Good practices of intersectoral collaboration for HIV, tuberculosis and viral hepatitis

The WHO Regional Office for Europe is collecting examples of good practices of intersectoral collaboration for HIV, tuberculosis and viral hepatitis for publication in a dedicated compendium.

This compendium will include examples of actions undertaken by sectors outside the health sector, possibly (but not necessarily) in collaboration with the health sector. The practices should be aimed at improving the outcomes or the determinants of the HIV, tuberculosis and viral hepatitis epidemics, as encouraged by the UN Common Position on ending HIV, TB and viral hepatitis through intersectoral collaboration. They should also be accompanied by impact evaluations and credible monitoring mechanisms or research.

The above-mentioned UN Common Position was developed with an inclusive and consultative process to identify shared principles and key actionable areas within and beyond the health sector to address HIV, tuberculosis and viral hepatitis in Europe and central Asia. It was successfully launched at a side event to the UNGA in New York in November 2018 and subsequently distributed within UN system to all UN Resident Coordinators of the region.

The good practices must be submitted in either English or Russian using the form provided below. All submissions will be reviewed by the WHO Regional Office for Europe against the following criteria: relevance, sustainability, efficiency and ethical appropriateness. The authorship of each good practice will be highlighted in the compendium, which is expected to be published in 2020.

The deadline for submission is 18 November 2019. If you have any questions, please do not hesitate to contact daram@who.int. 

Mass media as partners in counteracting HIV/AIDS epidemic

Mass media play a major role in fighting for human rights, especially when it comes to population groups vulnerable to HIV. Through the wide media coverage of successful human rights defence cases implemented by community and civil society, the government can see that the community of People Living with HIV (PLHIV) and people vulnerable to HIV can and should be an equal partner and an ally in fighting HIV/AIDS epidemic.

This helps with forming a positive image of PLHIV and representatives of other key populations in the society, decreases stigma and discrimination, raises their self-esteem and self-significance and gives motivation for further activities and professional growth.

Thanks to the coverage of successful practices in mass media, a large number of PLHIV, people who use drugs (PWUD) and representatives of other vulnerable groups gain opportunity to get basic human rights knowledge, action plans and tools, which allow them to solve problems related to violation of human rights due to HIV in their own regions independently.

Liudmila Vins, project manager of LUNa Social Support Centre, legal adviser of Interregional Center for Human Rights in Yekaterinburg, has applied to the Emergency Support Fund for key populations in EECA for a grant. The goal of her project is to change the legal environment and public opinion towards people living with HIV and representatives of groups vulnerable to HIV through mass media.

Liudmila, what is the core of your project?

Our way of working is as follows – our lawyer together with partners, street lawyers from the regions, collects successful legal practices and strategically important cases, prepares the gathered materials for media publications, provides a legal evaluation and an algorithm for solving the problem. An info manger writes articles based on the cases for mass media and our own media resources, passes information about these cases to journalists through mailing lists, social media, and connects media and people featured in the cases in order to prepare further materials.

Could you tell us about the intermediate project results?

Yes, the project has substantially helped us to develop the informational part of our work and also gave a start to a new project of educating Russian NGOs on working with media. We found 17 cases, which resulted in 33 publications. Each case contained a story of at least one person – the leading story character, and at least 2 more people connected to the story, close relatives of the leading character. In total 51 people were featured in the stories.

Please share the most interesting and remarkable moments of the project.

The most remarkable example of support within this project is Olga’s story (the name is changed). We published it on our website.

Local journalists quickly noticed this material; they immediately reacted and published a number of articles about the fact that a woman in detention facility doesn’t receive treatment for HIV-infection. The news travelled fast: one journalist made a lot of requests to government agencies and received a positive decision from government officials. The result was that this woman received medication the same day.

You started your social support activities for vulnerable groups in 2009. How have the statistics changed since then?

At that time harm reduction programs were developing actively. However, the issue of defending the rights of PWUD was still unresolved, so starting from 2012 I began to develop street lawyers programming in Yekaterinburg. The need for this kind of support is very high now. In 2012 legal assistance was given to 100 people per year, and there was one street lawyer. Currently we work with 5 street lawyers, and we give this kind of support to people on a regular basis.

Who are the street lawyers?

