Antonio Guterres Replied to AFEW Support Letter

Prof. Michel Kazatchkine, Special Adviser to the Joint United Nations Programme on HIV/AIDS on HIV, Tuberculosis and Hepatitis for Eastern Europe and Central Asia

AFEW International received a response to the letters we have sent to the United Nations Secretary-General Mr Antonio Guterres. We have sent two letters that can be read here and here, and asked Mr Guterres to support the position of Prof Michel Kazatchkine as UN special envoy on HIV/AIDS for Eastern Europe and Central Asia (EECA.)

83 organisations from the whole world signed the letter. We asked to reconsider the position of Prof M. Kazatchkine as UN Special Envoy for EECA, as he is in an excellent position to create a momentum to raise awareness on the disruptive situation the epidemics has caused in the region. Prof. Michel Kazatchkine played a crucial role in mobilizing local authorities, (inter)national civil society, donors, researchers and other relevant groups to come to better outcomes to the UNAIDS indicators as we see now. As a result, he enjoys great support from communities in the region.

“Mr Kazatchkine has been an unwavering champion for HIV/AIDS in Eastern Europe and Central Asia. With rising HIV infections across the region, he has served as a tireless advocate and helped to unite stakeholders across sectors to address pervasive challenges that continue to leave our most marginalized communities behind. Mr Kazatchkine is well positioned to build on this work in his new role as Special Adviser to the Joint United Nations Programme on HIV/AIDS (UNAIDS) on HIV, Tuberculosis and Hepatitis for Eastern Europe and Central Asia,” the letter is saying.

Mr Guterres also expressed the hope for the future collaboration with AFEW International.

The full version of the letter can be read here.

Civil Society Letter to Support the Position of Prof M. Kazatchkine as UN special Envoy on HIV/AIDS for Eastern Europe and Central Asia

To: United Nations Secretary-General Mr Antonio Guterres

Amsterdam, 22 January 2018

Re: Civil Society letter to support the position of Prof M. Kazatchkine as UN special envoy on HIV/AIDS for Eastern Europe and Central Asia dd 23 June 2017

Your Excellency Mr Guterres,

With this letter, we – undersigned civil society organizations – call on you to reconsider the position of Prof. Michel Kazatchkine as your Special Envoy on HIV/AIDS in Eastern Europe and Central Asia (EECA).

Michel Kazatchkine was recently announced to serve as special advisor to UNAIDS for HIV, tuberculosis and hepatitis C by the UNAIDS executive director Michel Sidibe.

We are happy to greet Prof. Michel Kazatchkine with his new position. We believe however that the urgency of three epidemics in the EECA region justifies a position as UN special envoy for the region. A region in which the HIV/AIDS, TB and viral hepatitis epidemics are out of control. This development concerns us deeply:

  • The annual number of new HIV infections in Eastern Europe and Central Asia increased with 60% between 2010 and 2016.
  • From all regions in the world, the EECA region is furthest away from reaching the UNAIDS 90-90-90 targets by 2020. Treatment coverage remains alarmingly low (28%), and less than a quarter of people living with HIV had suppressed viral loads (end-2016).
  • Specific populations, such as men who have sex with men, people who use drug users, sex workers, prisoners and migrants face specific human rights violations, impeding their access to prevention and health services.

Despite these alarming developments, donors and multilateral institutions are pulling out of the region. Achieving the SDG’s on health and the promise to leave no one behind is therefore still far away in the EECA region.

Prof. Michel Kazatchkine has played a key role in highlighting the region to institutions as UN Special Envoy on HIV/AIDS in Eastern Europe and Central Asia. He played a crucial role in mobilizing local authorities, (inter)national civil society, donors, researchers and other relevant groups to come to better outcomes to the UNAIDS indicators as we see now. As a result, he enjoys great support from communities in the region.

