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Kyrgyzstan

01. HIV care cascade

Institutionalizing effective models of, and processes in, HIV responses in the EECA region to impact the HIV care cascade in the region
ACTIVITIES

Decentralization of HIV testing services through integration to primary healthcare

Implementer
Contact
Period
IBA Hub
Giorgi Soselia
2022-2024
Progress to date

Synthesis Report on assessment of readiness of health systems to decentralize HIV testing services in 5 countries of the EECA region is developed and can be found at the link.

Technical support in implementation of simplified registration for ARVs

Implementer
Contact
Period
HAC
Denis Godlevskiy
2022-2024
Progress to date

Advocacy plans were developed for Kazakhstan, Kyrgyzstan and Moldova to further contribute to ARV price reduction. Official letters were sent to pharmaceutical companies and government authorities regarding further price reduction for ARVs, keeping the simplified procedures of registration of medicines and medical devices, etc.

Advocacy for engagement of patient community experts into national working groups to develop and adopt medicine procurement lists and technical procurement documentation

Implementer
Contact
Period
HAC
Denis Godlevskiy
2022-2024
Progress to date

Advocacy plans were developed for Kazakhstan, Kyrgyzstan and Moldova to further contribute to ARV price reduction. Official letters were sent to pharmaceutical companies and government authorities regarding further price reduction for ARVs, keeping the simplified procedures of registration of medicines and medical devices, etc.

Inclusion of PrEP into nationally approved service packages for MSM and/or other key populations

Implementer
Contact
Period
ECOM
Nikolay Lunchenkov
2022-2024
Progress to date

ECOM in partnership with WHO regional office for Europe analyzed five national PrEP protocols (Armenia, Kazakhstan, Kyrgyzstan, Georgia and Ukraine) and provided Report with recommendations on the steps needed to include PrEP into nationally approved standard package of servises.

Community groups conduct community-led assessment of national quality standards in accordance to IDUIT and organize dialogue with service providers and MOH/local authorities

Implementer
Contact
Period
EHRA
2023-2024

Integration of community-led monitoring (CLM) into the health care systems of countries in the EECA region to assure the quality of services for key populations (KPs)

Implementer
Contact
Period
ECOM
Nikolay Lunchenkov
EHRA
2022-2024
Progress to date

Practical handbook on community-led monitoring tools was developed in English and Russian languages. The checklist with EHRA and other partners for CLM was discussed and agreed upon.

On 2-8 December 2022, specialists from the Eurasian Harm Reduction Association (EHRA) conducted regional online training “Community-Led Monitoring Methods” for the representatives of community organizations in the CEECA region. The training was attended by 38 representatives of organizations from different vulnerable communities in the CEECA region. The aim of the training consisting of three online sessions was to train leaders of self-organizations from different key communities in the CEECA region to understand, which role CLM can play in their advocacy work, how to formulate the proper problem and research question for CLM, and which of the different methodologies can most effectively provide the data needed for advocacy. Video recordings of the training, as well as presentations can be found at the link.

Provision of HIV prevention services with precautions against COVID-19

Implementer
Contact
Period
APH
Nadiya Yanhol
2022
Progress to date

Work on shelters has expanded – in addition to 5 shelters for working with women who use drugs in conditions of violence (Ukraine, Serbia, North Macedonia, Kazakhstan), support for flexible shelters for representatives of the LGBT community in Kazakhstan, Uzbekistan, Kyrgyzstan and Tajikistan has been added. The program was distinguished by a special programmatic approach to working with clients – about 3,200 clients received material assistance in the form of food packages (Georgia, Kazakhstan). PPE support in Kaz for migrants and KGP (124,000 disposable masks, 1,000 antiseptics); CLM to provide quality services for clients of OST programs in 7 countries.

National Contingency Planning

Implementer
Contact
Period
APH
Nadiya Yanhol
2022
Progress to date

Supporting key group populations in a COVID setting “General contingency planning guide developed in the frames of the C19RM is available here.

Guide by APH for Contingency Planning for Key Population HIV Services during COVID-19 and Other Emergencies for North Macedonia, Serbia, Bosnia and Herzegovina, Montenegro, Moldova, Georgia, Kazakhstan, Uzbekistan, Tajikistan and Kyrgyzstan in English is available at the link https://aph.org.ua/en/eeca/ in the folders with the names of each country.

Community-led advocacy of elimination of identified critical discrepancies with the WHO prevention, testing and treatment guidelines

Implementer
Contact
Period
100% Life
Daryna Bondarenko
2022-2024
Progress to date

Current testing and treatment protocols analysis is finished in 7 countries (Armenia, Moldova, Georgia, Kazakhstan, Kyrgyzstan, Uzbekistan, and Ukraine) and recommendations to align the national protocols with the WHO guidelines are provided. The report is available at the link.

