Author: Inna Gavrilova, Ukraine
Two cities of Kyrgyzstan will soon join the Paris Declaration. After Bishkek and Osh, where almost 50% of the country population live, sign the political declaration on HIV/AIDS, the country will be able to accelerate its movement towards 90-90-90 targets.
“Paris declaration is the first step to start allocating funds from the local budget for HIV prevention and social support of people living with HIV (PLWH),” said Aybar Sultangaziev, Chairman of the Partner Network Association. “Besides, there will be monitoring of service delivery at the local level. Currently, healthcare system is managed only from the national level, with municipal authorities involved only nominally, which leads to a chaos and lack of comprehensive actions at the grassroots level. Paris Declaration will help us bring the issue of HIV/AIDS to the municipal agenda and make the efforts to resolve this issue more systematic.”
According to Mr. Sultangaziev, in early June a round table discussion will be held in Osh under the aegis of the #SoS_project regional initiative involving MPs, representatives of the Ministry of Health and civil society activists.
It is expected that political commitment to sign the Paris Declaration will be announced at this meeting.
As it was reported, earlier similar strategic efforts were also initiated in Bishkek, the capital of Kyrgyzstan: a relevant working group was created, with the action plan being discussed. General coordination to sign the Paris Declaration within the project “St. Petersburg and Bishkek: Key Populaitons and HIV & TB Prevention Priorities” is provided by AFEW International.
“Within this project, we focus on working with municipal level governments on HIV geographically-focused responses, which make a significant contribution to the achievement of 90-90-90 HIV/TB targets,” said Daria Alexeeva, AFEW International‘s program manager.
As of May 15, nine thousand of HIV cases were officially detected and registered in Kyrgyzstan, with almost 2 thousand deaths, almost 80% of PLWH aware of their status and 62% of them receiving ART.
It should be mentioned that in the recent years elimination of mother-to-child transmission of HIV has also been achieved, with less than 5% of such cas
es registered. Currently, Kyrgyzstan is getting ready to the WHO validation procedure.
Despite there have been successes in HIV response at the national level, cities and municipalities are not actively engaged in this process. Since 2015, health financing has been centralized, without local governments being involved. However, now there is a transition of HIV and tuberculosis treatment to the “primary” level, to the family health centres, and the role of local authorities responsible for relevant geographical area is to be strengthened.
“It will be a different structure, a different affiliation,” underlines Aybar Sultangaziev. “But first we need to prepare people, explain to them why it is needed and what the role of local government is. That is why we have all those meetings – to assess the readiness.”
Apart from re-distribution of responsibility, funding of the HIV response will also change. The National Transition Plan stipulates allocation of funds from the local budgets. Howe
ver, in practice this provision has not been fully implemented. According to Mr. Sultangaziev, signing the Paris Declaration will help to close this gap.
“The medicines and the therapy should be funded from the central budget,” he emphasizes. Meanwhile, social contracting, case management and some testing programs may be covered from the local budgets. This year, the total HIV budget grew by $330 thousand and reached over $900 thousand. If two other cities allocate 100 thousand each and support 4–5 local projects (outreach, support of PLWH, shelters) in each region, we will be able to fully substitute donor funding by 2023.”
