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Montenegro

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

Country level support to adoption and implementation of HTS guidelines and introduction of self-testing, community-based testing and decentralized testing into national policy documents and clinical guidelines, and harmonized testing policies and processes with new WHO recommendations in four (4) countries of the SEE sub-region (Albania, Montenegro, North Macedonia and Serbia)

Implementer
Contact
Period
SEE RCN
Damir Lalicic
2022-2024
Progress to date

In 2022, the project conducted an assessment on policies, regulations, and practice of HIV Rapid Testing/Self-testing in 4 SEE countries and developed a report on findings and recommendations. The purpose of this assessment was to evaluate country-specific policies, regulations, and practical factors that are currently facilitating or affecting community-level access to rapid diagnostic tests, including self-testing of HIV.

Introduction of self-testing, community-based testing and decentralized testing into national policy documents and clinical guidelines, and harmonized testing policies and processes with new WHO recommendations, including with TA provided by the WHO Regional Office, Europe

Implementer
Contact
Period
SEE RCN
Damir Lalicic
2022-2024
Progress to date

Costing Methodology for HIV infection testing costs based on current HIV testing strategies and RDT-based testing costs and data collection tool are developed, data on Kazakhstan and Georgia are collected, the reports are under finalization.

In 2022, the project conducted an assessment on policies, regulations, and practice of HIV Rapid Testing/Self-testing in 4 SEE countries and developed a report on findings and recommendations. The assessment was conducted in North Macedonia, Albania, Montenegro, and Serbia. The purpose of this assessment was to evaluate country-specific policies, regulations, and practical factors that are currently facilitating or affecting community-level access to rapid diagnostic tests, including self-testing of HIV. Some of the key recomendations which are suggested: to update National Guidelines/Protocols for HIV testing, outlining clear HIV testing algorithm in line with WHO recommendation including community based testing and HIV self-testing; update the existing internal protocol on HIVST; develop policy and advocacy recommendations for reducing HIV-related stigma and discrimination; integrate HIV self-testing into existing HIV service delivery models including OST programs. The report can be found at the link.

Introduction of the piloted PrEP models to the healthcare systems and advocate to revise and update national policy documents

Implementer
Contact
Period
SEE RCN
Damir Lalicic
2022-2024
Progress to date

Bosnia and Herzegovina and Montenegro are awaiting the launch of the PrEP pilot project between MCM (Protocols have been developed, client waiting lists are available, study-visits have been carried out for the project staff). The first clients are expected to receive PrEP in Q1 2023.

Bosnia and Herzegovina and Montenegro successfully launched a pilot PREP project among MSM (as of January 1, 2024, number of clients: BiH – 28, Montenegro – 51). Thanks to the coordinated work of the CSoS 2.0 project and partners in Balkans, a pre-exposure prophylaxis drug was purchased for both countries at 10 times cheaper than the commercial drug used in the countries for ART regimens. Our partners SEE Network, with technical support from WHO, developed Protocols and prepared PREP sites to launch the project.

Advocacy for PrEP financial costs to be covered by national funding schemes (including health insurance)

Implementer
Contact
Period
SEE RCN
Damir Lalicic
2022-2024
Progress to date

The second main activity regarding of PrEP was advocacy for PrEP financial costs to be covered by national funding schemes. Our focus in 2022 was preparation of set of recommendations for institutionalization of PrEP in Bosnia and Herzegovina and Montenegro and by the end of the year we finalized first drafts which is distributed to the stakeholders.

This activity is planned for 2024. But remarkable progress was achieved in Bosnia and Herzegovina, where funding for PrEP-related expenses was already included in national schemes.

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.

Procurement of condom vending machines to reduce contacts during COVID-19

Implementer
Contact
Period
APH
Nadiya Yanhol
2022
Progress to date

2 countries (Moldova, Montenegro) were supported in purchasing vending machines. 13 machines were purchased to reduce contacts during COVID-19.

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.

Assessment of OAT sustainability

Implementer
Contact
Period
EHRA
2023
Progress to date

Quality of harm reduction – mapping of the main challenges and barriers in the modernization of principles, values, and approaches in the work of harm reduction programs in Montenegro was held the report is available at the link.

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
Progress to date

Quality of harm reduction – mapping of the main challenges and barriers in the modernization of principles, values, and approaches in the work of harm reduction programs in Montenegro was held the report is available at the link

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

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).