WHO has held the analysis of HIV testing guidelines in 6 countries of EECA – Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan, Uzbekistan. The report is available at the link.

Decentralization of HIV treatment through integration to primary healthcare

Implementer
Contact
Period
IBA Hub
Giorgi Soselia
2022
Progress to date

Synthesis Report on assessment of health systems to decentralize HIV treatment services in 5 countries of the EECA is developed and can be found at the link.

Technical support in implementation of long-term contracts for ARV procurement

Implementer
Contact
Period
HAC
Denis Godlevskiy
2022-2024
Progress to date

Advocacy plans were developed for Kazakhstan, Kyrgyzstan and Moldova to further contribute to ARV price reduction. Official letters were sent to pharmaceutical companies and government authorities regarding further price reduction for ARVs, keeping the simplified procedures of registration of medicines and medical devices, etc.

Assessment of OAT sustainability

Implementer
Contact
Period
EHRA
2022-2023
Progress to date

Assessment of the sustainability of the opioid agonist therapy programme in the context of transition from donor support to domestic funding was conducted in Moldova and Tajikistan. The reports are being finalized and sent for design, they’ll be published by the end of Q1 2023. The assessments in Albania, Kyrgyzstan and Ukraine are ongoing and will be finalized in 2023.

02. Removing HR/gender barriers

Removing barriers to services for key populations to promote quality health interventions based on human rights principles; addressing gender barriers to services
ACTIVITIES

Legal environment assessment on MSM and trans people in 4 countries

Implementer
Contact
Period
ECOM
Yuri Yorskiy
2022
Progress to date

Legal environment assessments for Kyrgyzstan and for Uzbekistan were published.

Legal environment and situation analysis as well as mapping of civil society partners in the area of access by migrants to HIV and TB services

Implementer
Contact
Period
REGMH
Daniel Kashnitsky
2022-2023
Progress to date

On December 9, the REGMH with the assistance of the NCC Secretariat held in Dushanbe a Roundtable “Protection of health of migrants from Tajikistan”. The event was timed to presentation of a new study conducted by the REGMH: “Situation and Economic analysis of HIV-related health services in the field of migration in Tajikistan”.

On December 13, 2022, the Regional Expert Group on Migration and Health together with Central Asian Association of People Living with HIV held a Roundtable in Almaty “Health of HIV positive migrants in Kazakhstan”. The aim of the Round Table was to promote effective and timely treatment of international migrants living with HIV. During the meeting, the Situational and Economic analysis on the provision of HIV-related health services for international migrants in Kazakhstan was presented and discussed.

On December 19, REG together with local NGO “Real World. Real People” held a Roundtable in Armenia, Yerevan aimed to buster a discussion and exchange of experience on the provision of services for international HIV-positive migrants between heads of health authorities of the Republic of Armenia, government departments responsible for migration and civil society organizations. At the meeting, a study “Analysis of legal and institutional barriers to accessing HIV services among migrants in the Republic of Armenia” (developed by REG in 2021) was presented.

Also, in Q4 REG has launched a study is Kyrgyzstan.

On October 11, REG held an online meeting “Migrants’ access to HIV services in Central Asia and Caucasus” that gathered representatives of UNAIDS, Central Asian Association of PLHIV (Kazakhstan), TB People (Georgia), NGO “Real World, Real People” (Armenia), IFRC Central Asia, WHO Europe, Elton John AIDS Foundation, NGO Equality Movement (Georgia), AFEW (Kyrgyzstan), IFRC South Caucasus, Global Fund, WHO, and MSF. The goal of the meeting was to initiate a discussion and work out possible solutions to provide access to HIV services for those who urgently left the countries following the political situation.

Ensure a monitoring system for the implementation of the human right to health in prisons through national preventive mechanisms

Implementer
Contact
Period
FreeZone
Oleksiy Zagrebelnyi
2022-2024
Progress to date

An analysis of the current situation regarding the development and implementation of tools to ensure access to harm reduction services with a focus on OST was conducted by FreeZone in Georgia and in Kyrgyzstan.

An analysis of the current functioning of NPMs was carried out by FreeZone in Moldova and Kazakhstan.

For Moldova and Kazakhstan, Information on key indicators of the incidence of socially dangerous diseases in penitentiary institutions was collected, namely data on the total number of convicts held in penitentiary institutions; detailed information on the number of people living with HIV infection; the number of detected cases of tuberculosis; the number of convicts who were provided with treatment for viral hepatitis. The results can be found at the links: MoldovaKazakhstan.

