Facts abour EECA region

HIV epidemic status in Eastern Europe and Central Asia (UNAIDS, 2017)

Since the start of the epidemic:
• Over 76 million HIV-infected patients registered
• 35.0 million people died of AIDS-related illnesses
• The number of people living with HIV was 36.7 million, of which 2.1 million were children under the age of 15.
• 20.9 million people (28%) living with HIV received treatment
• 76% of pregnant women living with HIV had access to treatment to prevent transmission of the virus to the fetus
• In 2017, 1.8 million new HIV infections were reported worldwide.

Have you already registered your abstracts for the EECA INTERACT 2019 workshop?

Attention! Selected abstracts will get free registration. Please find here more information. 

School of MSM and TG Leaders

On August 12–16, the “School of MSM and TG Leaders” was held in Almaty, Kazakhstan.

The objectives of this training were: to mobilize and increase the visibility of the community in the country; to create cohesion of the community itself; to create a tolerant attitude of the general population towards LGBT people.

More than 20 novice activists from different parts of Kazakhstan got new knowledge and skills to create a safe environment, maintain health and to improve the quality of life of LGBT people in the country.

“This is one of the best training I attended because it is not just a lecture but real master classes and personal experience of successful people’’ says one of the participants of the School. Indeed, the presenters – Amir Shaykezhanov – editor of www.kok.team and Elena German – program director of the Eurasian Coalition on Male Health www.ecom.ngo shared their professional experience.

The world is changing rapidly and today the most creative and innovative thinking leaders are pushing forward. The training itself and the presentation of the material were very unusual. From the beginning, the group was immersed in a creative trance – the participants were declared heroes of the Game of Thrones universe. “Five houses” – five groups of participants were engaged in the development of their unique projects for implementation in their regions. “Video blog to increase visibility”, “Community centers to support the LGBT community”, “Live libraries for anti-discrimination of HIV-positive MSM within the community”, “Improving HIV literacy among the LGBT community”, “Legal protection of the LGBT community” – during “The School” all these projects have gone all the way from the origin of the idea to a completed project application for receiving funding from the event organizers – AFEW Kazakhstan.

“We could not choose the best or most relevant topic, since all topics are important for the community,” admitted Roman Dudnik, chairman of the jury, director of AFEW Kazakhstan. As a result, the jury members – representatives of AFEW Kazakhstan and the Kazakhstan Union of PLHIV – decided to finance all projects. Teams are ready and are going to start in September.

 

 

New collaboration of AFEW International

We are happy to announce that AFEW International represented by executive director Anke Van Dam became a consultant of an international project “Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling” awarded with NIH grant.

As one of the significant contributors AFEW International will act as a liaison to the key networks, organizations, and partners in the countries in the region of Eastern Europe and Central Asia. We will help the project team access data and the best level expertise for undertaking modeling in EECA. As well as we will provide consultations and feedback on the modeling process in the EECA region.

The overarching aim of the project “Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling” is to optimize HIV prevention strategies for people who inject drugs (PWID) in 108 countries worldwide using dynamic economic modeling based on multiple large data sources.

The project will:

1) Develop an epidemic model to estimate the impact of HIV prevention portfolios among PWID for every country with available HIV prevalence data among PWID (108 countries), based on data from multiple large systematic reviews.

2) Externally validate the model in 9 key countries with the highest numbers of HIV-positive PWID (including Russia and Ukraine)

3) Develop a user-friendly and web-based multi-platform portal for dissemination of the epidemic economic model and associated data.

The research team of the project consists of:

Natasha Martin, DPhil, Associate Professor, a leading economic infectious disease modeler (University of California);

Steffanie Strathdee, PhD, Professor and a leading epidemiologist focusing on HIV among PWID with 500 publications;

Javier Cepeda, PhD, Assistant Professor, an economic modeler with expertise in cost data collection among PWID;

Peter Vickerman, DPhil, Professor, a leading modeler of HIV transmission among high-risk groups including PWID, MSM and FSWs (the University of Bristol);

Louisa Degenhardt, PhD, Professor, an epidemiologist with over a decade of experience in conducting global systematic reviews on IDU and health harms among PWID (the University of New South Wales);

Sarah Larney, PhD (the UNSW team).

 

What is the indicative target of your country?

Nearly one year after the first-ever United Nations High-Level Meeting on Tuberculosis, the Stop TB Partnership, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Health Organization, call for immediate action to implement the commitments that were made by Head of States and Governments.

