
Montenegro
01. HIV care cascade
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)
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
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
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.
Advocacy for PrEP financial costs to be covered by national funding schemes (including health insurance)
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.
Provision of HIV prevention services with precautions against COVID-19
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
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
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.
02. Removing HR/gender barriers
ACTIVITIES
Developing and launching call for “Gender and HIV” small grants with special eligibility focus on Monitoring situation with human rights of Trans* people
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).
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.
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:
- Statistic country reports by APH on human rights violations based on REAct data collected in 2021 in Kyrgyzstan, in Georgia, in Moldova, in Tajikistan.
- Protectors or Perpetrators: the impact of unlawful policing on human rights and HIV. Join analytical publication in partnership with Frontline AIDS, Alliance for Public Health (Ukraine, Kyrgyzstan, Tajikistan, Moldova, Georgia, Uzbekistan), AIDS Foundation (South Africa), Gender Dynamix.
- Report on the results of the analysis of the Hotline calls by APH: Domestic and other forms of violence against women living with HIV and women in key populations during the COVID-19 pandemic in Tajikistan.
- REAct Statistical Report for the 1st half of 2022 by APH. Violations of the rights of people living with HIV and representatives of vulnerable groups in Georgia.
Situational Report by APH: Drug policy in Georgia and Challenges. - Series of publications by APH based on REAct data within regional campaign “16 days against gender-based violence”.
03. Budget advocacy
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
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
Municipal budget advocacy for cities that chose the Fast Track approach: Podgorica, Bar, Bijelo-Polje cities in the Balkan region
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.