#SoS_project launched

Alliance for Public Health, leading a regional consortium uniting Network of People living with HIV/AIDS 100% Life, Central-Asian PLH Association and Eurasian Key Populations Health Network (EKHN), manages the multi-country project ‘Sustainability of services for key populations in Eastern Europe and Central Asia region’, funded by the Global Fund in amount up to USD 13 million. The project will be implemented throughout 2019-2021 and aims to reduce the HIV epidemic in the Eastern Europe and Central Asia and South East Europe regions through accelerating progress on Fast-Track by 2020 and to ensure the sustainability of HIV services for key populations in 14 countries of the regions: Belarus, Bosnia and Herzegovina, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Montenegro, North Macedonia, Romania, Russia, Serbia, Tajikistan, Ukraine and Uzbekistan.

The project launch meeting was held on 26 March 2019 in Kyiv, Ukraine. It gathered all implementing partners, regional and global stakeholders, donors active in the region to discuss the program approaches and plans, get strategies advise and coordinate with other regional initiatives to maximize impact of investment.

At the project coordination meeting on 27 March all regional consortium members, project sub-recipients, implementing and technical partners in the region to discuss and coordinate the concrete plans and timelines for project activities among the implementers.

To achieve the expected savings, the project will develop strategies for optimizing the cost of ART regimens, which will lead to a decrease in the average cost of first-line ART. Advocacy activities will also be carried out aimed at reducing prices for ARVs and using savings to finance the needs of prevention and care services for the Key Groups and PLHIV. In addition, work to optimize clinical guidelines for ART, a list of drugs in accordance with WHO guidelines is planned, as well as advocacy to include countries in voluntary licensing and registration of generic manufacturers.

Andriy Klepikov, the Executive Director of the Alliance for Public Health, said that almost half of these funds ($ 5.6 million) will go to the advocacy of the reduction of prices for ARV drugs and optimization of procurement mechanisms.  Another quarter of the project budget ($ 3.2 million) is planned for budget advocacy. $ 1.6 million is provided for the removal of legal barriers, the same amount for project management. Another $ 1 million will go to operational research.

“The idea is not only to throw in some initiatives, but simultaneously with such interventions to launch operational research, which will help identify and prove their effectiveness,” explained Klepikov. – “It worked, in particular, in Ukraine. But we would not want other countries to take it on faith. In each country for advocacy, before the Ministry of Health will start funding, it is important to get a serious evidence base, which is collected through operational research”.

DPNSEE member organisations Cazas and Timok Youth Centre will be sub-recipients of the project in Montenegro and Serbia, while HOPS is involved in project implementation in North Macedonia.

New publication from Eurasian Harm Reduction Association

EHRAThe Eurasian Harm Reduction Association (EHRA) presented its new publication “Getting to know the Civil Society and Eastern Europe and Central Asia Delegations to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. An Information note for Eastern Europe and Central Asia”. The publication is developed within the project of the EECA Regional Platform for Communication and Coordination.

This Information Note is an easy-to-use document which allows for greater understanding of the work and role of the Communities, Developed Country NGO, Developing Country NGOs and the Eastern Europe and Central Asia (EECA) Delegations to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. The EECA Delegation is dedicated to the causes and concerns of the region, both from a public sector and civil society perspective. The other three Delegations have specific mandates to bring to the Board the issues of civil society and all the communities of persons living with, and affected by, the three diseases in those countries eligible for Global Fund support.

Getting to know the Civil Society and Eastern Europe and Central Asia Delegations to the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria

Whilst there are four distinct Delegations, these Global Fund Board representatives have similar practices for their internal functioning and in consulting with civil society and communities as well as established opportunities to engage with them. This document provides information concerning these key practices and opportunities. The communities and civil society organizations (CSO’s) in the EECA region will be able to use this document to better plan and coordinate their advocacy efforts and engage with their representatives to the Fund at the most opportune times and in strategic ways.