Targets that were agreed in the October 2018 Political Declaration of the High-Level Meeting of the General Assembly on the Fight Against Tuberculosis for 2018-2022 are:

1) to provide appropriate diagnosis and treatment to 40 million people with TB, including 3.5 million children and 1.5 million people with drug-resistant TB;

2) to reach at least 30 million people with preventive treatment, including 4 million children under the age of five, 6 million people living with HIV and 20 million other household contacts of people affected by TB;

3) to mobilize US$13 billion annually needed by 2022 for implementation;

4) to mobilize US$2 billion annually for TB research and innovation.

The Stop TB Partnership, in collaboration with Avenir Health, has produced a  breakdown of what the global 40 million and 30 million treatment targets mean for each country, using the latest estimates of TB disease burden and data on case notifications published by WHO. This country-by-country breakdown (http://www.stoptb.org/resources/countrytargets/) provides indicative targets and benchmarks that could be used to inform country dialogue, further refinement and development of official national and sub-national targets, linked to the development and updating of national strategic plans for TB and associated funding requests, including to the Global Fund.

TB is now the world’s leading infectious killer, surpassing even HIV. In 2017, TB killed 1.6 million people, including 300,000 HIV-positive people.

Several high-TB burden countries have already started to use indicative targets to plan their actions towards ending TB, and others must do so as well if we are to collectively achieve the targets of the High-Level Meeting.

“The UN High-Level Meeting in 2018 demonstrated much greater political commitment to tackling TB, but now we need to deliver. We urgently need increased international funding to fight TB, and increased domestic resource mobilization,” said Peter Sands, Executive Director of the Global Fund. “Together, we must step up the fight to diagnose and cure the millions currently being left untreated and to counter the threat of drug-resistant TB. We can only reach the goal of ending TB as an epidemic by 2030 if we act now.”

School for People Living with HIV

Today, the community of people living with HIV (PLWH) in Kazakhstan is actively developing – the voice of community can now be heard at all levels, up to the Ministry of Health and the Parliament.

An important role in achieving this progress belongs to the events for potential activists organized by the Kazakhstan Union of PLWH together with AFEW Kazakhstan. One of them is a series of workshops called “School for People Living with HIV”. Such workshops are aimed at developing the community of PLWH to scale up the advocacy to promote their rights and interests and ensure care and support for PLWH at the local and national levels. They are organized with financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria within the project “Building Foundation for Sustainable HIV Response in Kazakhstan”. Yagdar Turekhanov, Program Advisor at AFEW Kazakhstan, told about the progress achieved.

 

Yagdar, what is the School for PLWH and how was it established?

The first workshop of the School for PLWH was held in November 2018 and brought together over 50 PLWH from all over the country. They were “newbies” – most of them just recently learned about their HIV status and did not have any experience of working in HIV organizations. People were enrolled after a competitive selection by motivation letters. It was a basic workshop where the participants learned about HIV, its treatment, and the role of civil society. They also received support in accepting their HIV status, bolstered their self-esteem and confidence. Following the first workshop, 25 most active participants who demonstrated their leadership skills, were selected. The goal of those workshops was to train a young generation of activists and to mobilize the regions to make the PLWH community of Kazakhstan act in a more targeted and coordinated way.

How would you describe the profile of the school participants?

Most trainees of the school are people who earlier had an experience of participating in similar activities, mobilized their peers and established local NGOs, making a significant contribution to the promotion of PLWH rights, reduction of the ART prices, etc.

What is the situation with PLWH rights in Kazakhstan?

The situation is different, and currently it greatly depends on separate individuals – friendly specialists, doctors, police officers, and workers of penitentiary facilities – as well as on the bravery and knowledge of the activists. Where such people are not numerous, the situation with observing the PLWH rights is disastrous.

What should a person do in case if his or her rights are violated?

Be brave enough to talk about it. File the case. Make a precedent. For this purpose, the person may ask more experienced community members and friendly lawyers for help.

Since 2019, Kazakhstan started using the ‘test and treat’ strategy. What does it mean?

For Kazakhstan, this approach, first of all, means breaking the stereotypes, challenging the traditional perceptions and the wide-spread myths about ART. It means fighting the “bonuses schemes”, when people take therapy only to get some incentives, but not because they see the linkage between ART and better quality of life. It includes working with health professionals, who can formally observe the protocols, but in some indirect ways, with their intonations, phrases, or even directly make their patients understand that they do not believe in what they do. E.g., they can often say something like “According to the new rules, I have to prescribe therapy to you, but you can refuse, all the more so because you have pretty good test results and those drugs are chemical anyway” or “I realize that you want to give birth to a child, but still you have to think twice as your husband has HIV and even if he does not transmit the virus to you – what will be the future of your child?” We try to change this kind of approach.