Women-led research, “Monitoring of violence against women living with HIV”, including factors preventing support/help seeking behaviors for women living with HIV who experience violence

Implementer
Contact
Period
EWNA
Svitlana Moroz
2023

Developing and launching call for “Gender and HIV” small grants with special eligibility focus on Monitoring situation with human rights of Trans* people

Implementer
Contact
Period
EKPC
Dr. Karen Badalyan
2022-2024
Progress to date

Small Grants Programme with 4 selected projects run by grass-root NGOs in 2022 included:

  • “National Trans Coalition” NGO with the project titled “HIV prevention in Armenia through gender mainstreaming” (Armenia);
  • “The Public Association “Union for Equity and Health” NGO with the project titled “Gender Equality for sex workers” (Moldova);
  • “Rromnjako Ilo” Zrenjanin he Public Association” NGO with the project titled “Check your health – Equality for Trans Roma and Roma women/girls sex workers” (Serbia);
  • “NON-GOVERNMENTAL ORGANIZATION «NASHA DOPOMOGA»” with the project titled “RIGHT TO HEALTH!” (Ukraine).

Decriminalization of HIV and unintended HIV transmission

Implementer
Contact
Period
100% Life
Nadiia Savchenko
2022-2024
Progress to date

100% Life conducted an analysis of the legal environment in Georgia, Kyrgyz Republic and the Republic of Uzbekistan in order to identify regulatory legal acts that need to be amended to reduce the criminalization of people living with HIV.

Reduce criminalization of drug use and personal possession

Implementer
Contact
Period
ENPUD
Olga Belyaeva
EHRA
ECECACD
2022-2024
Progress to date

Two reports were developed on decriminalization of drug use in Georgia and Kyrgyzstan.

ENPUD is working on several strategic cases: in Moldova, unauthorized urine PAS test was prevented regarding an OST patient, as well as arbitrary detention of an OST patient in another case. In Ukraine, two strategic ongoing cases regarding keeping the driver’s license for the OST patient; and restoring activist`s rights and reputation, and punishing the police officers responsible for the provocation. In Kazakhstan, several strategic cases regarding taking cannabis for medical purposes. In Kyrgyzstan, a strategic case regarding provocation by the police with the planting of “evidence”; extortion of a bribe for the opportunity to be at large while “investigative” actions are going on.

Development and promotion of the Guiding principles (recommendations, model legislation etc.) on drug policy for the EECA region with specific advocacy efforts for reforming drug policy and decriminalization of personal drug use

Implementer
Contact
Period
ECECACD
2022-2024
Progress to date

The Guiding Principles document is developed and approved by the ECECACD. The first draft of the document was reviewed and discussed during in-person meeting of Commissioners on November 2, 2022 (the Minutes extract with provided recommendations to the document are available upon request). The document was amended accordingly to the recommendations and sent for the second review by Commissioners. Commissioners provided their recommendations and corrections to the text (the letters and texts with corrections are available upon request). Final amendments was done, the document was completed and finally approved by Commissioners (relevant correspondence is available upon request). The final version of the Guiding principles is under design

Improve anti-stigma legislation for LGBT

Implementer
Contact
Period
ECOM
Yuri Yorskiy
EKPC
Dr. Karen Badalyan
2024

Evidence-based advocacy interventions with the aim of removing legal barriers to, and improve the rights of, migrant access to HIV and TB care in sending and receiving countries of in EECA region: national and regional (EECA) meeting and roundtables with participation of civil society, migrant organizations, healthcare officials and parliamentarians

Implementer
Contact
Period
REGMH
Daniel Kashnitsky
2022-2024
Progress to date

On December 9, the REGMH with the assistance of the NCC Secretariat held in Dushanbe a Roundtable “Protection of health of migrants from Tajikistan”. The event was timed to presentation of a new study conducted by the REGMH: “Situation and Economic analysis of HIV-related health services in the field of migration in Tajikistan”.

On December 13, 2022, the Regional Expert Group on Migration and Health together with Central Asian Association of People Living with HIV held a Roundtable in Almaty “Health of HIV positive migrants in Kazakhstan”. The aim of the Round Table was to promote effective and timely treatment of international migrants living with HIV. During the meeting, the Situational and Economic analysis on the provision of HIV-related health services for international migrants in Kazakhstan was presented and discussed.

On December 19, REG together with local NGO “Real World. Real People” held a Roundtable in Armenia, Yerevan aimed to buster a discussion and exchange of experience on the provision of services for international HIV-positive migrants between heads of health authorities of the Republic of Armenia, government departments responsible for migration and civil society organizations. At the meeting, a study “Analysis of legal and institutional barriers to accessing HIV services among migrants in the Republic of Armenia” (developed by REG in 2021) was presented.

