Martine de Schutter Scholarship Fund Launched

AFEW International sets up Martine de Schutter Scholarship Fund that allows participants from Eastern Europe and Central Asia (EECA) to attend the 22nd International AIDS Conference (AIDS 2018). Martine’s commitment to the international fight against AIDS and her unwavering support to the Eastern European region has set an example for us to follow. That is why AFEW International established the Scholarship Fund named after Martine de Schutter – our friend and fellow activist.

As of today, Martine de Schutter Fund raised 103.000 EUR to cover the additional scholarships of the EECA applicants to come to Amsterdam for AIDS 2018. A part of the Martine de Schutter Fund has been distributed to the applicants from EECA through the established Scholarship Committee of the International AIDS Society (IAS) of which 45 are regular scholarships and 20 – for speakers who will be invited from the EECA region. AFEW thanks Gilead, Janssen Cilag, Deutsche AIDS-Stiftung and Aids Fonds for their contribution to this Fund.

Martine de Schutter was a strong advocate for human rights. For about 10 years she managed the European network AIDS Action Europe, which connects more than 400 AIDS organizations throughout Europe and Central Asia. Martine worked with dedication and passion to keep the AIDS problem on the agenda at the European Union and to connect all organisations working on the same issues in Eastern Europe. In 2014, Martine became the Program Leader for Bridging the Gaps: Health and Rights for Key Populations program. She travelled a lot and her last trip was to AIDS 2014 Conference in Melbourne on the MH17 plane that was shot down and crashed.

 

EECA Success on the Road to AIDS 2018

The total of 603 abstracts from Eastern Europe and Central Asia (EECA) were submitted to 22nd International AIDS Conference AIDS 2018 to be held in July in Amsterdam, the Netherlands. 182 abstracts out of them were selected for the abstract book, posters and oral presentations.

These results were achieved with the support of AFEW International, Dutch Ministry of Foreign Affairs and in partnership with EECA regional networks EHRA, ECOM, ECUO and GNP+.

“It is a great success, and we can see that especially by comparing it with the previous AIDS conferences. In comparison to the AIDS 2016 Conference that took place in Durban, South Africa, the amount of submitted abstract has more than tripled, and the number of accepted abstracts has increased by almost six times,” says AFEW International Project Manager of AIDS 2018 EECA Daria Alexeeva. “124 abstracts were submitted to AIDS 2016, and 31 were accepted. The acceptance rate has increased this year as well – 31% against 25%.”

The special group of 25 EECA organizations whom AFEW International supported with on- and offline training program on community-based participatory research and funded their local community-based researches, has shown even greater results. Eight of the abstracts that were developed based on their researches were accepted. 13 scholarships were awarded.

Besides, a special EECA communities networking zone was secured at the Global Village of the Conference. Challenges and successes of the region will be featured there. EECA regional networks and community organisations will use the zone to jointly advocate for financial sustainability for the AIDS response in the EECA region, vanishing legal barriers for effective prevention programs and increasing meaningful participation of the communities in decision and policy making.

AIDS 2018: Call for Journalists

The International AIDS Conference is the largest conference on any global health issue in the world. First convened during the peak of the AIDS epidemic in 1985, it continues to provide a unique forum for the intersection of science, advocacy, and human rights. Each conference is an opportunity to strengthen policies and programmes that ensure an evidence-based response to the epidemic. The 22nd International AIDS Conference (AIDS 2018) will be hosted in Amsterdam, Netherlands 23-27 July 2018.

The theme of AIDS 2018 is “Breaking Barriers, Building Bridges”, drawing attention to the need of rights-based approaches to more effectively reach key populations, including in Eastern Europe and Central Asia and the North-African/Middle Eastern regions where epidemics are growing. AIDS 2018 aims to promote human rights-based and evidence-informed HIV responses that are tailored to the needs of particularly vulnerable communities – including people living with HIV, displaced populations, men who have sex with men, people in closed settings, people who use drugs, sex workers, transgender people, women and girls and young people–and collaborate in fighting the disease beyond country borders.