The Global Fund is the world’s largest financing organization for HIV and AIDS, TB and malaria prevention, treatment, care and support programs. The Fund’s purpose is to attract, leverage and invest additional resources to end the epidemics of HIV, tuberculosis and malaria to support attainment of the Sustainable Development Goals (SDG’s) established by the United Nations. Since its founding in 2002, the Global Fund’s investments in the EECA region have contributed to considerable progress in combating three diseases as well as in developing enabling environments and the strengthening of health and community systems, making the Global Fund the major donor to support the HIV and TB response in the EECA region.

To read or download this publication follow this link>>>>

Serbia completed project application to the Global Fund

The National Committee for fighting HIV/AIDS and Tuberculosis, which performs the role of the Country Coordinating Mechanism in Serbia, adopted today the documents which will be submitted to the Global Fund to fight AIDS, Tuberculosis and Malaria. The project is expected to run from July 2019 to June 2022.

Back in 2016, the Global Fund allocated €1,098,351 for HIV and building resilient and sustainable systems for health. The allocation have been determined primarily based on disease burden and income level. Serbia is classified as an upper-middle-income country. Serbia committed to encourage additional domestic investment of 25%. The first amount agreed during the application in already included in the national budget for 2019.

The project seeks to scale-up HIV testing services for all key affected populations (KPs), preventive programs for men who have sex with men and sex workers and needles and syringes program (NSP) and other preventive programs for people who inject drugs. In addition, the project seeks to maintain and extend support provided by organizations of people living with HIV to people on antiretroviral treatment. The project will fund services provided by civil society organisations and will contribute to community system strengthening. In order to reach the maximum impact the majority of prevention and support interventions will be implemented at least in the two regions (Belgrade and Vojvodina) in which majority of KPs are concentrated based on surveillance data..

The civil society organisations, including DPNSEE and our three member organisations from Serbia Prevent, Duga and Timok Youth Centre, actively participated in creating the new national HIV strategy, in the work of the National Committee and the Working group for negotiations with the Global Fund.

Meeting of the Working group for negotiations with the representatives of the Global Fund

Global Fund eligibility list 2019

The Global Fund to Fight AIDS, Tuberculosis and Malaria has recently published its updated country eligibility list for 2019. The list reflects the eligibility determinations for the year 2019 (a non-allocation year) and is for information purposes only. Allocations are made once every three years following the outcomes of the Global Fund’s replenishment The 2020 Eligibility List will determine which country components are eligible for an allocation for the 2020-2022 allocation period.

SEE countries affected by changes are Bulgaria, Kosovo*, North Macedonia and Romania. Montenegro and Serbia remain eligible for HIV disease component due to high disease burden.

Bulgaria and Romania may be eligible for an allocation for HIV/AIDS for non-governmental or civil society organizations if there are demonstrated barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology for the 2020-2022 allocation period.

Kosovo is newly classified as an Upper-Middle Income country based on the latest three-year average of GNI per capita data. As Kosovo’s HIV/AIDS and TB burden are ‘Not High’, both the HIV/AIDS and TB components are now eligible for Transition Funding for the 20202022 allocation period.

North Macedonia‘s HIV/AIDS disease burden classification changed to ‘Low’ in 2018 to ‘High’ in the 2019 Eligibility List, resulting in one determination of eligibility. Country components must be eligible for two consecutive eligibility determinations to be classified as eligible on the Eligibility List.

According to the GF Eligibility Policy “Upper-middle income countries meeting the disease burden criteria, but some may be eligible for an allocation for HIV/AIDS to directly finance non-governmental and civil society organizations, if there are demonstrated barriers to providing funding for interventions for key populations, as supported by the country’s epidemiology. 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”.

To read full document with the eligibility list follow this link>>>>

An interesting webinar on social contracting

Health Policy Plus, APMG, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, UNAIDS, UNDP, USAID and others hosted a webinar on 6 March 2019 to discuss social contracting for HIV care, treatment and support. Presenters from around the world discussed how to plan for social contracting as part of a long-term sustainability strategy and how to advocate for it, touching on policy and regulatory challenges, how to develop mechanisms to put social contracting in place and how to implement and monitor social contracting’s success.

