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. 

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.

 

 

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.

EECA INTERACT is a step towards the development of unified community

Why is the Workshop EECA INTERACT so important for the EECA region?

Alexei Alexandrov, a member of the international committee of EECA INTERACT 2019, head of Minsk regional clinical centre “Psychiatry-narcology”.

EECA INTERACT can become a model for building regional and country interaction between young and experienced researchers, medical practitioners, employees of non-governmental organizations and members of community initiatives, as well as representatives of the government.

All these specialists are involved in solving the problems of HIV infection, tuberculosis and viral hepatitis, and also related problems of drug use, criminalization, prison health, stigma and human rights. The exchange of experience by specialists from EECA countries with similar situations on HIV, TB, Hep, drug use, the results of new studies and expert assessments will allow choosing the best solutions to change the situation and begin to really implement them.

For me, EECA INTERACT is not only a meeting with new colleagues and getting acquainted with the results of their work, discussing pressing issues, forming direct contacts to continue cooperation or a network of interaction. The seminar is a continuation of the efforts that we, experts of the EECA countries, are directing to respond to the HIV epidemic in the region, implementation of those innovations that have already been tested in the world and are evidence-based.

The workshop is a step towards the development of a unified scientific, expert and practical community of our countries, united by common tasks. Everyone can have their own vision of the situation, challenges and solutions, but only joint discussion and analysis will allow finding potential points of influence for success.

 

How would you rate the development of clinical and research networks in the EECA region today?

Sergii Dvoriak, a member of the international committee of EECA INTERACT 2019, M.D., D.Med.Sci, founder and senior scientist, UIPHP, professor at the department of social work, ALSRT.

In our region, a lot of problems are associated with the traditions and imperfections of medical education. For several years I conducted training seminars “Effective Treatment of Drug Dependence” in Salzburg (organized by the Open Society Foundation), where all participants, mainly doctors, were divided into 2 groups, the Russian-speaking from EECA and the English-speaking from Southeast Asia and Africa. People from EECA were educated in the “Soviet” system, the others – in the “Western”.

I noticed a very clear difference in the methods for solving clinical problems. People from EECA went into “philosophy” and the so-called pathogenetic way of thinking, and “Western” immediately appealed to existing protocols and standards, objective data, etc. I then realized that many of our specialists need to be retrained and they should focus on evidence-based methods, and not on general considerations and “clinical points of view.” For this, we need such meetings like EECA INTERACT, where these points can be emphasized. It is important also that decision-makers participate in such events.

In Ukraine over the past 10 years, significant progress has been made in the development of clinical and research links. To some extent, a solid research infrastructure has been created, several organizations were found which can not only participate in international collaborative projects but also independently carry out research and receive funding from donors such as National Institutes of Health, CDC, WHO etc. Unfortunately, national donors are still very sparingly involved in this process.

Ministry of Health also does not understand enough how important the systematic and continuous process of conducting scientific research is, and the importance of implementation projects is underestimated.

Officials believe that only mainly state institutions have the right to make scientific research. They expect global discoveries or creation of new vaccines, effective drugs, but they do not really understand that in the modern world only a limited number of countries and companies are able to take such steps. There are no such resources in EECA countries, but this does not mean that research is not needed. Doctors should be involved in scientific projects as much as possible, because this disciplines clinical thinking, makes it possible to get acquainted with the modern scientific context.

 

 

 

 

RADIAN for the EECA region

On the 10 of September the Elton John Aids Foundation with Gilead Sciences announced the launch of a new project RADIAN. This major project aims to bring support to Eastern Europe & Central Asia, where the AIDS epidemic is on the rise.

A ground-breaking initiative

The global community now has the tools to meaningfully address new HIV infections; however, HIV is on the rise in Eastern Europe and Central Asia (EECA). To address the challenges in EECA and ensure no one is left behind in the global effort to end the HIV/AIDS epidemic, the Elton John AIDS Foundation and Gilead Sciences have partnered together in a ground-breaking initiative called RADIAN.

RADIAN is a natural evolution of the existing collaboration between the Foundation and Gilead in the EECA Key Populations (EECAKP) fund, which gave the organisations a greater understanding of the urgent needs in EECA and the necessary experience to respond. The RADIAN partnership will provide investment, support and on-the-ground resources over the next five years to support interventions and drive measurable impact in EECA.

Model Cities

RADIAN consists of two programs: ‘Model Cities’ and the RADIAN ‘Unmet Need’ Fund. The programme will support innovative approaches, including new models of care and expanded prevention and healthcare programmes, led by groups who are on-the-ground and part of the community. The first RADIAN ‘Model City’ will be Almaty, Kazakhstan’s largest city. Additional ‘Model Cities’ will be announced in 2020

The Radian Unmet Need Fund

The RADIAN ‘Unmet Need’ fund will support local initiatives across the EECA region and beyond the select ‘Model Cities’. Initiatives selected will focus on prevention and care, education, community empowerment, and novel partnerships. The programme will be implemented locally, working with key stakeholders and partners.

The project encourages local and regional organisations in EECA who share its vision of significantly improving the quality of care for PLHIV, addressing new HIV infections and AIDS deaths to apply for grant funding when the Request for Proposals opens in mid-October 2019. Best practices and learnings from the local implementation of RADIAN over the next five years will be used as a blueprint towards creating change across the region.

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).

 

In honor of Elena Grigoryeva

The Pride Walk which will take place on the 2nd of August in Amsterdam will be dedicated to the murdered Russian LGBT and human rights activist Elena Grigoryeva.