If you are a journalist and interested to learn more, please register at http://www.aids2018.org/Media-Centre. There are still opportunities for scholarships. You can also subscribe to newsletters to support your work in-country. For further questions, please contact media@aids2018.org

EECAAC 2018: Treatment or Epidemic

The problems of EECA were discussed at the VI Eastern Europe and Central Asia AIDS Conference in Moscow on 8 – 20 April 2018

Author: Anastasia Petrova

Russia accounts for two-thirds of the new HIV cases in Europe and Central Asia. This is what the UNAIDS data show. One of the key factors contributing to the further spread of the epidemic is low treatment coverage: only one-third of people who need treatment get it. This fact, as well as other problems of the region, were discussed at the VI Eastern Europe and Central Asia AIDS Conference (EECAAC 2018) held in Moscow on 8 – 20 April 2018.

“What should be done to make sure that every HIV positive person has access to high-quality modern treatment from the day he is diagnosed with HIV in any place of our huge country? Maybe we should all – activists, business, government – honestly recognize that the AIDS war is lost, should join our efforts and reconsider where we are and where we go,” said Aleksandr Chebin, the activist of the Patient Control Movement, Yekaterinburg.

Patients demand treatment

“A special program was adopted in Russia to prevent the spread of the virus in the country, which allowed significantly increasing HIV/AIDS patients’ coverage with treatment services,” told Olga Golodets, Deputy Prime Minister of the Russian Federation at the EECAAC 2018 opening ceremony. However, experts say that the measures taken are not enough.

According to Vadim Pokrovskiy, Head of the Russian Federal AIDS Centre, only 35.5% of people living with HIV in Russia receive treatment. Even those who are registered in HIV care are not guaranteed treatment. In early 2018, fifteen regions of the country have reported stock-outs of antiretrovirals (ARVs).

On activists’ of the Patient Control Movement made attempts to voice this message at the opening ceremony T-shirts there was a message STOP, STOCK-OUTS!

Activists of the Patient Control Movement made attempts to voice this message at the opening ceremony. During the speech of Olga Golodets, people present at the ceremony stood up and took their coats off. Red letters on their snow-white T-shirts read STOP, STOCK-OUTS! This silent protest was a way for the patients to express their indignation with access to treatment in the country.

“Fight with HIV is a joint fight, which includes civil society and the volunteers who are now standing in front of us,” said the public official about the protest.

Disease of the system

According to experts from the International Treatment Preparedness Coalition in EECA (ITPCru), stock-outs are a systematic problem in Russia.

“The Ministry of Health announces tenders too late, and then the suppliers fail to supply drugs to the regions in time,” said Natalia Yegorova, Monitoring and Advocacy Officer, ITPCru.

Svetlana Prosvirina representing SIMONA+ project mentioned that according to the survey held by the patients’ community, 50% of patients of the AIDS centres faced problems when receiving their antiretroviral therapy (ART), such as stock-outs and frequent changes of treatment regimens.

“Apart from the stock-outs, we also identified other barriers in access to the health services: location of the AIDS centres, queues, long list of medical examinations to be completed before ART initiation (which is a significant barrier for injecting drug users), long-term before treatment start – 1 to 3 months, and health care system-related problems, such as stock-outs of ARV drugs and diagnostic tools,” told Svetlana.

Tim Martino, Deputy Director of UNAIDS called Russia to adopt the international ‘test and treat’ strategy. This approach stipulates treatment initiation not waiting for the immune status going down. Such strategy proved effective in the African states. However, it is still ignored in Russia.

Vinay P. Saldanha, UNAIDS Regional Director for Eastern Europe & Central Asia explained that to cover all patients with treatment the price of a yearly course per patient should not exceed USD 100

Timofey Nizhegorodtsev, expert of the Russian Federal Antimonopoly Service delivered a speech at the session “Strategies to Enhance Access to ARVT and Drugs to Treat Comorbidities in the EECA in the Light of Current State of Affairs.”

“Currently, a draft law on public health is prepared, which will allow local producers to manufacture the required drugs at affordable prices,” he said

Price reduction is the key

Only a sharp price reduction will make it possible to provide all people in need with treatment in the country, experts say. Vinay P. Saldanha, UNAIDS Regional Director for Eastern Europe & Central Asia explained that to cover all patients with treatment the price of a yearly course per patient should not exceed USD 100.

“Only in this case, the Russian Federation has a chance to achieve the 90-90-90 targets and meet the commitment to end the HIV epidemic by 2030,” pointed out Mr. Saldanha.