These are people from the key populations community who are taught the basics of human rights defense. So, they can provide basic support with human rights defense, and then, if necessary, pass on cases to professional lawyers.

What is the attitude of the key populations’ representatives towards your activities?

We have a good connection with our target group, they are happy to receive our support. However, there are certain difficulties. For example, a person can disappear for a period of time while being under our supervision. Then (s) he appears again in a month, and we have to start from the beginning.

Why do you think it is so important to involve representative of key populations in such work?

Almost all of our staff members except for two are people from the key populations/PWUD community. I have been in remission for a long time myself. I think that a different approach is simply not effective. Nobody can truly understand PWUD as well as a person who has gone through it too, and most importantly, who was able to overcome it and solve a problematic situation successfully.

When people are doing something for the society, they often have an ideal example of such society in mind. Do you have one?

I don’t have examples of an ideal situation in any country. There are drawbacks everywhere. When it comes to talking about the approach to working with PWUD in Russia, I reply that there’s simple no such work. Those few NGOs that provide harm reduction programs, can’t reach all the PWUD to the full extent. For me the ideal situation is when the system of social support is developed in the country, there are harm reduction programs, access to quality treatment, and there is no stigma and discrimination within the society.

The project is supported by the Elton John AIDS Foundation and Aidsfonds.

Support. Do not punish!

In June 2019, dozens of cities in the EECA region hosted the campaign «Support. Do not punish». Activists took to the streets to publicly protest against repressive drug policies.

This action, which is held annually all over the world, is a great chance to once again draw attention to this unresolved problem. How it was in the EECA region in 2019 you can read here.

Plans for 2020

Are you part of a collective, network or organisation advocating for drug policies that prioritise health and human rights? Are you planning to join the 2020 Support. Don’t Punish Global Day of Action and have an outstanding plan to build momentum? If your answer is “yes” then this call for applications might be for you!

Through this call, the Support. Don’t Punish campaign aims to identify and support local partners (up to 7) with funding of between USD 2,000 – 4,000 for strategic, creative and collaborative projects building up to the 2020 Global Day of Action that advance drug policy reform, bolster harm reduction and build bridges with/within/between communities disproportionately affected by the “war on drugs” (e.g. people who use drugs, farmers of crops deemed illicit, youth, ethnic minorities, LGBTQ+, among many others).

You can apply for the grant here.

What is “Support. Do not punish”?

Support. Don’t Punish is a global grassroots-centred initiative in support of harm reduction and drug policies that prioritise public health and human rights. The campaign seeks to put harm reduction on the political agenda by strengthening the mobilisation capacity of affected communities and their allies, opening dialogue with policy makers, and raising awareness among the media and the public.

The campaign’s yearly high point is the Global Day of Action, which takes place on, or around, 26th June (the International Day Against Drug Abuse and Illicit Trafficking). Historically, this date has been used by governments to showcase their drug control “achievements” in coercive terms. The campaign’s Global Day of Action seeks to reclaim and shift that day’s narrative. And so, every year, an increasing number of  activists in dozens of cities all over the world join this unique and multifaceted show of force for reform and harm reduction.

The Support. Don’t Punish campaign aligns with the following key messages

  • The drug control system is broken and in need of reform
  • People who use drugs should no longer be criminalised
  • People involved in the drug trade at low levels, especially those involved for reasons of subsistence or coercion, should not face harsh or disproportionate punishments
  • The death penalty should never be imposed for drug offences
  • Drug policy should focus on health, well-being and harm reduction
  • Drug policy budgets need rebalancing to ensure health and harm reduction-based responses are adequately financed.

 

Anke van Dam is a member of the advisory board of the European Forum for Primary Care

Anke van Dam, executive director of AFEW International has been elected as a member of the advisory board of the European Forum for Primary Care.

What is The European Forum for Primary Care?

The European Forum for Primary Care (EFPC) was initiated in early 2005 by a group of interested parties from several countries.

The basic aim of the Forum is to improve the European population’s health by promoting strong Primary Care. This is done by monitoring the state of Primary Care in the European countries, by collecting information on conditions that matter for strong Primary Care, and by exchanging experiences.

The Forum connects three groups of interested parties: the health care field, health policy makers, and the producers and evaluators of health care information. These interested parties work at three levels: the local or district level, the national level, and the supra-national level. By linking policy practice and research the Forum intends to stimulate policy making based on vision and evidence as much as it intends to support PC practice oriented towards quality and equity.

