EECA Organisations Supported Michel Kazatchkine

Michel Kazatchkine, United Nations Secretary-General’s Special Envoy for AIDS in Eastern Europe and Central Asia

AFEW International has reached out to organizations and networks in Eastern Europe and Central Asia with the request to sign the support letter for re-appointment of Michel Kazatchkine as United Nations Special Envoy for HIV/AIDS in Eastern Europe and Central Asia.

His contract/mandate as UN special envoy on HIV/AIDS for Eastern Europe and Central Asia ends on 30 June. His role in addressing three epidemics in the region (HIV/AIDS, tuberculosis, hepatitis) and to raise awareness at political and scientific level of the concerns regarding HIV, TB and viral hepatitis in the EECA region is crucial and very important, especially now as we have the opportunity to highlight the challenges and successes of the region at AIDS2018 Conference. Therefore, there is a dire need for a continuation of his support.

The letter, signed by more than 70 signatories has been sent to United Nations Secretary General António Guterres. You can read the letter here.

WHO 2017 Sondalo Training Course for TB Management and Control is Announced

World Health Organisation collaborating centre for tuberculosis and lung diseases announces training course on implementing the WHO End TB strategy and the new vision of TB Elimination: skills for managers and consultants. The training will take part in Italy on September 24 – October 7, 2017.

The overall goal of the training course is to further develop the necessary skills to plan, implement and evaluate a TB control programme, based on the new WHO End TB Strategy, with a special focus towards the 2016-2035 targets and goals’ and the ambitious vision of TB elimination.

The course uses innovative approaches, being centred around Fictitia (a fictitious country in which all consultancy activities take place and where participants are involved as temporary WHO Consultants performing a WHO country mission); it is interactive and exercise based, being a mixture of presentations, exercises, workshops, site visits and role plays based on data from Fictitia.

The course is composed of three parts: introduction; implementation of the WHO post-2015 global TB control and elimination strategy (End TB); planning and M&E of the TB control and elimination strategy in Fictitia. More information about the course and participation can be found here. Course agenda can be found here.

Application deadline: July 31, 2017
Payment deadline: August 20, 2016

For further details, queries and application forms and procedures, please contact Lia D’Ambrosio at: info@publichealthcg.ch, lia.phcg@gmail.com, liadambrosio59@gmail.com.

The Photo Exhibition ‘Life in the Shadow’ was Shown in the Netherlands

Last week the photo exhibition ‘Life in the Shadow’ was brought to the Netherlands by public Foundation ‘AIDS Foundation East-West in Kazakhstan.’ It was possible to see the images of people affected by HIV and tuberculosis during Wolfheze workshops in the Hague on 31 May – 2 June.

The main goal of the exhibition is to reduce stigma and discrimination against people with HIV and tuberculosis.

“We were very lucky with the opportunity to bring the exhibition to the Netherlands and show it to the bigger number of people,” the project manager of AFEW Kazakhstan Kristina Zhorayeva is saying. “Our models were very brave to show their faces and share their personal stories. They wanted to tell people that they are not different and they also have dreams and hopes.”

At the end of March the photo exhibition ‘Life in the Shadow’ was shown in Almaty, Kazakhstan. Some people from Kazakhstan saw the images for the first time in the Netherlands though.

“I have heard about this exhibition from AFEW, and today I saw it in the Netherlands even though it was displayed in my native Almaty,” the head doctor of one of the private clinics of Almaty Galiya Tulebayeva is smiling. “I look at these pictures of the patients with pleasure. It is great to see that there are smiles on their faces and they are in positive mood.”

As of February 2017, in Kazakhstan there were registered 29,568 HIV cases. According to the official data, in 2016 there were 14,345 tuberculosis patients registered in the country.

Visitors reviews of the photo exhibition ‘Life in the Shadow’

Jamshid Gadoev, WHO Country Office for Combating Tuberculosis, Hepatitis and HIV-AIDS in Uzbekistan:

– Only brave people can show themselves in such a way. They got sick and went through the processes that other people are going through now and do not hesitate to show all of this. On each photo I see a smile. Probably, they are happy with their treatment and are glad that they were rescued. They seem to be happy with their lives.

We also published a book and made a video about what tuberculosis patients feel before, during and after their treatment. We asked our patients to associate tuberculosis with some color, and children were asked to associate it with color and with the animal. Many people said that the disease for them is associated with red, yellow or black. Children usually said that their illness is a red teddy bear. Adults told that for them tuberculosis is black and is associated with the sound of a trumpet. After treatment, these associations often change and colors become brighter.