The key results of EECAAC 2018, as well as the actions to be taken, are included to the Final Statement of the VI Conference. The document is currently to be adopted by the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor) and will be published before the end of April.

EECAAC 2018: in Search of Optimism

Peter Reiss, Local Co-Chair of the 22nd International AIDS Conference (AIDS 2018), Professor of Medicine at the Academic Medical Centre (AMC) in Amsterdam, the Netherlands

Author: Marina Maximova, Kazakhstan

While the VI Eastern Europe and Central Asia AIDS Conference (EECAAC 2018) was going on in Moscow, Svetlana (the name was changed), a 28-year-old woman living in Karaganda, Kazakhstan became a mother for the first time. It seems that these events are not related at all. However, these two facts were brought together not accidentally. At the international forum, scientists, medical professionals, policy-makers, public officials, international experts and civil society activists argued and discussed how to curb the HIV epidemic and achieve the ambitious 90-90-90 UNAIDS targets. Meanwhile, they were not particularly optimistic. At the same time, a woman living with HIV for eight years gave birth to healthy twins. Maybe it is a sign that we should not give up hope?

Optimists and pessimists together

The question of HIV vaccine has become proverbial. For many years, the best scientific minds of the world have been struggling to invent it. There is no consensus among scientists about the feasibility of a panacea for HIV – the discovery of a vaccine.

Vadim Pokrovskiy, Head of the Russian Federal AIDS Centre honestly says that he is pessimistic about it.

“Personally, I think that it is not possible. There are infectious diseases, to which people naturally become immune after they recover from them. HIV is more like malaria, which does not belong to this category. However, I would be very happy to see such vaccine discovered,” says Dr. Pokrovskiy.

Salim Abdool Karim, Director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA), vice versa, says that he has never been as optimistic about the HIV vaccine as today.

“A study on the production of HIV antibodies is already in progress. In South Africa, there is a woman, whose antibodies kill about 87% of all known modifications of the virus. We take her antibodies and test their efficiency in HIV prevention,” tells the scientist.

This positive attitude is also shared by Peter Reiss, Local Co-Chair of the 22nd International AIDS Conference (AIDS 2018), Professor of Medicine at the Academic Medical Centre (AMC) in Amsterdam, the Netherlands. He points out that HIV vaccine trials successfully started in Thailand several years ago. Currently, research is going on and the preliminary data are promising. However, this work takes a long time.

Prolonged ART gives a hope for tomorrow

At EECAAC 2018, the leading world scientists shared information about the development of two ARV drugs with prolonged effect

At EECAAC 2018, the leading world scientists shared information about the development of two ARV drugs with prolonged effect. It means that people living with HIV will be able to substitute daily pills with periodic injections. It is much more convenient. Currently, two major research studies of prolonged-action drugs are going on in South Africa.

Stefano Vella, Head of the Department of Therapeutic Research and Medicines Evaluation at the Italian National Institute of Health says that the studies of prolonged-action drugs are currently underway.

“It is not just about injections, but also about implants. For instance, like female contraceptives. It is important that there should be an option to remove them in case of side effects. Every patient should have a choice which medicines to use and the patient’s preferences should be taken into account,” he says.

There is no doubt that the right to choose has an impact on adherence to treatment. For those who have problems with adherence, the ability to take drugs not in the form of pills and without the need of daily administration may be the key to undetectable viral load and better quality of life.

Just a story

Svetlana from Karaganda learned about her positive HIV status when she was 20. The woman did not have a vaccine. For a long time, she could not accept her diagnosis. She even had suicidal thoughts. Svetlana had no idea how to go on living her life. However, she met a man, fell in love with him and they got married. ARV medicine helped her to give birth to healthy children. The happy mother with her babies has already been released from the maternity clinic. The twins have a good appetite; they are quickly gaining weight. This is the main cause of optimism for the woman.

According to the statistics since the 1990s, only in Karaganda region mothers living with HIV gave birth to more than 400 babies. Last year, 36 babies were born. They all remain under follow-up care until they turn 18 months old.