The membership of AFEW International

Anke van Dam: «The membership to the advisory board of the European Forum of Primary Care allows AFEW to learn from primary health care providers in European Countries and further the best practices to ensure equity in health and bring those to Eastern Europe and Central-Asia. What does it mean and what are the conditions when we talk about access to health services, gender and inequality per diseases? This is all discussed in the EFPC and the necessary role of primary care. AFEW International brings knowledge and vast expertise about the EECA region and a great network of contacts with organizations, institutes, agencies and professionals to the EFPC.

With the help of European Forum of Primary Car AFEW International hopes to build the bridge and to facilitate exchange, linking and learning between professionals from East and West».

 

The Coordination Committee called on the Global Fund to support the fight against HIV epidemic in Russia

The Coordination Committee for the prevention and control of HIV/AIDS in Russian Federation, responsible for oversight and coordination of the implementation of the Global Fund grants in Russia, called on the Global Fund to allocate funding to support civil society organizations in their fight against HIV epidemic in Russia for the next three years.

2019 is the year of the replenishment for the Global Fund to Fight Aids, Tuberculosis and Malaria (Global Fund) and by the end of this year, based on the results of the replenishment, the Global Fund will make a decision on the allocations for the eligible countries to address HIV, TB and Malaria for the next 3-year period.

According to the 2019 Global Fund Eligibility List, the Russian Federation has met the requirement of two consecutive years of eligibility based on income classification and disease burden and is now eligible to receive an allocation of funding to support the HIV/AIDS response for the next 3 years. Since the Russian Federation is not on the OECD-DAC List of ODA recipients, according to the Global Fund’s Eligibility Policy, the Russian Federation may only be eligible for an allocation to support the HIV response efforts by non-governmental or civil society organizations and only if the country demonstrates barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology.

According to the Global Fund’s Eligibility Policy, “the eligibility for funding under this provision will be assessed by the Secretariat as part of the decision-making process for allocations. As part of its assessment, the Secretariat, in consultation with UN and other partners as appropriate, will look at the overall human rights environment of the context with respect to key populations, and specifically whether there are laws or policies which influence practices and seriously limit and/or restrict the provision of evidence-informed interventions for such populations.”

It is a well-known fact that Eastern Europe and Central Asia (EECA) is the only region in the world where the HIV epidemic continues to grow , and Russia has been considered as the “driving force” of this regional growth. According to the UNAIDS 2018 Global AIDS Update, “the HIV epidemic in Eastern Europe and Central Asia has grown by 30% since 2010, reflecting insufficient political commitment and domestic investment in national AIDS responses across much of the region. Regional trends depend a great deal on progress in the Russian Federation, which is home to 70% of people living with HIV in the region. Outside of the Russian Federation, the rate of new HIV infections is stable.

 

 

For people living with HIV in Belarus

Since July 19, 2019, a new version of article 157 “Transmission of Human Immunodeficiency Virus” of the Criminal Code of Belarus has been enforced. Despite the approved amendments to this article, it still contributes to vulnerability of the key populations, in particular serodiscordant couples (where one of the partners has HIV). However, a solution has been found, thanks to which the amendment will be able to serve for the benefit of people living with HIV.

For reference

There is a number of important provisions in the new version of article 157 of the Criminal Code of Belarus.

  • Knowingly exposing another person to HIV is punished with a fine or an arrest or imprisonment for up to three years.
  • If an individual, who knows about being infected with HIV, transmits HIV to another person recklessly or with indirect intent, this offense is punished with imprisonment for the term from two to seven years.
  • The action stipulated by the second part of this article committed against two or more persons, or a person who is known to be a minor, or with direct intent, is punished with imprisonment for the term from five to 13 years.

Besides, the amendment to this article says that the individual committing the actions stipulated in the first and second parts of the article may be relieved from the criminal liability in case if the other person, who was exposed to HIV or was infected with HIV, had been in advance warned about the fact that such individual had HIV and voluntarily agreed to perform any acts, which led to HIV exposure.