Alexei Bobrik, WHO technical specialist on HIV, tuberculosis and hepatitis, WHO Country Office, Ukraine:

– To overcome the burden of these diseases, it is necessary to talk about this problem so that the population knows about it, and the negative attitude towards the diseases decreases with time. It is necessary to communicate information, so that there is no stigma and discrimination. We must know that normal people are vulnerable to these serious diseases as well.

AFEW Kazakhstan Helps People Getting out of the Shadows

29,568 HIV cases were registered in Kazakhstan as of February 2017. According to the official data, in 2016 there were14,345 tuberculosis patients registered in the country. Usually, these people hide themselves, and are often afraid even to tell their relatives about their diagnosis. But there are also those who openly talk about their status, and who show that it is possible to get out of the shadow.

At the end of March, the photo exhibition ‘Life in the Shadow’ dedicated to the World Tuberculosis Day took place in Almaty. AIDS Foundation East-West in Kazakhstan organized this event. The exhibition featured photos of people affected by HIV and tuberculosis. Today we will tell the stories of some of them.

LEARN TO LOVE YOURSELF

After the death of her mother in 2008, Venera started to lose weight. The woman thought it was because of the grief she was experiencing, but still went to the hospital for the X-rays and medical tests. There it was discovered that Venera had an open form of tuberculosis.

Venera realized that it does not matter what your position in the society is, the tuberculosis makes everyone equal

“By that time, I was very weak and all the time felt sick in my stomach. I weighed 48 kilograms,” says Venera. “During three months I was out there with an open form of tuberculosis until they accepted me in the hospital. All I wanted at that time was to lie down and die! I was in darkness, alone, rejected by everyone. I did not believe that I would get out of that hospital alive. All the time I was sick because of the pills. My son and my sister, who, after my mother’s death, was taken to an orphanage, as I did not have time to register custody, were the only people who kept me alive. They called me, told me they needed me, asked not to die. It was the strongest motivation to live! After some time, I started to feel better and began recovering.”

A year later, Venera was diagnosed with tuberculosis and lung disintegration. At that time, the woman was pregnant. Since no one told her that during the pregnancy tuberculosis can be treated, Venera was advised to have an abortion.

“In the hospital they gave me the bed that was standing in the hallway, and soon the whole department knew I had tuberculosis,” Venera recalls. “People were scared of me. The gynaecologist was commenting something like, why people like me are even allowed to give births at all. That was such a humiliation!”

After she got out of the hospital, Venera realized that it does not matter what your position in the society is, the tuberculosis makes everyone equal. The woman became stronger and kinder, started to pay more attention to her relatives, helped those who needed help. Three years later, Venera gave birth to the healthy twins.

“I defeated tuberculosis. If you have such diagnosis, do not be not afraid and believe that you will recover!” says Venera. “Do not be scared of anyone, this is not a disgrace. Most importantly – do not refuse the treatment, otherwise you can infect your relatives and friends. Learn to love yourself!”

A DECISION TO LIVE

To those who only got to know about their diagnosis, Salavat advises to be strong and take care about their health

Salavat has been living with HIV since 2011. The man has heard something about this disease, but did not have a clear understanding of it. He thought it was somewhere far away, not here, and he could not even imagine that he could get infected.

“The doctor was calming me down, saying that people live with it, that it is not fatal, that in the future there probably will be a medicine… At first, of course, I felt bad, but I quickly overcame my fears,” Salavat says. “I made a decision to live. Now I know a lot about HIV. I am confident that I can work, and I am able to live. I know that we are the same people as everybody else, we are not infectious.”

To those who only got to know about their diagnosis, Salavat advises to be strong and take care about their health. It is very important to enjoy life, to share joy, and not to lapse into a cocoon of self-isolation.

ACCEPTING THE DIAGNOSIS

Oksana learned that she was HIV positive in the rehabilitation centre for drug addiction.

The acceptance of her diagnosis benefited Oksana’s professional and personal development

“It was scary, somehow I made myself believe that I had only five years left to live and I have to fill my last years with fun and unforgettable experience!” Oksana is saying. “Before my diagnosis, I thought that HIV is something that is far away and it is impossible to get it in Kazakhstan.”

At that time, the woman needed support, and she got it from her family. The first one who learned about her diagnosis was Oksana’s sister.