In our letter of 23 June 2017, we asked to continue the position of Prof. Michel Kazatchkine as your Special Envoy on HIV/AIDS in Eastern Europe and Central Asia. We express our disappointment about not having received a response yet.

We understand that Prof Eric Goosby continues as UN special envoy on TB, due to the important UN High Level meeting on TB in September 2018.

At the same time, the AIDS 2018 conference in July 2018 will be a key moment for the region and for the world as well. The Dutch government acknowledges the issues and has prioritized Eastern Europe and Central Asia for the conference. We applaud their leadership as this is the moment to bring political leaders, policy makers, scientists, clinicians and community leaders together and draw attention to the urgent need to next steps. Prof. Michel Kazatchkine is helping in the process. We, the civil society organizations, look forward to your presence and support in Amsterdam next July.

We ask you to re-consider the position of Prof. Michel Kazatchkine as your Special Envoy for Eastern Europe and Central Asia, as he is in an excellent position to create a momentum to raise awareness on the disruptive situation the epidemics has caused in the region.

Please, support this letter by signing it before Monday, 29 January 5pm CeT. You can sign this letter here

Yours sincerely,

Anke van Dam,

Executive Director, AFEW International

Vinay Saldanha: Treatment should be Provided to all HIV-positive People

Author: Anastasia Petrova, Russia

This year, the issue of treatment coverage for people living with HIV has been broadly discussed in Russia on World AIDS Day. We are talking on this topic with Vinay Patrick Saldanha, Director, Regional Support Team for Eastern Europe and Central Asia (EECA), UNAIDS.

– Mister Saldanha, today at the press conference, organised by the movement Patient Control, we heard that in Russia only up to one third of all people living with HIV receive treatment. What measures are to be taken to reverse the situation?

– A hard and fast decision is to be taken on adopting the ‘test and treat’ strategy. In line with the World Health Organization (WHO) guidelines, which have already been used for several years, all people with the HIV status should get uninterrupted and high-quality treatment. At the same time, treatment guidelines issued by the Russian Ministry of Health state that priority in treatment should be given to the patients with the immune status below 500 СD4 cells. Thus, with the limited access to drugs, doctors have to prescribe therapy to those who have the weakest immunity and open the so-called waiting lists. In many regions, the situation is critical.

Now in Russia there are mass HIV testing campaigns. However, to motivate people to get tested the second part of the strategy – the ‘treat’ component – should also be offered. If a person is concerned as he had some questionable contacts or he knows that his sexual partner is HIV positive, it means a direct risk of infection. It would be very good for such person to check his HIV status. However, if he knows in advance that he would not get treatment and that the AIDS centres have the “waiting lists,” he will not be highly motivated to get tested. To remove those questions from the agenda, all national governments should adopt the ‘test and treat’ policy. I am happy to say that in Eastern Europe and Central Asia there are quite a few countries, which have already announced following this policy: Armenia, Ukraine, and Kazakhstan. They treat all patients who test positive: the patient can seek and get help. If Russia wants to achieve the 90/90/90 target by the end of 2020, the decision to ‘test and treat’ is to be taken in 2018.

– A year ago, Russia adopted the State Strategy to Combat the Spread of HIV through 2020. How do you assess its effectiveness?

– The very fact that there is such a strategy is a great achievement. For many years, the epidemiological situation remained complicated due to the lack of a strategy. For the first time, the government issued an important state document calling to urgently accelerate the measures to combat HIV. It is very good that such measures are to be taken not only by the government, but also by the society, mass media, private sector and trade unions.

However, it would be good if people who prepared the Strategy would define clear and measurable targets for each year: what should be the reduction in the new HIV cases, how many patients are to be enrolled to treatment. The five-year goals are defined but how is it possible to split them and follow up on the achievement of interim targets each year?

