A two-day high-level regional meeting “Response to HIV and TB Challenges: Transition from Donor Support to Sustainable Health Systems” is being held on December 12-13 in Tallinn and initiated by the Ministry of Social Support in cooperation with the Health Development Institute within the framework of Estonia’s Presidency in the Council of the European Union.
Officials and activists opened the event with welcome speeches: Yevgeniy Osinovskyi, Minister of Health and Labor of Estonia; Wolfgang Philipp, Head of Crisis Management and Preparedness in Health, Directorate-General for Health, European Commission; Nikos Dedes, Chairman of the Board of the European AIDS Treatment Group; Lachin Aliyev, participant of the general meeting of the East Europe and Central Asia Union of People Living with HIV (ECUO PLWH) and the Director of the Estonian Network of People Living with HIV.
Yevgeniy Osinovskyi, Minister of Health and Labor of Estonia:
“The spread of HIV and TB in Europe continues to be a special concern in many Eastern European countries, where the situation is more drastic, while access to treatment is one of the lowest in the world.
In many countries, the services needed to fight these diseases, were developed with the support of donor funding. In order to achieve sustainable and efficient services, we need to find ways to ensure public funding for these services and integrate them into national health systems.
Estonia is an example of sorts for other countries in Eastern Europe. We transferred HIV services to public funding from the donor support almost a decade ago. We worked out a political agreement that this is a priority issue, and we have been consistently increasing public funding. In the recent HIV action program for the upcoming period we have included an ambitious goal to significantly reduce the number of new HIV cases in the coming years”.
Lachin Aliyev, Representative of ECUO PLWH and Director of the Estonian Network of PLWH:
“We are here because we want our participation to uphold universal access to high-quality services for prevention, treatment, care and support for communities of people living (“living” is the key word here!!!), with HIV based on fairness and respect for human rights! We work in the name of recognizing the values of human life, respect, dignity and equality of all people, free from any suffering. Working amidst complex political and socio-economic processes, sometimes even upheavals, community organizations are the drivers of change for state policies and practices in health and social support systems, as well as socially important services.
By providing them, NGOs and communities stand at the forefront of advocacy for the interests of the populations most vulnerable to HIV/TB, thereby filling gaps in state social policies. The NGOs mainly use the resources to meet the needs of the society, and not to promote their own interests.
I really hope that everything we think and dream about, everything we are calling upon, was stemming from the right to be healthy and safe, from being committed to our common goal! We work for the improved health and freedoms as an integral part of society, of the entire European area”.
Representatives of the Ministries of Health and Ministries of Finance of the European countries, representatives of the Balkan countries and the Eastern Partnership countries, the European Commission, WHO, other international organizations, civic associations, other institutions involved in financing programs aimed at fighting HIV and TB and providing relevant services participate in the event.
Andrey Agafonov, Senior project management and social programs specialist of ECUO PLWH:
“We, the PLWH community, and the ECUO PLWH, as the only regional network representing the PLWH community in the Eastern Europe and Central Asia region, welcome the openness of the governments of the EU countries to the dialogue on urgent issues related to HIV/TB and express our appreciation for the honor to open this event granted to us”.
Participants in the Tallinn meeting are looking for opportunities to ensure a smooth transition from donor funding to sustainable public funding. It’s worth mentioning that representatives from Lithuania, the Netherlands, the UK, Romania, Moldova, Serbia, Bulgaria, Montenegro, Ukraine and Russia presented their reports with reviews of best practices, challenges, opportunities and risks in HIV and TB programs integration into public health systems at the meeting. A separate block will focus on the roles and responsibilities of various institutions and organizations in the fight against the HIV and TB epidemic.
David Ananiashvili, Director of the Georgian Group Plus, representative of ECUO PLWH:
“I believe that the pooling of HIV and TB programs should only take place if there is a real need for it. In countries with a low prevalence rate, pooling can have the opposite effect. Adherence is the cornerstone of the TB treatment programs efficiency in the country”.
In Estonia national HIV services were built with the support from the Global Fund, including harm reduction services for drug users, which were crucial to reducing the number of new HIV infections.
Armen Agajanov, ECUO strategic information manager, summarized the main challenges prevalent in the region:
“- The European Region is the only region in the world where HIV morbidity and AIDS mortality are still on the rise.
– True, not all the countries of Eastern Europe and Central Asia are current EU members, but they still belong to the European region. The international community, including the European Commission, EU member states, the Global Fund, UN organizations, etc., should develop a dialogue with EECA countries on overcoming obstacles to universal access to prevention, treatment, care and support.
– Lack of funding continues to pose a serious obstacle to HIV prevention programs expansion aimed to effectively combat the epidemic in the region. As the Global Fund, the main donor in our countries, is withdrawing from the region and discontinues financing, countries should ensure transition to public funding, which in most cases is almost unrealistic due to the need in significant expenditures.
– The EU as one of the stakeholders should support the transition to national, governmental funding in EU member states, accession candidates, as well as neighboring countries.
– If the epidemic in the EECA region is not taken under control, in this situation the EECA countries would be very likely to “export” HIV in the EU.
“The services and financing of these services must be efficient and sustainable, patient-centered, person-centered”.