“Later I asked her what she felt when she found out that I was HIV positive,” Oksana remembers. “Surprisingly enough, most of all she was worried about me, because the first thing I could convince her in was that I had only five years to live. About three years later, I accepted my diagnosis. I realized that I am not dying, and started to learn how to live with HIV.”

The acceptance of the diagnosis did not only benefit Oksana’s professional development, but also her personal development.

“I am happy to be busy with my favourite things, I am with a person I love and my family is very friendly. I learned how to live with HIV. You just need take more care about your health and love life!” Oksana resumes.

TO BELIEVE IN RECOVERY

After being diagnosed, Sultanamurat started to appreciate life more

The only thing Sultanmurat knew about tuberculosis was that it is a dangerous disease. When he heard his diagnosis, he became horrified.

“I experienced haemoptysis. It was scary, but I did not even suspect that it could be tuberculosis. I thought that I had some problems with my internal organs,” recalls Sultanmurat. “I really wanted to be cured, but the treatment was going very difficult. In the beginning, I did not tolerate the medicine and developed allergies. I was fighting with myself, tried not to miss a single day of taking medications and injections. Now I feel much better.”

After being diagnosed, Sultanamurat started to appreciate life more, treated people who are ill with better understanding, began to appreciate and love his relatives even more.

“I would like to tell those who are diagnosed with tuberculosis that this disease is curable, like many other diseases. The main thing is to follow the regime in everything, do not miss taking pills and eat well, move and do sports, be friendly,” Sultanmurat says. “The most important thing is to believe in the best, that is, in your recovery.”

AFEW Works Towards Ending Tuberculosis in the EECA region

World Tuberculosis Day is being recognized on the 24th of March in the whole world. This annual event commemorates the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes TB.

The theme of World TB Day 2017 is “Unite to End TB.” AFEW International‘s activities are also aimed on ending tuberculosis in Eastern Europe and Central Asia. In Kazakhstan, KNCV and AFEW-Kazakhstan are developing a model for structural collaboration between public health (TB, HIV, primary health care) and non-public sector through the DGIS-funded project in Almaty. AFEW International is coordinating this project. In March of 2016, a stakeholders meeting was organised to establish a Stop TB Partnership for Kazakhstan. This partnership reflects a close collaboration between different stakeholders, patients form an important group, working in the field of TB and HIV. 31 participants from NGOs, public TB and HIV services, and representatives of the Stop TB partnership of the Republic of Tajikistan took part in the meeting. The representatives from Tajikistan presented the value, successes and challenges of such partnership.

Kazakhstan is one of the three countries selected to develop a model to strengthen engagement with non-public sector for improved quality of TB/HIV services. Almaty was chosen for the implementation of the model because it is the largest urban area in the country. The project supports the establishment of a network of NGOs that have the capacity to provide TB and HIV care to the most vulnerable populations, and build a partnership between public and non-public sectors to improve access to TB and HIV care by the development of a referral mechanism.

Roman Dudnik: “People with HIV and Tuberculosis are the Same as We Are”

A photo exhibition dedicated to the World Tuberculosis Day will be opened in Almaty, Kazakhstan on March 18. The purpose of this exhibition is to show that people living with HIV or tuberculosis are the same as everyone else. This exhibition is one of the first important public events held by AFEW-Kazakhstan in 2017. We are talking about this and discussing other plans for this year with the executive director of AIDS Foundation East-West in Kazakhstan, Roman Dudnik.

– How was the year of 2016 for you? What were the new and exciting things that happened?

– Even though the year of 2016 was difficult, it was successful for us. We moved to a different office. Before, we were in the small office building. Now we are in the new building with much more space. The repairs were made based on our requirements, using our colours. There is a very good energy here, and it helps to work good.
In 2016 we finished the first part of the project HIV React that is financed by USAID/Central Asia, and we got the extension for the next three years. This is our main project. It is regional: we work in Kazakhstan, Kyrgyzstan and Tajikistan. Being the part of this project, we are working in preventing HIV among injecting drug users in prisons. We also work with people living with HIV who are getting ready to be released, and those who are already released. With specially developed START plus program, we prepare a person for his release two months before it happens, and then continue to work with a person for another four months after the release. Additionally, we train medical and non-medical staff of correctional facilities and employees of non-governmental organizations. This program is unique and does not work in many countries of the world. All efforts are aimed at preventing HIV infection and supporting those who live with HIV. The main goal, of course, is to encourage a person to get tested for HIV. If the test is positive, then we send a person to the AIDS centre, and we motivate him to start treatment with antiretroviral medicine, if necessary. We also help to restore needed documents, find jobs, renew social connections. This program is unique because it has a human face. We are aimed at a specific person, at solving of his or her problems. We also try to form skills so that people can solve their problems in the future themselves.