One of the goals of Pride Parade is to draw attention to the current situation of LGBT people in countries where homosexuality is still an offence. The Pride Walk 2019 started with a manifestation at the Amsterdam Homomonument on Saturday 27 July 2019, where a photo of Grigoryeva was placed. After the manifestation, activist Kirill Khattoev, who demonstrated with Grigoryeva in the past, carried Grigoryeva’s photo at the front of the march through the city.

Who was Elena Grigoryeva?

Elena Grigoryeva was murdered near her home in Saint-Petersburg on the 21 of July probably because of her involvement in the Russian LGBT movement.

She was a brave defender of the LGBT community’s rights, who participated in various civil initiatives. Because of her activism, she had been receiving death threats for some time. Also, as acquaintances of Grigoryeva said, her name was on a list of LGBT activists published by a Russian website that called on people to take vigilante action against them. The site was designed to help users to hunt and torture Russian gay people and was recently taken down by authorities after more than a year online.

Still a problem

Across the globe, lesbian, gay, bisexual, and transgender people continue to face endemic violence, legal discrimination, and other human rights violations on account of their sexual orientation or gender identity.

AFEW pays a lot of attention to defending human rights of LGBT communities and the rights approach towards sexual orientation in the Eastern Europe and Central Asia region. In this region chronic forms of stigma, discrimination and violence based on sexual orientation are still creating huge barriers for individuals to seek medical attention and for LGBT community to access testing services and life-saving HIV, TB, viral hepatitis prevention. AFEW advocates for the equality and full recognition of the civil rights of lesbians, gay men, bisexuals, transgender people in the EECA region.

 

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 and Aidsfonds.

#EECAINTRACT

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

 

 

AFEW-Kyrgyzstan Started the Year with Rebranding

By changing the name “AIDS Foundation East-West in the Kyrgyz Republic” at the beginning of the year 2019, AFEW-Kyrgyzstan emphasized its involvement in the international AFEW Network. Another reason for changing the name and logo of the organisation is the expanding capabilities.

“Now we are working not only in the field of HIV and AIDS. We are implementing tuberculosis treatment projects, conducting large-scale researches, carrying out advocacy campaigns to protect the rights of people and for the economic empowerment of women. Therefore, the former name no longer fully reflects our goals and values,” says the Chair of the Board of AFEW-Kyrgyzstan Natalia Shumskaya.

The new logo has retained one of the key elements of the previous one – the human figure, because everything AFEW does is aimed at helping specific people. The figure also shows that AFEW-Kyrgyzstan works, involving people from the community, and for them.

Three blue and one red objects around the white pattern represent different countries since AFEW-Kyrgyzstan is a part of an international network and is ready to use the experience of foreign partners to build a healthy future in the country.

In an updated form, AFEW-Kyrgyzstan is ready to welcome its old partners again and look for new opportunities to help people from key populations.

UN High-Level Meeting on Tuberculosis: People should be the Centre of the Fight

New York, 26 September 2018

The challenge of tuberculosis (TB) is faced worldwide, including across all of Europe and Central Asia. 1.6 million people died of the disease in 2017, and Heads of State are meeting today to discuss the matter at the UN General Assembly. TB kills more people each year than HIV and malaria combined. As one of the top ten leading causes of death TB deserves the highest political attention.

“I call on leaders of the world to commit to ending TB in their countries by allocating the necessary resources in their health budget, and involve us, civil society and communities in helping to reach the unacceptable 36% of people with TB who are still missed by health systems every year,” says Yuliya Chorna, the Executive Director of the TB Europe Coalition (TBEC).

Traditionally, people in many countries of the European region have been treated in hospitals for long periods from six months to two years. Patients have to suffer not only the burden and toxicity of a long-term treatment with heavy antibiotics but also being apart from their families, jobs and social lives.

“TB patients are no longer infectious by at most two weeks after they start and receive effective treatment. It is ridiculous that many programmes still isolate people from society for many months. No wonder people are afraid to seek a diagnosis. TB care has to be designed for and with people,” says Ksenia Shchenina, a former TB patient from Russia and Board Member of TBEC.

While European Heads of States are noticeable by their absence at the meeting, the WHO Europe region continues to be a hotspot for the spread of the multi-drug resistant (MDR) form of TB. Conservatism in the way TB is being treated in Europe and the lack of involvement of civil society and communities in TB care, who play a vital role for treatment adherence, has led to terrible figures in Eastern Europe and Central Asia. Too many countries report rates of around 30% of new cases being multi-drug resistant. Furthermore, worldwide only 25% of people with drug-resistant TB are on treatment.

Yet we still don’t have the right tools to fight TB. Our leaders have not allocated the right amount of funds to develop new vaccines, diagnostics, and treatment. We continue to have an astonishing annual $1.3 billion gap in Research & Development for TB.

“While the European Union congratulates itself on allocating on average less than €30 million per year to TB research initiatives in the last four years, it should think of reorienting its priority setting in health research to a needs-driven approach. Our taxpayers’ money should go to funding priorities neglected by the private sector,” says Fanny Voitzwinkler, Chair of the TBEC Board.

The UN High-Level Meeting on TB held on 26 September 2018 is a time for action and unity. We need changes if we want to stop the millions of preventable deaths caused by TB. Civil society can contribute greatly to effective people-centred care, it wants to be involved and will be watching to make sure the commitments made by world leaders at the HLM will be put into practice.

Source: TB Europe Coalition