On October 11, REG held an online meeting “Migrants’ access to HIV services in Central Asia and Caucasus” that gathered representatives of UNAIDS, Central Asian Association of PLHIV (Kazakhstan), TB People (Georgia), NGO “Real World, Real People” (Armenia), IFRC Central Asia, WHO Europe, Elton John AIDS Foundation, NGO Equality Movement (Georgia), AFEW (Kyrgyzstan), IFRC South Caucasus, Global Fund, WHO, and MSF. The goal of the meeting was to initiate a discussion and work out possible solutions to provide access to HIV services for those who urgently left the countries following the political situation.

REAct (https://react-aph.org/): Monitoring of human rights violations and discrimination against PLHIV and KPs. Responding to such cases through provision or referring to legal or social services to victims and through advocacy actions. In Georgia, Kyrgyzstan, Moldova and Tajikistan, REAct system was initiated within SoS_project#1.0 in 2020, and in 2022 is transferred to national funding, meanwhile APH continues to provide technical support to users. In Ukraine, REAct was implemented in 2019 and is functional within national GF grant. REAct system is supported by APH in Uzbekistan for 2022-2023, in 5 Balkan countries – for 2022-2024, and in Armenia and Azerbaijan – for 2023-2024. At the same time, regional networks ECOM and ENPUD started to use REAct program for documentation in several countries of the region and are supported for 2022-2024 within SoS_project#2.0 grant.

Implementer
Contact
Period
APH
Victoria Kalyniuk
ECOM
Yuri Yorskiy
ENPUD
Olga Believa
2022-2024
Progress to date

Cumulatively, during 2022 there were registered 6700+ cases in 13 countries (Albania, Armenia, Bosnia and Herzegovina, Georgia, North Macedonia, Moldova, Montenegro, Kazakhstan, Kyrgyzstan, Tajikistan, Serbia, Ukraine, Uzbekistan) involving 170+ CBOs, as well as regional networks such as ECOM (in Uzbekistan, Tajikistan, Armenia, Kazakhstan, Kyrgyzstan) and ENPUD (Georgia, Moldova, Ukraine, Kyrgyzstan, Kazakhstan, Tajikistan, Belarus).

The following publications are available:

03. Budget advocacy

Budget advocacy for sustainable services for key populations in the EECA region
ACTIVITIES

REGIONAL: regional dashboard (with 2 integrated portals) + preliminary results to be reflected on the timeframe / deadlines, at least for this year

Implementer
Contact
Period
APH
Maria Malakhova
2022-2024
Progress to date

ToR for the dashboard is under development; methodologies and approaches to data collection for the social contacting and sustainability and transition portals are being updated.

National info system with database, service provider app, and client app

Implementer
Contact
Period
APH
Maria Malakhova
2022-2024
Progress to date

ToR is developed, specifications are being developed, team is being trained, development is due to start in April 2023.

Virtual social worker

Implementer
Contact
Period
APH
Maria Malakhova
2022-2024
Progress to date

Concept is developed, scripts are under development, research is being carried out to identify the optimal technical framework.

Legal framework for financing HIV services from domestic funds – development and approval

Implementer
Contact
Period
IBA Hub
Roman Drozd
2022-2024
Progress to date

Targeted activities were held in all project countries to discuss with national and international, governmental and non-governmental stakeholders the changes needed to enable sustainable and uninterrupted funding of HIV-related activities from national resources. Through targeted advocacy, technical support, and an integrated approach to HIV funding, in 2022 the project team managed to allocate approximately 1,7 million USD at the national level to programs for key populations, using social contracting mechanisms: Moldova – 154,126.84 USD; Kazakhstan – 118,529.33 USD; Kyrgyzstan – 61,000 USD; Tajikistan – 19,200.00 USD; Georgia – 357,000 USD; Ukraine – 931,453.96 USD.

Increasing domestic financing of countries for services to key groups

Implementer
Contact
Period
IBA Hub
Roman Drozd
2022-2024
Progress to date

Targeted activities were held in all project countries to discuss with national and international, governmental and non-governmental stakeholders the changes needed to enable sustainable and uninterrupted funding of HIV-related activities from national resources. Through targeted advocacy, technical support, and an integrated approach to HIV funding, in 2022 the project team managed to allocate approximately 1,7 million USD at the national level to programs for key populations, using social contracting mechanisms: Moldova – 154,126.84 USD; Kazakhstan – 118,529.33 USD; Kyrgyzstan – 61,000 USD; Tajikistan – 19,200.00 USD; Georgia – 357,000 USD; Ukraine – 931,453.96 USD.

Regulation of service packages for key groups

Implementer
Contact
Period
IBA Hub
Roman Drozd
2022-2024
Progress to date

In the reporting period, the Emergency package of services for key and vulnerable groups of the population in the field of HIV, and TB in the context of military conflicts was finalized, including tariffication. On its basis, in 2023, the process of advocacy and promotion of implementation at the level of countries in the EECA region will be launched.