– Working in three countries in Central Asia with the same groups of population in HIV React project, can you observe the common tendencies?

– The general trends in all three countries are that HIV in places of detention exists, and the number of new cases of HIV transmission is increasing. Convicts is the group that requires intense attention and constant work. There is a very high level of stigma from prison staff. Of course, the reason for this is a lack of information, and this is what we are trying to correct through the trainings. The most successful project is implemented in Kyrgyzstan, where the criminal executive system is more open and sympathetic to such activities. In Kazakhstan and Tajikistan it is a little more difficult, but despite this, we manage to work and implement all planned activities within the framework of the project.

– Besides this, what were other projects that you worked on in 2016? 

– Since January we started with the new City Health project with the financial support of the Global Fund, where the main grant recipient is the International Charitable Foundation “Alliance for Public Health”. The project works in five cities of the EECA region. We are responsible for work in Almaty. Implementing this project, we will involve the city administration in the prevention of HIV infection among vulnerable groups: injecting drug users, men who have sex with men, and sex workers. We plan to create a city council on HIV/AIDS. We know that the project is not simple, but it is interesting for us. For Almaty, the project is very important, since it is the most populated city in the country, and the problem of HIV infection is especially relevant here. It will be important for us to make this a successful model and to duplicate this experience to other cities and countries.

– A year ago you had a school of tolerance, the goal of which was to reduce stigma on the part of health care providers. Please, tell us if you can see the results of this school?

– It is difficult and too early to talk about the results. Stigma and discrimination are big problems for Kazakhstan and whole Central Asia, and this is one of our main areas of work. One school of tolerance cannot solve this issue. Without any doubt, there is a big difference in how people come to the training, and what they think after three or five days of the training. In our training, we focus on the personal qualities of a person, perform the situations when the participant himself acts as a client or the representative of a vulnerable group, and is experiencing everything what the client is experiencing by himself. Human intolerance was formed long ago, and one year of work cannot change it. Nevertheless, there is already some progress in this field.

– On the 18th of March you will have the photo exhibition dedicated to the World Tuberculosis Day. Please, tell us more about it.

– The exhibition is intersecting with the topic of stigma and discrimination. We invite everybody to come and see it. It will be held from 18 to 31 of March in the gallery June 24. During the exhibition, there will be master classes, lectures, and talks with people who are depicted on the photos. On the photos, there are 15 Kazakhstani people who live with HIV, or who were cured of tuberculosis. The name of the exhibition Life in the Shadow speaks for itself, because due to the human ignorance, the heroes of our photos should hide their diagnosis from others and live with their problem alone in fear. Now they have opened their faces for the exhibition and they are not afraid to share their experiences. By each photo, there is a written piece with the story of the person: what he was going through, what he was thinking about. The purpose of the exhibition is to shed light on everyday life of people affected by HIV and tuberculosis. They are just like us. The only difference is that they know their diagnosis and they have to fight for their health. Myths and prejudices about HIV and tuberculosis make them hide this part of their lives. Although, the understanding and support of others is what helps them to defeat the disease. The exhibition is positive; people are smiling on the photos. We made only colour photos that show people in everyday life: in the flower shop, in the metro, during painting. During the exhibition, we will tell the visitors about HIV and tuberculosis, tolerance. We will also distribute flyers with the information about where you can bring, for example, bags with clothes that are no longer needed and help people who live with HIV in such a way.

– Even though it is almost the end of the first quarter of 2017, I still would like to ask you about the plans of AFEW-Kazakhstan for this year.

– We plan to work with our projects further. In April, we will be having big regional training about gender violence. We already invited a very good professional in this field to be our trainer. This is a new topic for us, and everything new is interesting for us.

The Union demands that TB be included in the WHO list of bacteria for which new antibiotics urgently needed

social-shareToday, 28 February, International Union Against Tuberculosis and Lung Desease stated that it is unacceptable that tuberculosis (TB) was excluded from the World Health Organization’s (WHO) published list of antibiotic-resistant ‘priority pathogens’, released yesterday.

