Kyrgyzstan revising national protocols to improve HIV treatment

WHOWHO

A meeting on 7–10 August 2017 contributed to the ongoing revision of Kyrgyzstan’s national protocols to improve HIV treatment by bringing together national specialists and WHO experts.

The meeting’s objectives were to recognize barriers in accessing HIV services and to identify effective methods to:

  • initiate timely treatment;
  • ensure that people living with HIV adhere to treatment and regularly see their doctor;
  • monitor treatment outcomes; and
  • ensure that viral load does not allow transmission.

This joint work is part of the ongoing collaboration between WHO/Europe and the Ministry of Health of Kyrgyzstan in support of the revision being conducted by the Republican AIDS Center in compliance with the latest WHO guidelines. These efforts are aligned with Den Sooluk, the national health-care reform programme, which identifies HIV as one of the country’s priorities.

New AIDS cases with tuberculosis in 2015 among the highest reported in the Region

Since 2009, the number of people receiving antiretroviral therapy (ART) in Kyrgyzstan has increased by about 4 times, and there are signs of stabilization of the HIV epidemic. However, Kyrgyzstan’s overall rate of newly diagnosed HIV infection remained relatively high in 2015. The percentage of new AIDS cases with tuberculosis in 2015 (61%) was among the highest reported in the WHO European Region. The percentage of people diagnosed with HIV at a late stage of infections was also very high (61%) and above the 2015 average for the Region as a whole (48%).

Working groups to revise national protocols

Kyrgyzstan established a national working group for the revision of HIV treatment protocols in June 2017 with WHO support. Outcomes of the group’s discussions were presented to WHO and the Ministry of Health, sparking a dialogue on options to optimize treatment regimens and ensure quality of treatment and costs saving.

In the new version of the national protocols on ART, regimens are to fully align with WHO’s 2016 “Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection”. The protocols will also take into account the 2017 update on the transition to new antiretroviral medicines and the management of advanced HIV disease.

Another national working group focuses on strengthening HIV laboratory capacities with the support of the Centers for Disease Control and Prevention (CDC) of the United States of America. This group provided the rationale for scaling up laboratory monitoring of treatment, especially given the high numbers of people living with HIV in Kyrgyzstan who start ART in late stages.

Efforts in line with the European action plan for the health sector response to HIV

In addition to the workshop, WHO held meetings and roundtable discussions with representatives of specialized institutions, care providers and an extended network of experts and partners who reported on progress achieved and challenges to overcome.

Discussions focused on the implementation of the country’s current and future HIV grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria, and overall national efforts in line with the Action plan for the health sector response to HIV in the WHO European Region.

These discussions ensured an inclusive process for finalizing the first draft of the national HIV treatment protocols by creating synergies among relevant partners, institutions and sectors. It is expected that the national HIV treatment protocols will be finalized and endorsed by the end of 2017, and the “Treat All” approach will be implemented in 2018.