– Vadim Pokrovsky said that the Strategy does not have a strong financial background…

– It is a question of state priorities. I think that Russia, having the resources and knowing how to distribute them in the best way, is able to find the sufficient funding to combat HIV. This is not just about the budget increase. There are high-quality drugs, which are less expensive than those procured in Russia. Thus, apart from allocating two or three times more money from the state budget, the cost of drugs may also be reduced. In the last two years, thanks to the pro-active approach of the Ministry of Health, an unprecedented reduction in the cost of HIV treatment in Russia was observed. Such price reduction strategy shall be continued until all patients have access to drugs. My estimate is that in the EECA region the cost of treatment should not exceed 200 US dollars per patient.

– Speaking about price reduction, do you mean compulsory licensing?

– This as well. When compulsory licenses were discussed for the first time, the Russian government represented by the Ministry of Health was concerned that the foreign pharmaceutical companies may leave our country, stop the clinical trials and Russia would be excluded from the innovations. I know over 15 countries in the world, which issued compulsory licences for HIV drugs. In none of those cases, none of the pharmaceutical companies ceased their activities in such countries. Vice versa, such policy led to sharper price declines and scaled up access to treatment. That is why I strongly welcome the discussion of this question at all levels.

One option is to issue a license to produce drugs in the country and another is to facilitate the procurement of quality drugs from abroad at lower prices. Thus, Brazil, for example, for 20 years was famous for producing most “first line” drugs for its citizens. However, three years ago, even before the WHO guidelines were issued, it was the first country to make a decision to treat all people living with HIV. After all the costs were calculated, it became clear that such coverage could not be reached if only locally produced medicines are used. Then the country started purchasing generic medicine from Indian brand producers for 400 US dollars per patient a year. It is a very interesting example of how access to high-quality medicine may be ensured without violating the patent rights.

– Surely, you will take part in the XXII International AIDS Conference in Amsterdam next year. What are your plans for this event?

– We have a joint plan for two very important conferences: VI Eastern Europe and Central Asia AIDS Conference (EECAAC 2018) and the XXII International AIDS Conference (AIDS 2018) in Amsterdam next year. As UNAIDS, we are co-organizers of the ЕССААС 2018 and members of the AIDS 2018 Committee. We encourage specialists and mass media representatives to not only take an active part but also to build kind of a strategic bridge between those conferences. We would like the international participants to intensively share their experience at ECCAAC 2018 and representatives of the EECA region to broadly present their developments at AIDS 2018.

Michel Kazatchkine Became the Special Advisor to UNAIDS

Michel Kazatchkine joined Undetectable means Untransmittable campaign

United Nations Special Envoy for HIV/AIDS in Eastern Europe and Central Asia (EECA) Michel Kazatchkine was recently announced to serve as special advisor to UNAIDS for HIV, tuberculosis and hepatitis C. Such announcement was made by the UNAIDS executive director Michel Sidibe. The term of Michel Kazatchkine as the Special Envoy for HIV/AIDS is coming to an end.

AFEW International is happy to greet Prof. Michel Kazatchkine with his new position. It is important to have Prof Kazatchkine continue his work as a special advisor to UNAIDS, we believe however that the urgency of three epidemics in the EECA region would have justified a position as UN special envoy for the region. The annual number of new HIV infections in EECA increased with 60% between 2010 and 2016. From all regions in the world, the EECA region is furthest away from reaching the UNAIDS 90-90-90 targets by 2020. Treatment coverage remains alarmingly low (28%), and less than a quarter of people living with HIV had suppressed viral loads (end-2016). Specific populations, such as men who have sex with men, drug users and sex workers face specific human rights violations, impeding their access to prevention and health services.

AFEW International is also hoping for the support of Prof. Michel Kazatchkine during the 22nd International AIDS Conference that will take place in Amsterdam in 2018. The largest health conference in the world will have a special focus on Eastern Europe and Central Asia. The need and the urgency to show the challenges of the EECA region during the Conference are extremely vital.