The Union further added that the WHO must revise the list to include TB – the world’s leading infectious disease killer – with immediate effect and called upon the international community to support demands that TB be included in the catalogue of bacteria posing the greatest threat to human health – and for which new antibiotics are urgently needed.

The bacteria that cause TB kill more people than any other infectious pathogen. Latest WHO figures state that in 2015, 1.8 million people died, including 210,000 children. An estimated 580,000 people were reported to have drug resistant versions of TB – both multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) – while actual numbers affected could be even higher.

The only way of treating TB is with antibiotics. Current treatments for resistant forms of TB are arduous and are accompanied by side effects that include deafness and psychosis, as well as practical difficulties for families, communities, health systems and livelihoods.

TB R&D has been systematically underfunded during the previous decade. The current spending of $620 million on all TB R&D (vaccines, diagnostics and treatment) is only one third of the $2 billion annual funding target outlined in the 2011–2015 WHO Global Plan. Funding in TB drug R&D is only 28% of the $810 million called for in the Global Plan to End TB 2016-2020. This is counter to the global aim of accelerating progress against TB in order to reach the ‘End TB Strategy’ by 2030.

“It is outrageous to sideline TB from global antimicrobial resistance (AMR) efforts. The Union strongly urges WHO to include TB on its list of priority pathogens. Among the group of antimicrobial-resistant diseases, drug-resistant TB is a leading cause of sickness and death.

Failing to include TB on its list was a dramatic departure from the data, and it undermines efforts to find the new and better treatments that patients desperately need. This is particularly critical for those countries where drug-resistant TB is epidemic,” said José Luis Castro, Executive Director, The Union.

“As G20 leaders are set to meet and discuss an agenda for tackling antimicrobial resistance, The Union strongly urges them to follow the data. They should include TB in any G20 initiatives aimed at increasing R&D investments and piloting models to deliver new medicines used to treat antimicrobial-resistant disease,” said Dr Jeremiah Chakaya Muhwa, President of The Union.

Source: The Union

U.S. Government Introduces New Drug to Help Save Lives of TB Patients in Tajikistan

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Source: Asia-Plus

Acting Deputy Chief of Mission of the United States to Tajikistan Lucy Jilka on January, 31 joined the First Deputy Minister of Health and Social Protection of Population of Tajikistan Saida Umarzoda, national health leadership, physicians, TB doctors, and stakeholders to celebrate the introduction of bedaquiline to Tajikistan. This is the first new drug approved for the treatment of tuberculosis (TB) since the 1960s.

According to the U.S. Embassy in Dushanbe, U.S. company Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson, created bedaquiline to treat drug-resistant tuberculosis and protect public health. Janssen is donating 30,000 courses of this life-saving new TB drug to qualified countries.  The United States, through USAID’s Office of Global Health, is partnering with Janssen to introduce bedaquiline in Tajikistan.

Tajikistan is on the list of countries with a high prevalence of multi-drug resistant TB, and has growing numbers of patients with extensively drug-resistant TB, for which there was no effective treatment available within the country.  Bedaquiline, also called by its brand name Sirturo, offers a better chance to cure patients with these forms of TB and will help reduce the transmission of drug-resistant tuberculosis in the community.

USAID is leading the free distribution of this lifesaving medication through its Bedaquiline Donation Program in collaboration with Tajikistan’s Republican Center for TB Control, the Ministry of Health and Social Protection of Population, and other partners to introduce the new drug, build capacity to expand treatment, and pilot new shorter treatment options for drug-resistant tuberculosis.  A key international partner in these efforts is the Challenge TB Project, which is implemented by the Dutch TB Foundation, KNCV.

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Source: Asia-Plus

Bedaquiline received accelerated approval for use in the United States in December 2012, and it is used to treat Americans with drug-resistant TB.  In Tajikistan, per World Health Organization recommendations, fifty patients were initially enrolled in treatment courses containing bedaquiline, with one hundred and fifty more to begin treatment during 2017. The progress of treatment will be monitored by trained specialists at designated treatment centers.

The Challenge TB Project is one of the many assistance projects made possible by the American people through USAID. Over the last 25 years, the U.S. Embassy in Dushanbe has provided more than $1.8 billion in programs that support Tajikistan’s security, democratic institutions, social sector, and economic growth.  In February, Tajikistan and America will celebrate 25 years of diplomatic relations.

Source: Asia-Plus