Avoiding prosecution

Before this amendment was enforced, the People PLUS Republican Public Association in cooperation with the Republican Center for Hygiene and Epidemiology held a round table to develop a set of measures, which would allow people to fully use the amendments in laws and protect themselves from the criminal prosecution. It resulted in the development of a road map and other documents regulating the fact of warning, which would lead to the enforcement of this amendment. Such documents include.

– New form “How to warn another person that I have HIV”

– Form to warn a contact person of a patient with HIV

– Memo on HIV prevention

Anatoliy Leshenok, Director of the People PLUS Republican Public Association

“When preparing the documents, we tried to take into account any possible circumstances and potential barriers,” says Anatoliy Leshenok, Deputy Director of the People PLUS Republican Public Association. “For example, the Investigative Committee, commenting on the amendment, pointed out that it is important to understand what is the procedure to check in which state an individual gave his or her consent to have a contact with a person living with HIV, to check if he or she had enough information, etc. The Notary Chamber suggested to register informed consent as a confirmation of consent for the contact with a person living with HIV. The Republican Center for Hygiene and Epidemiology developed a new notification form to be used when registering people with HIV diagnoses for follow-up, provided explanations on the amendment to article 157 of the Criminal Code of Belarus and told that it is possible to come to them with a partner to register the fact of warning of HIV exposure. A memo on HIV notification has also been developed and will be published within our project. It will be given to the partners of HIV-positive people. The memo contains contact details of the organizations providing services to PLWH as well as legal consultations.”

Who is at risk?

In the recent 6 months, there were 55 criminal cases initiated in Belarus based on article 157 of the Criminal Code. This number is similar to the one that was registered in 2018. However, it should be noted that 28 cases out of this total number were opened based on the first part of this article, where there is no fact of HIV transmission, but only a perceived risk.

“Recently, we were defense witnesses at a court hearing, when the defendant was charged with putting five sexual partners at risk of HIV,” tells Anatoliy. “The defendant did not transmit HIV to any of those partners – he took ARVs and had an undetectable viral load. The court took into the consideration the scientific consensus statement on HIV transmission, the answer of a WHO representative and the reply from the Professor of the Infectious Disease Department of the Belarus State University on the risk of HIV transmission by a person with suppressed viral load. However, the verdict of the court was that there was still a risk of HIV transmission, so the sentence remained unchanged – 18 months at standard regime penal colony. Just imagine – 18 months of imprisonment for not transmitting HIV to anyone!”

In fact, article 157 put a question mark over the existence of serodiscordant couples, who often live together for many years and even have children. Usually, within such criminal cases charges are brought against a husband or a wife, while the “victim” clearly states in court that he or she has no complaints to the spouse and that he or she was consciously taking risk to conceive a child with a loved one.

Drawbacks of this article also relate to the fact that criminal cases are initiated with no complaints from the victim.

“When making amendments in article 157, we were suggesting more radical changes – to fully exclude responsibility for exposure to HIV from this article – but the society is so far not ready for such changes,” continued Anatoliy. “Currently, the cases initiated based on this article are reviewed, where the sentences directly state that the partner was informed about HIV and consciously agreed to the actions, which led to HIV transmission or exposure to HIV. According to the Code of Criminal Procedure, the review of such cases is initiated by penal colonies and prisons, and if a person is not imprisoned, such person should file a relevant request for review with a court.”

First successes 

Approval of the amendment to article 157 of the Criminal Code “Transmission of HIV” allowed talking about the first successes of the activists in HIV response in Belarus. Now hundreds of people can have the record of their conviction expunged.

“People PLUS” thanks for the help provided in 2017-2019 by HIV justice, GNP +, EWNA. Amendment to art. 157  was brought in  Criminal Code Belarus thanks financial and technical assistance from these organizations.

Thanks the Emergency Support Fund for Key Populations in Eastern Europe and Central Asia (EECA) People PLUS have implemented additional set of measures people living with HIV in Belarus will be able to avoid criminal prosecution.

Children’s health is a top priority

In Atyrau, Kazakhstan, the incidence rates of tuberculosis among children (0-14 years old) and adolescents (15-17 years old) are significantly higher than the national average: the incidence of tuberculosis in 2017 here is 1.5 times higher than the average around the country.