Michel Kazatchkine was appointed United Nations Secretary-General’s Special Envoy for AIDS in Eastern Europe and Central Asia in July 2012. Mr Kazatchkine has devoted thirty years of his professional life to the AIDS response. From 2007 to 2012 he served as the Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria and from 1998 to 2005 he was Director of the French National Agency for AIDS Research. Between 2005 and 2007 he served as France’s Global Ambassador for HIV and Communicable Diseases.

90-90-90 Strategy was Discussed in Tajikistan

Civil sector representatives together with the heads of the AIDS prevention and control centers in Tajikistan worked out practical steps for the implementation of the voluntary counselling and testing (VCT) service in the activities of public organizations. They talked about this during the meeting National strategies of expanding access to HIV testing. Response measures for the implementation of UNAIDS strategy 90-90-90. Republican public organization AFEW Tajikistan shared its successes on September 6, talking about the work of its HIV voluntary counselling and rapid testing point in Qurghonteppa.

“Thanks to this meeting, now I have a vision of how to organize a VCT office in a public organization, where to start, what documents should be prepared and what services should be consulted beforehand. This meeting with its practical exercises, in my opinion, united us with the partners. This can influence the personal growth of each participant,” the director of Tajikistan Network of Women Living with HIV in Dushanbe Tahmina Haydarova is saying.

During the meeting, 50 representatives of state, public and international organizations from Gorno-Badakhshan Autonomous Region, Khatlon and Sughd Region, and the city of Dushanbe talked about the interaction of state and public organizations in providing integrated and coordinated services to key populations in the field of HIV, TB/HIV. They also got acquainted with the main provisions of new UNAIDS strategy 90-90-90, key activities of the National Program to Counteract the HIV/AIDS Epidemic in the Republic of Tajikistan for 2017-2020, and AFEW Tajikistan experience in integrating services and introducing VCT.

The meeting National strategies of expanding access to HIV testing. Response measures for the implementation of UNAIDS strategy 90x90x90 was held within Bridging the Gaps: Health and Rights for Key Populations project that is funded by the Dutch Ministry of Foreign Affairs.

Reasons for Drug Policy Reform

Michel_Kazatchkine_2012

Text: Michel Kazatchkine, UN secretary general special envoy on HIV/AIDS in Eastern Europe and Central Asia

Why is eastern Europe the only region in the world that still has a growing HIV epidemic? In one of the region’s countries, Russia, more than two thirds of all HIV infections, and 55% of the near 100 000 new infections reported last year, resulted from drug injection.

Some 3.2 million people in eastern Europe inject drugs, and about 1.5 million of them are in Russia. In 2007 the number of newly reported HIV cases among Russian people who inject drugs (12 538) was similar to the number in the rest of eastern Europe (12 026). But since then the numbers have diverged hugely.

Scaling up of harm reduction programmes in several countries coincided with a stabilising of HIV rates—and fewer than 7000 new cases outside Russia in 2014. In Russia, however, where access to sterile needles and syringes is low and opioid substitutes remain illegal and unavailable, the number of people who inject drugs newly infected with HIV climbed to nearly 22 500 in 2014.

Criminalisation of drug use

The reasons for Russia’s high figures include the prohibition and effective criminalisation of drug use, repressive law enforcement, and stigma around drug use. These factors lead people to inject in unsafe conditions for fear of police and arrests and result in needle sharing and overdose.

In 2015, the United Nations’ secretary general, Ban Ki-Moon, called for “careful rebalancing of the international policy on controlled drugs.”

“We must consider alternatives to criminalisation and incarceration of people who use drugs,” he said. “We should increase the focus on public health, prevention, treatment, and care.”

The World Health Organization, the United Nations Office on Drugs and Crime, and UNAIDS jointly recommend a package of harm reduction interventions as best practice to reduce the risk of acquiring, and improve treatment of, HIV, hepatitis, and tuberculosis among people who inject drugs. Such strategies, which do not require prohibition of harmful behaviours, are key to reducing death and disease because drug dependency is characterised by people’s inability to abstain.

