Transition to the sustainability of HIV response in EECA region: regional approach

On the 25 July, at the ActiveEast Zone in the Global Village of the AIDS 2018, EHRA organized a session “Transition to the sustainability of HIV response in EECA region: regional approach”.

The aim of the session was to discuss and help the participants to better understand the situation in EECA region with regard to transition from the Global Fund’s support of HIV services for key populations to national funding, sustainability of such services, and the role of the regional HIV projects in this context. Next representatives from major SEECA regional and national networks shared their perspectives on the current situation with national ownership of HIV programs: Alexandrina Iovita, Human Rights Advisor, CRG Department, Secretariat of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Andrey Klepikov, Executive Director, Alliance for Public Health (Ukraine); Gennady Roshchupkin, Community Health Systems Coordinator, Eurasian Coalition on Male Health (ECOM); and Ana Filipovska, SEE RCM Coordinator.

The participants of the session have discussed that the process of transition to domestic funding has started in CEECA several years ago, and now it is possible to identify several major themes around which the civil society concentrates its efforts: ARV price reduction (needed to reduce wastage of resources and put more people on treatment with the state amount of allocations); increasing the volume of domestic funding for social contracting mechanisms for HIV-service NGOs; mobilization of more funding because otherwise the region isn’t likely to reach its targets for HIV. And there are already encouraging experiences do exist in the region in almost each of these areas: in aspects of reducing pricing of medications for ensure that treatments reach more people (e.g. Ukraine), importance to work with the city and regional levels (e.g. Kyiv, Odessa, Almaty), developing mechanisms for government to contract NGO services for key populations (social contracting) in addition to the concerted efforts to allocate funding for these services (e.g. in Macedonia). The factors in this work is solidarity, learning from bad and good practices including from SEE, using international organization engagements until it is there including WHO.

But even with some positive changes happening now in these areas, the Global Fund and other international donors should have longer-term and nuanced transition policies, which will help prevent ruining community systems on the national and regional levels that still almost fully rely on their support.

The Global Fund has been supporting regional projects in EECA which address sustainability. There have been concerns how to make these regional efforts more effective. At the moment of the session, the Global Fund still was in the final stages of its decision which regional proposal on HIV will be selected for their support in 2019-2021; such long process was related to some concerns over strengths and weakness of all the proposals received. The decision to support the application submitted by the Alliance for Public Health and Ukrainian Union of People living with HIV was announced by the Global Fund the next week after the conference. In case of TB, the decision was taken a month ago, it will be the continuous support for the TB-REP project.