Take part in the Fast Forward Award 2018

Proud winner of the first edition of the Fast Forward Award: Ugandan Network of Young People living with HIV/AIDS (UNYPA)

The Fast Forward Award searches for ‘golden eggs’ – innovative interventions organised by and for the community. The awards aims to link these innovative local solutions with donors in order to increase funding for communities and scale up successful approaches.

Four community-led organisations will be selected to pitch their local innovation on stage at AIDS 2018. A high-level jury of innovation experts and investors will select a winner. The winner receives the Golden Egg, Fast Forward Award, for best community HIV/AIDS solution!

Are you a community-led organisation? Do you implement an activity, approach, or project, which fits this description? Apply or nominate others to take part in the Fast Forward Award 2018!

The deadline is the 7th of May 2018. Download the full call for proposals and/or the application form.

Source: aidsfonds.org

How to Become AIDS 2018 Participant

To register for the 22nd International AIDS Conference with the standard fee is possible before May 18. After this date, the registration will be possible only with the higher fee. Deadline to submit a visa application and to request a Letter of Invitation is June 1.

We are presenting this and other information on how to register for the Conference in our new video. Especially for you, we explained online registration in details and answered your questions.

Will see you in Amsterdam in July!

Ex-Prisoner in Tajikistan Advocates Healthy Lifestyle

Umed is a participant of the START Plus programme implemented with AFEW-Tajikistan

Author: Nargis Harambaeva, Tajikistan

Umed Boev, age 41, an ex-prisoner from Tajik town of Bokhtar advocates healthy lifestyle among risk groups – people who use drugs, sex workers and ex-prisoners.

In 2001, when Umed was 24, he went to Russia to earn money. He liked partying and spent quite some money on that. In 2004, during one get-together he had a quarrel and a fight, causing another person grievous bodily harm. He was sentenced for 10 years and served his time at Novosibirsk maximum security prison.

While in confinement, Umed tried heroin for the first time. One syringe was often shared by many people. One day his fellow countrymen, who served sentence in the same prison, found out and talked to him.

“They convinced me to stop taking drugs, telling me that prayers would help. I mustered all my will power, it was extremely hard during withdrawal, but I stuck it out. I prayed hard and it really helped me. I stopped using drugs,” tells Umed.

10 years later, when Umed returned home, he was diagnosed with HIV.

“Upon return, I first worked at a construction site, then the crisis hit and the construction was put on hold. I needed money. An acquaintance of mine told me I could donate blood and get some money that way. Therefore, I went to the clinic and they did an HIV test and the result was positive. I was registered with the clinic but I did not take my diagnosis seriously, did not take antiretroviral therapy,” recalls Umed.

Timely request for help

Because of his weak immune system, soon Umed developed tuberculosis.

“In December 2015, I suddenly felt very ill, had a torturing cough for three months. In April 2016, I was taken to a hospital and diagnosed with tuberculosis. I was in a very poor state of health. I could not even walk, had no appetite. During that time, I rapidly lost 20 kilos. Only later doctors told me I turned for help just in time. Another couple of weeks and I would have died. I was treated, and recently when I had fluorography examination tuberculosis was gone. I am so happy about that,” he says.

Today Umed is a participant of the START Plus programme implemented with AFEW-Tajikistan. The purpose of the programme is to reduce the prevalence level of public health concerns like HIV, TB and viral hepatitis at penitentiary facilities and improve the quality of life of persons released from prison.

“I discovered help for people like me when I was diagnosed with tuberculosis. I came to AFEW-Tajikistan local office in Bokhtar. I received food packages as well as assistance in the form of information. Currently, they are helping with the purchase of necessary medicines,” tells Umed.

Becoming part of the Board

Umed is a member of the Board of representatives of key population groups that was organised within AFEW-Tajikistan office in Bokhtar to help persons in risk groups who are neglecting their health.

“There are four of us in the Board. I am responsible for creating awareness among key groups about infectious diseases. These groups include ex-prisoners, people who use drugs and sex workers. We help AFEW-Tajikistan, inform them about the needs of the groups, adjust assistance that is being provided so that it gains better quality and effectiveness,” says Umed.

By the way, one of the topics of the 22nd International AIDS Conference in Amsterdam is prison health. Other public health issues like HIV, hepatitis and TB in Eastern Europe and Central Asia will be also in focus during AIDS 2018.