For this very reason, the project on Implementation of Highly Effective Measures of Prevention and Treatment of Tuberculosis among Children and Adolescents, the purpose of which is to improve the organization of activities on TB prevention among adolescents and children, is ongoing here, in Atyrau. The project is implemented by the international organization Project HOPE – Kazakhstan within the framework of the Social Investment Program of Tengizchevroil LLP, in cooperation with the National Scientific Center of Phthisiopulmonology of the Ministry of Health of the Republic of Kazakhstan.

“The high incidence of tuberculosis in this region may have several reasons, explained Bakhtiyar Babamuradov, the Project HOPE Representative in Kazakhstan. One of them is a low coverage of new-borns by the BCG vaccination, as parents refuse vaccination for personal reasons and religious beliefs. In addition, low levels of alertness and awareness of kindergarten and school personnel, as well as of the parents, about the symptoms of tuberculosis lead to delayed treatment at the medical facilities. Therefore, the important components of the project include increasing the health and non-health personnel alertness to the symptoms of tuberculosis, as well as raising the public awareness about the necessity of tuberculosis prevention. Media is also actively involved in the work”.

According to the test results, 85 teachers, lecturers and educators of preschool and educational institutions, who had participated in the seminar on Prevention of Tuberculosis among Children and Adolescents have demonstrated a 40% improvement of knowledge level (from 51% up to 92%).

“Alliance for supporting youth affected by the problem of tuberculosis” by Sanat Alemi

Fight against tuberculosis among the youth of Kazakhstan plays an important role in the work of AFEW Kazakhstan, and in particular, the Sanat Alemi public foundation. In the framework of the “TB/HIV Prevention & Care – Building Models for the Future” project in March 2019, the “Alliance for supporting youth affected by the problem of tuberculosis” was presented in the country. The main goal of the alliance is to comprehensively support young people with TB, as well as increase their adherence to treatment, and improve the quality of life.

Consultations and trainings are regularly held for members of the Alliance; sports events and joint trips aimed to unite children who until recently didn’t even know with each other are organized to promote a healthy lifestyle. Such active events contribute to rapprochement and building communication among children and adolescents.

Peer navigators – indispensable medical assistants

Author: Marina Maximova, Kazakhstan 

Over the past three years, express HIV testing in key populations in the East Kazakhstan region of Kazakhstan increased by a third. Peer navigators play a very important role in this success.

Today among key populations, including people who use drugs, sex workers, men who have sex with me, etc. there is a major increase in infection in the country. Representatives of these groups usually don’t come to AIDS centers and medical facilities for testing, but, as experience has shown, they easily visit non-governmental public organizations (NGOs) or ask peer navigators for such services.

Peer navigators – who are they?

The term “peer navigators” is very popular among social activists. People living with HIV (PLHIV) become voluntary medical assistants and help professionals to care about patients. They do express testing for HIV infection in peri-gingival fluid, provide counseling, and, if necessary, accompany PLHIV to AIDS centers for complete testing.

“Another important work of peer navigators is to increase the motivation of PLHIV for the constant and systematic use of special antiretroviral therapy (ARVs), which is extremely necessary for our patients to improve their health, – says Marina Zhigolko, head of the East Kazakhstan Center for the Prevention and Control of AIDS. With the participation of volunteers, in recent years, PLHIV adherence to treatment has quadrupled. Today, more than 80 % of these people take rescue therapy and can work fruitfully, have families, give birth to healthy children”.

Today in the East Kazakhstan region there are 20 peer navigators. In the framework of the USAID Flagman project, they are provided with rapid tests, tablets for record-keeping, disposable syringes, lubricants, and promo materials.

Personal example and motivation

Sergey Baranyuk, a peer navigator from the Answer public foundation, packs a backpack in the morning and sets off on his route to work “in the field”. He is an ex-prisoner, has been living with HIV for many years, he used drugs. Today Sergey has a family, a job, and he helps other people to overcome the life situation he had before. His life experience helps him to convince those who, for various reasons, fall out of medical control and are not tested for HIV.

“The express test for peri-gingival fluid is convenient to use,” says Sergey. It can be done on a bench in a park, in a car, at home. After 15-20 minutes, a person already knows his HIV status. While he is waiting for the result, a peer navigator can talk to him about the risks of behaviour, ways of transmitting HIV infection and precautions. ”

Trust on the Health Route

Over three years, with the joint work of peer navigators and health visitors in the East Kazakhstan region, the number of PLHIV on follow-up has doubled. People come for medical monitoring of health, testing and medication. Peer navigator work not only in the regional center, but also in villages. For example, some villages of Glubokovsky, Shemonaikhinsky, Ulan districts, as well as Ridder-city are also under the control of public activists.