To view the recording of the webinar, follow this link>>>>

Slides from the webinar are available following this link>>>>

Health Policy Plus also prepared a factsheet Social Contracting: Supporting Domestic Public Financing for Civil Society’s Role in the HIV Response from which you can learn more about social contracting and how it can support domestic public financing for civil society’s role in the HIV response. You can find the factsheet following this link >>>>

Joint Briefing on Global Fund Catalytic Investments for Harm Reduction

The Global Fund to Fight AIDS, Tuberculosis and Malaria is the largest donor for harm reduction in low and middle countries (LMICs), providing two-thirds of all international donor support. In May 2019, the Global Fund Board will approve the 2020 – 2022 allocation methodology and catalytic investment priorities, ahead of replenishment for the Global Fund in October 2019. These will have significant implications for harm reduction in LMICs and as such, the ability of the Global Fund to step up the fight and get back on track to end AIDS by 2030.

This briefing, developed by the Harm Reduction International  in collaboration with the International HIV/AIDS Alliance, compiles evidence of the crucial nature of catalytic investment funds for harm reduction. In the briefing, we urge the Global Fund Board to safeguard catalytic investment funds – including multi-country grants, matching funds and strategic initiatives – regardless of the replenishment outcome, in order to sustain life-saving services for people who inject drugs and to incentivise domestic investment in harm reduction.

You may access the briefing following this link>>>>

A tool presenting the situation in South East Europe

The Drug Policy Network South East Europe published the document  Addressing the acute funding crisis facing harm reduction services in South-East Europe with the aim to emphasize the acute funding crisis facing harm reduction services in Balkan states and South-East Europe, to influence the policies and actions of the Global Fund to Fight AIDS, Tuberculosis and Malaria  and other donors. It is a complementary part of a larger body of work being done by a wide range of partners – including the Open Society Foundation and the International Drug Policy Consortium – to document the consequences of changes in donor eligibility policies, and to urgently try and influence donor policy away from a withdrawal from middle-income countries in South East Europe.

DPNSEE worked with their partners and members across the region to gather case studies of Opioid Substitution Therapy stock-outs or shortages, service closures or reductions in coverage, and other critical issues experienced by civil society partners in South East Europe related to transitions away from Global Fund support. Through interviews with key stakeholders and desk-based research, DPNSEE gathered information, experiences, feedback and recommendations from Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Kosovo*, Macedonia, Montenegro, Romania and Serbia.

The material was collected in November – December 2017. Since then, it was used only internally. The document was published and shared with the participants of the South East Europe pre-Conference meeting, held in November 2018 in Bucharest, Romania.

Click here to download the document >>>

Global Fund Results Report

The Global Fund to Fight AIDS, Tuberculosis and Malaria released a report today demonstrating that 27 million lives have been saved by the Global Fund partnership through the efforts of the Global Fund and its partners. This is proof of the effectiveness of the global commitment to tackle the world’s deadliest infectious diseases.

The Results Report 2018 includes key annual results achieved in countries where the Global Fund invests:

  • 17.5 million people received antiretroviral therapy for HIV.
  • 5 million people tested and treated for TB.
  • 197 million mosquito nets distributed to prevent malaria.

The progress comes against the backdrop of new threats to global health. Having reduced sharply since the peak of the epidemic, global HIV infection rates are now declining more slowly, and remain extremely high among key populations in some countries. Tuberculosis is now the leading cause of death from infectious diseases, with 1.7 million deaths per year, and the world is missing 4.1 million cases of TB every year – cases that go undiagnosed, untreated and unreported. In addition, progress against malaria has stalled. In 2016, there were 5 million more cases of malaria than 2015. With growing resistance in drugs to treat malaria and in insecticides for mosquito nets, efforts to control malaria are at stake.

Independent opinions state that if the world only maintains current levels of investments and programming against the three epidemics, internationally agreed targets for 2025 and 2030 will be unattainable.

The world risks losing control of all three epidemics. A resurgence will cost countless lives, undermine economic and human development, and threaten the health security for all people on the planet.