Continue reading here.

UNAIDS Regional Director for Eastern Europe & Central Asia Address

wad2016_day_hp_2_jpg1 December 2016, UNAIDS — Dear colleagues!

On the occasion of World AIDS Day, 1 December 2016, on behalf of the UNAIDS Regional Office for Eastern Europe and Central Asia, I am pleased to share some important updates on the new UNAIDS global report and key events and initiatives in the HIV response in our region.

This week UNAIDS launched our new global report ‘Get on the Fast-Track: The life-cycle approach to HIV’ showing that countries are getting on the Fast-Track, with an additional one million people accessing treatment globally in just six months (January to June 2016). By June 2016, approximately 18.2 million [16.1 million–19.0 million] people living with HIV had access to the life-saving treatment, including 910 000 children – double the number five years earlier. If these efforts are sustained and increased, the world will be on track to achieve the target of 30 million people on treatment by 2020. Please see the full report here.

On 3 November 2016, Ministries of Health from 12 countries of Eastern Europe and Central Asia adopted the Minsk Statement on ‘HIV and Tuberculosis: Treatment for All’, calling for expanded and rapidly scaled-up access to affordable, quality-assured medicines for HIV and TB. Please see more information about the meeting and the adopted Statement here.

The Government of Ukraine has announced that in 2017 it will double funding from the national budget for HIV and TB treatment, and fully finance the national opioid substitution therapy programme for people who inject drugs – a key population in Ukraine that is at higher risk of HIV infection. Please see more information here.

The first National AIDS Conference in Kazakhstan ‘HIV: Yesterday, Today, Tomorrow’ was held in Almaty on 12-13 October 2016. Over 170 representatives of government, academia, health sector and civil society groups from different regions of Kazakhstan joined the event and discussed the importance of measures to be taken to put Kazakhstan on the Fast-Track. Please see more information here.

On the occasion of the International Day of Youth, a series of activities were organized by the Youth Foundation of Armenia to raise awareness among young people about healthy lifestyles and HIV prevention. One of the main events was a concert in Yerevan on 17 November 2016, attended by over 10.000 youth. Information about HIV testing and prevention was shared through social videos, leaflets and other materials throughout the day.

In Tajikistan, the Minister of Health called for people to know their HIV status during the first ever public event on HIV prevention in Dushanbe. The event, in support of the ‘Hands up for #HIVprevention’ campaign, united more than 500 representatives of the Government of Tajikistan, health professionals, celebrities and young people. Please see more information here.

In the Russian Federation, the next phase of the national campaign ‘#StopHIVAIDS’ will be launched on 28 November in Moscow, under the leadership of Svetlana Medvedeva’s Foundation for Social and Cultural Initiatives. As part of this campaign, a series of activities will take place across Russia from 28 November to 4 December, including open lectures in schools, vocational schools and universities. The campaign will feature the Russian Minister of Health, Veronika Skvortsova, Minister of Education, Olga Vasilieva, Minister of Communications and Mass Media, Nikolai Nikiforov, the Head of Rospotrebnadzor, Anna Popova, and various non-governmental organizations. Please see more information about the campaign here.

22Please join the UNAIDS World AIDS Day Hands Up for #HIVprevention campaign. The campaign is focused on different aspects of HIV prevention, offering space for people to express their views on what they think needs to be done to strengthen HIV prevention efforts. You can upload your photo/video on the special campaign event page on Facebook or Twitter. Thank you for helping us in raising awareness and reaching wider audiences. We encourage you to join the campaign!

I would like to end this letter with a video message by Michel Sidibé, UNAIDS Executive Director on the occasion of World AIDS Day 2016.

Sincerely,

Vinay P. Saldanha
UNAIDS Regional Director for Eastern Europe & Central Asia