Many people prefer to come for testing at an NGO. For this, for example, the public funds “Answer” and “Kuat” have specially equipped rooms. Here people can talk frankly and do a test.

The first six months are the most important in the work of peer navigators. After some time, patients start to understand the importance of treatment themselves. But before peer navigator should find a person from the risky behaviour group and convinces him to find out his HIV status and, if necessary, start treatment.

“Navigators are our ears, eyes and foot,” says Neil Mamyrbekova, head of the treatment department at the Semey AIDS Center. «One doctor is not able to single-handedly cover patients, set them up for treatment, and convince them in the possibility to start a new life. A person must come to us prepared, therefore navigators are our main assistants. They are trusted!»

Death caused by disregard of the human rights

Author: Nikolay Borisov, www.kommersant.ru

Human rights activists call the Russian State Duma to introduce urgent amendments to the current laws regulating the stay of people with HIV, tuberculosis and other severe diseases in places of confinement. This is the conclusion of the study initiated by the Risk Group Project aimed at the protection of rights of such inmates.

Addressing the Federal Penitentiary Service of Russia, project activists ask to ensure that health departments are not subordinated to the administration of correctional facilities and pre-trial detention centers, to prohibit admission of the inmates with severe health conditions to punitive isolation wards and not to hinder the activities of public inspectors. The activists point out that 7% of all people living with HIV in Russia stay in places of confinement, that is why improving the situation of inmates living with HIV could have a positive effect on the response to HIV in the country in general.

The Risk Group project targeted at the protection of rights of inmates with HIV, tuberculosis, syphilis and other infectious diseases in the Russian penitentiary institutions is implemented by the Rus Sidyashchaya NGO with support of the Emergency Support Fund for Key Populations in EECA.

According to the Federal Penitentiary Service of Russia, in 2014-2017, 32% of deaths among inmates were caused by HIV.

Thus, today HIV is the most widespread cause of death in places of confinement. To illustrate this situation, project participants tell the story of D (told by his lawyer, Maria Eismont): when D was admitted to the pre-trial detention center, he tested positive for HIV, but was not informed about the test result. That is why he failed to receive antiretroviral treatment and learned about his diagnosis only a year after. By court decision, D was released from further imprisonment with a diagnosis “advanced stage of AIDS.” “In fact, he was released to die,” comment representatives of Rus Sidyashchaya NGO. “This case also demonstrates that administrators of the penitentiary facilities release people with severe health conditions not to benefit such people but to improve their own statistics.”

After reviewing the cases of inmates with HIV and tuberculosis, human rights activists say that managers of pre-trial detention centers and correctional facilities do not use the opportunities to release such inmates from punishment when it is necessary: “Though there is a list of severe health conditions that hinder further service of punishment, members of relevant medical commissions often fail to disclose the real diagnoses of such inmates.” Project activists even found some pre-trial detention centers where such medical commissions did not exist at all. Thus, in December 2018 Olga Vekovshinina, member of the Sverdlovsk Regional Public Oversight Committee found a severely ill inmate B in Correctional Medical Facility N51: “He had respiratory failure, his skin was dry and pale, he had emaciation and was not able to speak, he could hardly whisper words as all his oral cavity, oesophagus and respiratory tract were covered with fungus.” An application for release was submitted to Nizhny Tagil court straight away, but the man died: “His death was caused by disregard of his rights, which led to the disregard of his severe health condition.”

Rus Sidyashchaya NGO questions accuracy of the reports prepared by the Federal Penitentiary Service of Russia and stating that in the recent five years the number of deaths among Russian inmates due to health conditions decreased by 33%, in particular due to tuberculosis — by 38.6%, due to HIV — by 24.2%. “Such a sharp decline of death rate may be a result of manipulations with statistics rather that provision of proper treatment to the inmates,” says Aleksey Fedyarov, Head of the Legal Department at the NGO. “Often to ensure such a “mortality reduction effect” correctional facilities take all possible measures to urgently release incurable patients, who die soon after leaving the institutions, which allows to improve the death rate statistics in such penitentiary facilities.”