As the leading multilateral organization that invests in ending the 3 epidemics, funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria in its Sixth Replenishment needs to increase by more than 20% to ensure a fund of between $16.8 and $18 billion for 2020 to 2022.

The Results Report 2018 is available from the Global Fund webpage following this link>>>

Shall Romania become eligible for Global Fund HIV allocation again?

Today, Romania spends about 70 million euros for HIV treatment, care and support towards reaching universal access, covering 12,247 people with HIV out of 15,212 as of 2017. However, “the Romanian authorities invest practically no money in HIV prevention”, says Nicoleta Dascalu, project manager from the Romanian Association Against AIDS – ARAS. That is why becoming ineligible for the Global Fund’s support of HIV became yet another dramatic episode in Romania’s HIV history.

The Global Fund’s Revised Eligibility Policy was approved at the 39th Board Meeting. In the revised version, the OECD DAC ODA requirement unfortunately was left as it was – but the term “political barriers” in the same provision was replaced with just “barriers,” with a note that eligibility for funding under this provision will be assessed by the Secretariat as part of the decision-making process for allocations. In addition, the Secretariat will look specifically at whether there are laws or policies that influence practices and seriously limit and/or restrict the provision of evidence-informed interventions for key populations.

It is not clear yet if the replacement of the term “political barriers” with just “barriers” will somehow influence Romania’s chance to receive an allocation for its HIV component within the next allocation period; speculation suggests probably not. The only chance for the Romanian HIV component to become eligible again for Global Fund funding is the elimination of the relevant requirement in the Eligibility Policy, says Dragos Rosca, the Executive Director of the Romanian Harm Reduction Network.

Read more in the analysis Ivan Varentsov prepared for the Aidspan website following this link>>>>

The Global Fund awarded only one HIV multi-country project

In December 2017, The Global Fund to Fight AIDS, Tuberculosis and Malaria called for proposals from qualified organizations to provide programming for the HIV strategic priority area “Sustainability of services for key populations in Eastern Europe and Central Asia region” under the Multicountry catalytic funding modality for the 2017-2019 Allocation Period. Five proposals were submitted. The Global Fund announded at the AIDS 2018 Conference last week that all of them were not of excellent quality and that only one will be supported. Here is the information about which one was awarded.

New levers of change in Eastern Europe and Central Asia:
Global Fund awarded multi-country project to the Alliance led regional consortium

On July 31, 2018, the Global Fund announced its decision on the approval HIV multi-country project ‘Sustainability of services for key populations in EECA region’ submitted by consortium of regional organizations from Eastern Europe and Central Asia (EECA) – Alliance for Public Health, All-Ukrainian Network of PLWH 100% Life, Central Asian PLWHA Association and Eurasian Key Populations Health Network (EKHN), together with technical partners and TB People. The proposal incorporated contributions from Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russian Federation, Tajikistan, Uzbekistan and Ukraine.

The Global Fund informed that the application from Alliance-led regional consortium was approved in full amount with the total budget over $ 10.5 million for three years (2019-2021).

The main objective of this project is to ensure the sustainability of services for key populations and to substantially improve the HIV cascade in the key countries of the EECA region.

“EECA is nearly the only region globally with rising HIV infections. We have very ambitious targets: to stop this dangerous trend and to make services for key populations accessible and sustainable in our region. We are ready to cooperate and join efforts with all partners to make national funding for key populations a reality!’, – stated Andriy Klepikov, Executive Director of Alliance for Public Health.

“Nine countries with high levels of HIV in the region will be able to use technologies and solutions that have already proven effective. We, as the largest patient organization, are ready to partner with our colleagues to provide access to treatment, services and resources for all key populations and patients,” – said Dmitry Sherembey, Head of Coordination Council, 100% Life.

Although the main focus of the project is HIV, the consortium of regional organizations will be working closely with the multi-country TB project which will be implemented by a consortium led by PAS Center (Moldova) in 2019-2021 with the support of the Global Fund.

This is the joint victory of national, regional and international partners and the consortium is looking forward to implementing the work together.

DPNSEE congratulates the Consortium and wishes them success in implementing the project.