 

  • The project applicant is the organization “Albanian Association of People Living with HIV/AIDS (PLWHA)” with the project titled “New approach on transforming the spiral of exclusion and marginalization, towards the right of recognition before the law, gender-diverse and reduce the violence in health-care settings for trans persons in Albania”.
  • The project applicant is the “National Trans Coalition” NGO with the project titled “Strategic pathway to remove structural barriers for trans* communities to PrEP and PEP services in Armenia”. The proposed project has been designed to establish favorable conditions for improving access of Trans* communities to PrEP and PEP services in Armenia.
  • The project applicant is the organization “STAR STAR” Skopje with the project titled “Community Mobilization to Mitigate Funding Cuts and Gender Inequality in National HIV Programs for Sex Workers in North Macedonia”. The project is envisioned as a response to the latest developments in North Macedonia related to provision and delivery of HIV prevention services for key populations.
  • The project applicant is the organization “Rromnjako Ilo” Zrenjanin he Public Association” NGO with the project titled “Supporting health wellbeing and safety of Trans and Intersex Roma, sex workers and HIV+”.

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
SEE RCN
Haris Karabegovic
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:

REAct system is available and functional at the national level in the following counties. It enables documentation of cases of human rights violations: Albania (45 cases), Armenia (182), Azerbaijan (174), B&H (70), Montenegro (60), Kazakhstan (363), North Macedonia (42), Tajikistan (1155), Serbia (24), Uzbekistan (835). More detailed data of 2023 is available in REAct Regional Digest and REAct website.

Cumulatively in 10 countries, 49,9% of documented cases were responded by REActors, their organizations or through referral to partner NGOs or institutions. During 2023 in 10 countries, there were provided 2162 consultations about human rights, 1022 consultations with professional lawyers. In 168 cases REActors helped to draft simple legal documents, such as complains or statement to police, in 236 cases represented client’s interests in medical facilities, assisted in getting medical services and support, in 336 cases – accompanied the client in the initial appeal to the police. There were at least 20 strategic court cases, and at least 162 cases were used for shadow reports to UN Treaty Bodies.

03. Budget advocacy

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

Assessment of the legal framework to fund HIV services with domestic funds: sustainability planning; advocacy campaign on change of laws and regulations; establishment of Parliamentary group for HIV,TB, Hepatitis and STIs

Implementer
Contact
Period
SEE RCN
Damir Lalicic
2022-2024
Progress to date

Preliminary consultations were held in 2022and assessment was planned in 2023.Domestic funding for HIV services is increased. The funding of Tirana municipality for NGOs offer HIV services was $32,000. The level of funding for HIV-related activities from the City of Skopje remained approximately the same as is in 2021 –approximately 35,000 USD. MoH from Montenegro allocated 100.000 EUR for funding NGO HIV programs in 2022. In Bosnia and Herzegovina for increase services for key populations and PLWHA. was two grants. One grant was from Ministry of Civil affairs, Department for Health and it was about 26 000 Euro for nine CSOs, Partnerships in Health was one of them but also our partners from the Project, Victoria and Ruka Ruci. The second grant was from Federal Ministry of Health, and it was for HIV testing and counselling on HIV, education for KAP and youth. It was about 13 500 Euro and it was granted to the Partnerships in Health. In Serbia there was 19214 USD in total from municipality funding for HIV services in Serbia.
Until now there is Parliamentary group for HIV, TB Hepatitis and STIs established in Bosnia and Herzegovina.

Regulation of service packages for key groups

Implementer
Contact
Period
SEE RCN
Damir Lalicic
2023
Progress to date

Strategic Brief on Business Continuity (link) and Strategic Brief on Social contracting (link) were developed. In addition, Analysis of Quality of Services Provided in Azerbaijan was held and is available at the link.

Municipal budget advocacy for cities that chose the Fast Track approach: Podgorica, Bar, Bijelo-Polje cities in the Balkan region

Implementer
Contact
Period
SEE RCN
Damir Lalicic
2022-2024
Progress to date

As the result of budget advocacy the city administrations in Dushanbe ($130 000), Podgorica ($43 000), Skopje ($35 000), Tirana (USD 32,000), Novi Sad (USD 9,000), Sabac ($7 500) and Zvezdara ($4 000) allocated funds for the implementation of activities that would achieve the goals of the Paris Declaration.