Human rights activists point out that the cornerstone of the human rights violations in places of confinement is lack of public control:

“Correctional facilities and pre-trial detention centers use their status of closed settings and hide the facts of human rights violations. If we have public control, very unpleasant stories will emerge.”

Based on the study, the Risk Group Project activists make a number of conclusions. First of all, they call to ensure that health departments are not subordinated to the administration of penal colonies and pre-trial detention centers and prohibit admission of the inmates with severe health conditions to punitive isolation wards. “Medical departments of pre-trial detention centers and correctional facilities do not recognize the diagnoses established by the “outside” doctors,” underline human rights activists. “Unless the diagnosis is confirmed by medical department of the facility, the patient is not able to receive the required treatment. As the repeated diagnostics may take weeks or even months, it leads to the aggravation of the patient’s health state, and in case of HIV — to the development of opportunistic infections.”

During the writing of this article, Kommersant did not manage to get a comment about this situation from the penitentiary service. Vasiliy Makiyekno, retired colonel of the Federal Penitentiary Service of Russia says that correctional facilities are often located in remote areas and it is difficult for civil doctors to get there: “It is too expensive to bring people, organize transport, so sick inmates do not have access to emergency care.” He also said that before being placed to a punitive isolation cell, inmates are examined by a doctor, who would not allow placing a sick person there. “Formally, health workers are not subordinated to the administrators of correctional institutions,” says the expert. “Of course, often there are some informal relations, but if an inmate dies in such an isolation cell, the doctor will have a tough time. He may face not only disqualification or dismissal, but also a criminal case.” “In general, oversight is ensured by the prosecutor’s office. There is also internal control: if there are any problems in the facility, sooner or later they cause an explosion,” says Vasiliy Makiyekno, adding that public oversight requires high qualification of the oversight commission members.

“Taking into consideration the work done, we call the deputies of the State Duma to make relevant amendments to the Federal Law “On public control of human rights in places of detention and assistance to persons in places of detention” and to the Criminal Procedure Code,” summed up Aleksey Fedyarov. “We need to get the message that there is such a need across to the deputies.”

The source of the material – https://www.kommersant.ru/doc/4038943

Newspaper Kommersant N127 dd. 22.07.2019, p. 5

Monitoring of HIV-related stigma and discrimination

The ways in which HIV-related stigma and discrimination are manifested and experienced are complex and varied. Many different measures from different perspectives are currently used to monitor HIV-related stigma and discrimination.

To better understand the status of HIV-related stigma and discrimination and progress towards their elimination, support advocacy for addressing HIV-related stigma and discrimination and highlight data gaps, UNAIDS is coordinating the development of summary measures of HIV-related stigma and discrimination. Please see the concept note for more background information.
Starting on 19 August 2019 for a period of three weeks, various elements of the draft measures will be discussed. A few key questions will guide the moderated discussion each week. Inputs and recommendations from each week will be shared at the start of the following week and used to inform the next element of the measures to be discussed.
To participate in the consultation please read more information here.

Through the 2016 Political Declaration on HIV and AIDS, the global community committed to eliminating HIV-related stigma and discrimination by 2020 “for the equal enjoyment of all human rights and equal participation in civil, political, social, economic and cultural life, without prejudice, stigma or discrimination of any kind” of people living with, at risk of and affected by HIV.
The proposal is to develop one summary measure of HIV-related stigma and discrimination and four accompanying summary measures of stigma and discrimination experienced by sex workers, gay men and other men who have sex with men, people who inject drugs and transgender people related to factors other than HIV. This will make it possible to capture the diverse forms of stigma and discrimination that may be experienced by key populations most affected by HIV that may not be directly due to HIV but that have important impact on the HIV response.

This virtual consultation aims to encourage broad participation, particularly of people living with and affected by HIV, gay men and other men who have sex with men, transgender people, young people, sex workers, people who use drugs and women, from all regions. Contributions through this consultation will be used to inform the development of the measure(s) and ensure they are people-centered, reflecting the lived experiences and realities of people, and meaningful to inform programmatic action.
A summary of inputs and recommendations from the consultation will be shared in September 2019.