PLWH Network Launches New Concept Clinics in Ukraine

Author: Yana Kazmirenko, Ukraine

All-Ukrainian Network of People Living with HIV (PLWH) plans to open five 100 Percent Life all-patients-friendly clinics this year. The ultimate plan is to cover the entire Eastern Europe and Central Asia (EECA) region.

The Project to create the 100 Percent Life network of clinics is a challenge for the Charitable Organisation All-Ukrainian Network of People Living with HIV/AIDS. It is considered to be the largest patient organization throughout the former Soviet Union. During the past several years, modern medical centres accessible for all patients have been opened in each region of Ukraine. Medical centres will provide treatment and social support to those frequently dealing with discrimination at regular hospitals: people living with HIV, representatives of key risk groups. HIV-positive patients will receive services free of charge, clients, in general, will receive them at below-market prices.

In autumn of 2016, a pilot clinic was opened in Poltava, and this year medical centres in Kyiv, Zaporizhia, Lviv, Chernihiv and Zhytomyr will receive their first patients. The capacity of the clinic in the capital will be 900 patients per month.

The Network is preparing to present the Clinic Network Project at the 22nd International AIDS Conference AIDS 2018 in Amsterdam. They are convinced that such format will be highly sought in all countries of the EECA region.

“The first centre of this kind abroad will be opened in Moldvova – they have liberal legislation. Georgia and Kazakhstan are also expressing interest,” says Dmitriy Sherembey, the Chairman of the Coordination Board of Charitable Organisation All-Ukrainian Network of PLWH.

The philosophy and services of these clinics will be a drastic difference from the reality of Ukrainian AIDS centres. Below is the outline of the main differences.

Donors become investors

The Clinics Project changes the roles of donors and non-profit organisations. Under the PLWH Network, model donor organisations become investors, and non-governmental organisations (NGOs) become entrepreneurs.

“At the present time, donors award grants, and in the end, they receive a report on “why it did not work and how flawed the world is.” We are knocking this system down: each hryvnya spent on the clinic by donors continues to work after grant completion. All profit from clinics will be invested into the development of new services. The donor acts as an investor and receives profit not in monetary equivalent but in humanitarian terms,” says Mr. Sherembey.

According to calculations of the Network Head, 50 thousand dollars invested in a clinic will turn into a million within 20 years. At the same time, money spent by a patient at the clinic will turn into a service to a person who wants to live, as opposed to being just owner’s profit.

Medical staff of Poltava clinic praised for thoughtful treatment. Photo by PLWH Network

The clinic in Poltava has become profitable just six months after opening. This gives a chance to NGOs to say good-bye to the role of petitioners and enter the market of medical services, which is rated at 100 billion US dollars a year in Ukraine.

“The network of clinics will allow maintaining programmes and staff in case the Global Fund leaves Ukraine. We have been observing the negative experience of closing up programmes and discharging specialists in the Eastern European countries that have joined the European Union,” adds Yaroslav Blyakharskiy, Manager of Social Entrepreneurship Section of PLWH Network.

Medical centre is put together like Lego

Each clinic will have a different set of services, depending on the diseases in the region, what is offered by competitors and the paying capacity of the population. Three specialists will form the basis: a family doctor, an infectious disease specialist and a drug treatment specialist.

Poltava was not a random choice for the pilot project – it is a typical medium-size Ukrainian city. If the project proved to be sought after in this city, it is bound for success in other regions.

“The pilot clinic provides help in the following fields: neurology, allergology, nosology, narcology, pain and withdrawal syndrome relief. Narcology has proven to be in the highest demand,” says Mr. Blyakharskiy.

In Kyiv centre this list will be supplemented with gynecology, urology and dermatology.

Progressive standards of care

Progressive European treatment protocols will be used at 100 Percent Life medical centres. The Clinics Project is integrated into the medical reform, which is currently dismantling the Soviet-times model. Under the reform, each citizen of Ukraine will have to select a family doctor; and the Government will transfer money to the doctor for treatment of this patient. The family doctor will be able to prescribe antiretroviral therapy, which is currently received by 90 thousand patients in Ukraine.

