methadone many times, but did not believe that it can help me, even though many of my “colleagues” in the streets were telling about its positive effects. During my communication with social workers of AFEW-Tajikistan, I received all the answers to my questions. They told me everything about opioid substitution therapy (OST) and all aspects of using of methadone. I decided to try this treatment myself,”– Makhmad says.

Before entering OST program, Makhmad faced many problems in his everyday life and with his family. “Frankly, I never thought about my family and my kids. All my thoughts were about how to find drugs”, – he says. Thanks to “Bridging the Gaps” program support, Makhmad passed medical observations, got needed tests and afterwards was included in OST program that was implemented by state detox center of Qurghoonteppa.

“After some time of participation in OST program I felt positive changes. First of all, I stopped to think about how and where to find my dose of heroin. Besides, my relations with family members improved. I have also found the job. I feel myself healthy and I can say it with a confidence that everything is good in my life. When I now see people I know who are still using drugs, I explain them that methadone is something that can really help us”, – Makhmad tells.

Social workers of AFEW-Tajikistan are continuing to provide assistance to Makhmad. In return, he does some volunteering work for AFEW, and together with the social workers Makhmad is informing people who use drugs about available services within “Bridging the Gaps” program in Qurghoonteppa.

“Bridging the Gaps: Health and Rights of key populations” project is funded by the Ministry of Foreign Affairs of the Netherlands is implementing in Qurghoonteppa by AFEW-Tajikistan Branch in Khatlon region. People who use drugs or are affected by HIV epidemic can receive client management and HIV prevention services including assistance in initiation and adherence to treatment. Only in the first half of 2016, 84 PUDs were provided by AFEW-Tajikistan’s assistance to pass needed medical observations on free of charge base and 16 of them finally were included in OST program.