Is there a place for innovations in the PLWH community of Kazakhstan?

The active part of PLWH community is, of course, open to innovations – they are ready to introduce new approaches as soon as they learn about them or come up with them. Most of the general population are kind, empathetic people who are totally unaware of the modern scientific achievements in terms of HIV prevention and treatment. They are afraid for themselves and for their loved ones, thinking that HIV is a death sentence. Many people still think that HIV is transmitted through household contacts (“I know that HIV is not transmitted through air or touch, but just in case I would better protect my children from contacts with HIV-infected people”). It looks like this situation can only be changed by young people who are in their nature more open to new things, more tolerant and less prejudiced. Efforts aimed at young people, primarily at the students of medical colleges and universities, with the involvement of PLWH community, can gradually change the status quo. By the way, it is already happening – slowly but surely.

Will there be any workshops in future? Who will be able to participate in them?

Funding of such activities is currently very doubtful – donors gradually lose their interest to Kazakhstan, while attracting government funding is so far rather challenging. However, PLWH community is looking for new opportunities. Apart from the Schools for PLWH, PLWH camping events are held on a regular basis, where people more and more often pay for their own participation. Information about such events is shared through HIV NGOs, AIDS centers, social networks and messengers. The priority is given to “novices”. More experienced PLWH community members can try on the role of trainers after passing a competitive selection.

 

 

 

 

 

UNAIDS outlines progress on HIV, but decries funding cuts

The Joint United Nations Programme on HIV/AIDS (UNAIDS) released its latest report on the status of the HIV epidemic and the global response ahead of the 10th International AIDS Society Conference on HIV Science (IAS 2019), taking place this week in Mexico City.

The report highlights the impact community programmes have had in successfully expanding access to HIV treatment, supporting adherence and preventing new infections. However, it also shows that this progress is slowing and has been uneven, and that global funding for the HIV/AIDS response has fallen for the first time.

“We urgently need increased political leadership to end AIDS,” said UNAIDS interim executive director Gunilla Carlsson. “This starts with investing adequately and smartly and by looking at what’s making some countries so successful. Ending AIDS is possible if we focus on people, not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reach people most affected by HIV.”

Some countries are meeting or exceeding the UNAIDS 90-90-90 targets – 90% of people living with HIV knowing their status, 90% of those diagnosed being on antiretroviral therapy and 90% of those on treatment having viral suppression by 2020 – while others are falling behind.

Global progress stood at 79% knowing their status, 78% on treatment and 86% with viral suppression in 2018. However, when looking at the proportion of all people living with HIV worldwide – not just the proportion of the previous subset – the figures are less impressive, with just 62% being on treatment and 53% having viral suppression.

But these figures mask some notable disparities. Nearly 90% of people in Western and Central Europe and North America know their HIV status and are on treatment, but only about 80% of those have an undetectable viral load. In Asia and Latin America, the proportions tested and on treatment are lower, but almost everyone on treatment has achieved viral suppression. Eastern Europe and Central Asia, the Middle East and North Africa, and Western and Central Africa are falling behind on all three measures.

Globally, new infections and AIDS-related deaths continue to decline, but less steeply than before. At the same time, the number of people on HIV treatment continues to rise and appears on track to meet the 2020 target. According to UNAIDS global estimates, in 2018:

  • 37.9 people worldwide were living with HIV;
  • 23.3 million (62%) had access to antiretroviral therapy;
  • 1.7 million newly acquired HIV;
  • 770,000 died from AIDS-related illnesses.

This represents a 16% drop in new infections since 2010, with most of the progress seen in Eastern and Southern Africa. But incidence has increased in some regions including Eastern Europe and Central Asia (up 29%), the Middle East and North Africa (up 10%) and Latin America (up 7%).

The report shows that members of key populations and their sexual partners now account for more than half (54%) of the 1.7 million people who newly acquired HIV in 2018. These groups include men who have sex with men, transgender people, sex workers, people who inject drugs and prisoners. In Eastern Europe and Central Asia and in the Middle East and North Africa, these populations are thought to account for 95% of new infections. Here too, the distribution of who bears the brunt of the epidemic varies widely by region.

Despite the availability of antiretrovirals that can prevent mother-to-child HIV transmission, just 82% of pregnant women have access to them, resulting in 160,000 new infections among children – well short of the target of less than 40,000.