A mobile application as your health manager

100 Percent Life medical centre will make all communications between patients and medical staff automated as much as possible. Clients will be able to install an application on their mobile phones enabling on-line arrangement of appointments, medical tests, receipt of prescriptions and seeing the entire treatment regimen. Patient’s medical record will also be available electronically. The application will allow covering 60% of all communications between the patient and the clinic.

Medical centre accommodates the patient

Poltava clinic is open until 10 p.m. seven days a week. For the PLWH Network it is vital that all categories of patients get equal access to proper quality services and treatment and do not face rejection and discrimination.

According to the research conducted by the PLWH Network, around 19% of surveyed HIV-positive patients in Ukraine have faced refusal of medical examinations that did not involve contact with blood (the research is titled Evaluation of multiple stigma faced by high risk group representatives with regards to HIV infection – editor’s note). Around 80% of patients were refused by the consulting physician.

HIV in Georgia: is there any stigma

Author: Irma Kakhurashvili, Georgia

Our meeting with David Ananiashvili was appointed in a green courtyard of the Infectious Diseases, AIDS and Clinical Immunology Research Centre. The Centre is located in an old building in one of the central districts of Tbilisi, Georgia. The authorities have been promising a new working space for the centre since long ago, but so far there has been no progress in this process. However, David feels at home – he knows every corner here. He was one of the first people in Georgia who publicly spoke about their HIV status. David is the head of the Georgian Plus Group NGO. Since 2000, the NGO has been implementing various projects to protect the rights of people living with HIV and standing up to stigma and discrimination.

In the meeting room, David says that the civil society sector in the area of HIV/AIDS is quite small. Besides, there are not many resources available to fight stigma. In Georgia, all people have access to free HIV treatment (antiretroviral therapy is available and accessible for patients since 2004 through the grant of the Global Fund to Fight AIDS, Tuberculosis and Malaria), while stigma is one of the main factors hindering access to testing of HIV. David says that most stigma-related issues may be observed in health facilities, in the relations between doctors and patients. The HIV-related stigma in the healthcare system – both in state-run and in private clinics – is so strong that sometimes doctors and other medical personnel do not provide the required high-quality services. There have been cases when doctors refused to perform life-saving surgeries if their patients had HIV.

Stigma is reinforced by myths

The situation is worse in regions of the country, especially in smaller towns and villages where patients are afraid of social isolation and are reluctant to disclose their status even to their family members. Here, the HIV diagnosis still leads to the feelings of panic and helplessness as it used to be in the 80s.

“HIV is a stigmatized disease causing a number of emotional and social problems. Stigma is reinforced by a variety of myths, for instance, that HIV is a result of the person being irresponsible, practising immoral behaviours or using drugs,” explains David.

The community of people living with HIV in Georgia is not as open as it should be but David believes that everything has its time and that this issue may be resolved. Current scale of the response to hepatitis C may serve as a good example. Until 2015, people in Georgia had never talked out loud about this disease, but after the government started the national program of hepatitis C elimination the ice was broken: many people were able to recognize they had hepatitis and start effective treatment.

In the nearest future, hepatitis C elimination programme will also include screening for HIV, which means that the patients who are tested for hepatitis C will also be screened for HIV. The initiator of this idea – AIDS Centre – is sure that integrated services will significantly improve the HIV detection rates. David says that countering stigma requires a comprehensive approach instead of one-sided efforts.

Strategic plans

The estimated number of people living with HIV in Georgia is 12,000 people. Apart from countering stigma and discrimination, the main goal in the AIDS response is detection of the new HIV cases.

David says that there is a need to bring up the issue of preventive treatment of discordant couples in Georgia. Pre-exposure prophylaxis of HIV (PrEP) is a new method of HIV prevention. PrEP provides additional protection in cases when people do not use condoms for whatever reason.

David Ananiashvili and his colleagues plan to make their contribution to the development of a new National Strategic Plan to Fight HIV/AIDS. Its main objectives will be delivery of services to vulnerable groups and further scale up of prevention programmes.

“We would like to implement a new project by creating a consortium to make sure that in future our services – counselling centre, mobile clinics, outreach services, group activities, etc – and interventions are explicitly described in the HIV/AIDS strategic plan and to add new services to the existing ones. We will conduct focus groups, identify common challenges and needs to analyse and understand which services are needed for vulnerable populations and which of them are more effective,” says David.