Regarding HIV prevention, the report says that only around 300,000 people worldwide – including 130,000 in the US – are using pre-exposure prophylaxis (PrEP), although this is at best a rough estimate. Similarly, although people who inject drugs account for a high proportion of new HIV infections in some regions, many lack access to adequate harm reduction services.

Although it is harder to gauge progress in this area, the report notes that stigma, discrimination, criminalisation, harassment and violence remain problems for many people living with HIV.

 

EECA INTERACT 2019

We are pleased to announce that, on the 18-19th November 2019, the first EECA INTERACT Workshop 2019 will take place in Almaty, Kazakhstan.

The EECA INTERACT 2019 Workshop builds scientific research capacity while simultaneously strengthening clinical, prevention, and research networks across the Eastern Europe and Central Asia (EECA) region. EECA INTERACT 2019 is an abstract-driven workshop focusing on factors unique to the region’s HIV, TB, and hepatitis epidemics. Bringing young and bright researchers together with top scientists, clinicians, and policymakers, EECA INTERACT 2019 aims to ignite a conversation that will build a stronger scientific base to serve the region and connect to the world.

EECA is the only region in the world where the HIV epidemic continues to rise rapidly. UNAIDS estimates point to a 57% increase in annual new HIV infections between 2010 and 2015.1 The World Health Organization has warned of a sharp rise in rate of HIV and tuberculosis coinfection, which poses a real threat to progress.2 Significant barriers to prevention and treatment services remain for people living with and affected by HIV, TB, and hepatitis across the region. For example, although the HIV epidemic in EECA is concentrated predominantly among key populations, particularly among people who inject drugs, coverage of harm-reduction and other prevention programs is insufficient to reduce new infections. The region urgently needs more effective strategies of prevention, treatment, and care and support that are tailored to the particular circumstances of individual countries.

The Amsterdam Institute of Global Health and Development (AIGHD) has over a decade of experience delivering in-country workshops and conferences that bring young researchers and established international experts together to share original research and state-of-the-art reviews on a wide range of topics. AIGHD has co-hosted the INTEREST Conference (the International Workshop on HIV Treatment, Pathogenesis, and Prevention Research in Resource-limited Settings) since its inception in 2007. The conference has grown from a small workshop to a full conference of more than 500 attendees each year.

Building on these proven results, AIGHD will collaborate closely with AFEW International and the AFEW network (AFEW) for EECA INTERACT 2019. AFEW’s deep roots and experience in the region offer a way to build sustainability into the new workshop, placing priority on local contributions. The EECA INTERACT 2019 will bring scientists, clinicians, members of civil society, and government officials together to tackle topics facing individual countries while building capacity and strengthening research and clinical networks. The two-day conference will focus on topics that are specifically relevant to EECA and dive deeply into particularities of the host country Kazakhstan, showcasing its successes, remaining challenges and responses.

The workshop objectives are:

  • To provide cutting-edge knowledge in the fields of epidemiology (modelling), treatment, pathogenesis, and prevention of HIV, TB, and viral hepatitis as well as chronic conditions;
  • To exchange ideas on providing and supporting HIV testing services and clinical care provision to adults, adolescents, and children living with HIV to achieve 90-90-90 goals;
  • To foster new research interactions among leading investigators and those who represent the potential future scientific leadership for health care and research in the region;
  • To build research and clinical capacity across EECA.

We invite researchers from EECA to submit their abstracts in the workshop. Selected abstracts will get free registration. Please find here more information.
Interested parties who do not have abstracts, but also wish to attend the event, can fill in an application form that will be considered by the committee. Please find here more information.

The deadline for all applications is September 20, 2019.

EECA INTERACT 2019 is organized by AFEW International, Amsterdam Institute for Global Health & Development (AIGHD), AFEW Kazakhstan and the Kazakh Scientific Center of Dermatology and Infectious Diseases.

EECA INTERACT 2019 is sponsored by Johnson & Johnson, Gilead, Aidsfonds.

Venue of the event: Hotel Mercure Almaty City Center.

#EECAINTRACT2019

If you have any further questions, please contact Helena_Arntz@AFEW.nl.

 

 

Bishkek signed the Paris declaration!

Yevgeny Yuldashev

Today, Bishkek, the capital of the Republic of Kyrgyzstan, has signed the Paris Declaration, thus becoming the first Central Asian Capital to join the Fast Track Cities Initiative: Ending the AIDS Epidemic by 2030. Signing of the Declaration stimulates cities to achieve 90-90-90 goals, offering to strategically partner key populations, providing sustainable access to HIV testing services, treatment and prevention, and fighting stigma and discrimination. 

 “I am pleased to be here today on behalf of the entire community of people living with HIV in Kyrgyzstan,” says Yevgeny Yuldashev, a peer consultant of AFEW Kyrgyzstan. “Often we are invisible, or society pretend that they don’t see us, or they don’t want to see us. But we exist, we are people too, we also deserve to live happily. The signing of the Paris Declaration today, I hope, will draw the attention of the mayor’s office and other officials to the problems of HIV-positive people.”

Tatyana Kuznetsova, deputy mayor of Bishkek, and Aleksander Goluysov, Coordinator of the UNAIDS Office in Kazakhstan

“For us, this is a very important event, for our city, for the whole country. This initiative is very relevant in general for large cities. Bishkek is the administrative, cultural and scientific center of the country. Improving the health and well-being of the citizens is the most important task of our municipality, ” – said Tatyana Kuznetsova, vice mayor of the city of Bishkek, in her speech.

The signing ceremony of the Paris Declaration was held in the Bishkek City Hall and was organized with the support of AFEW Kyrgyzstan, who is implementing the project “St. Petersburg and Bishkek: Key Groups and Priorities for HIV and TB Prevention” in Kyrgyzstan.

 

Nonexistent? We exist!

On the 28th of June in the framework of Drug Policy Week at the University of Geneva a documentary film “Nonexistent? We exist!” was shown.

The film is based on the result of the Program to expand the access of vulnerable groups to HIV / AIDS prevention, treatment and care services, which was implemented in the Russian Federation in 2015-2018.

The film told about the results of work under the Program to expand the access of vulnerable groups to HIV / AIDS prevention, treatment, and care services in Russia. This author’s documentary film about how the sincere desire of people to support each other, mutual respect and respect for rights should be the foundation of a modern health care system. Especially regarding socially significant diseases, such as HIV infection.

“This film is very authentic because it was created in cooperation with the representatives of key populations”, says Maria Yakovleva, executive director of the Russian Charitable Foundation “Candle”.

“Today 1 million people with HIV positive status live in Russia. A lot of them represent key populations at risk for HIV: people who inject drugs, men who have sex with men, sex-workers. With the help of this film we hope to draw the attention of our international partners to the problem of HIV infection in Russia and to show them that we are still far away from solving the problem and we need any support from the world society”.

The film was created by journalists Igor Kuzmenko and Alexey Kurmanayevsky from DUNews (Drug Users News) – an independent Russian-language news channel about events in and around a community vulnerable to HIV / AIDS.

After the film, there was a discussion about advocating for the needs of people who use drugs in Russia. Participants talked about the achievements of the project and the difficulties that communities are experiencing now caused by the absence of stable funding and stiffening stigma and discrimination of key populations. Daria Alekseeva, AFEW International Program manager, told about the role the organization plays in communities’ lives in the EECA region and particularly in Russia. AFEW International in cooperation with Aidsfonds provides small grants within the framework of the Operational Assistance Fund for key populations to help communities to execute harm reduction programs and to provide services to people.

You can watch the film “Nonexistent? We exist!” here https://youtu.be/5I5ZFug1Cbg.

 

 

“Orange morning”

On the 28th of June, in the framework of the project Fast-Track TB/HIV Responses for key populations in EECA (Cities) Almaty city in Kazakhstan held an important event for the community of people who use psychoactive substances – a photo exhibition “Orange morning”. The event was organized in honor of the World Campaign “Support. Don’t Punish”, which is held annually on the 26 of June, on the International Anti-drugs Day.

#SupportDontPunish is a global grassroots-centered initiative in support of harm reduction activities and drug policies that prioritize public health and human rights.

The color of this protest and the need to overcome aggressive drug policies and stereotypes against people who use psychoactive substances, with a focus on women, has become orange.

Women, the characters of the photos, shared their life stories about aggressive drug policies and systems that destroy their lives. The event organizers say that the main goal of the exhibition is not to appeal to emotions, not to cause regret, sympathy, condemnation or contempt. The goal is to call for the end of this senseless war that doesn’t bring any results. The war on drugs is beneficial only to politicians, law enforcement agencies and drug mafia.

AFEW Kazakhstan in the face of Roman Dudnik, executive director of the organization, supported the exhibition. “The greatest value of such events is that the campaign “Support. Don’t punish” is becoming more and more popular and followed in the world, and this is an excellent result,” Roman says.

A video report from the exhibition you can watch here https://youtu.be/1qS6J4gwfbw.