New challenges, what is ahead?
In September 18 - 19, 2017 Bishkek for the first time during a long period hosted the national high - level conference “New Challenges of HIV and TB”.
The main message of this event was to draw the attention of politicians and decision - makers to the problems of HIV and tuberculosis infection in the country and the region in order to strengthen interaction and implement innovative approaches in the HIV and TB prevention programs.
It should be noted that the conference was attended by about 250 people including the representatives of the civil sector, state agencies and international organizations, who arrived from all over the Eastern Europe and the Central Asia region.
The conference was opened by Mr. Talantbek A. Batyraliev, the Minister of Healthcare of the Kyrgyz Republic. In his speech, the Minister described new and innovative approaches towards the treatment of HIV and tuberculosis:
“Early detection of HIV and tuberculosis will facilitate the treatment and prevention of the diseases as well as halting their prevalence. Therefore, officials and various organizations should unite and fight together against the spread of these diseases”.
In addition to the treatment approaches the Minister touched upon the urgent problems of stigma and discrimination against PLHIV and their family members:
“About 90% of the officials never visited the remote regions of the country and are not aware of the statistics of HIV and tuberculosis patients; many continue to follow stereotypes when thinking about PLHIV and their families. It is important to start a full - scale fight against stigma and discrimination at all levels.”
The representatives of the civil society expressed in their speeches their concern over the reduction of funding from the Global Fund, in the light of the fact that in 2014 the country received from the GF USD 7.5 million, while in 2017 this funding made USD 5 million, it is expected that in the future the funding of programs will be twice reduced. This data caused alarm both among the representatives of the NCOs as well as among the members of the Parliament of the Kyrgyz Republic.
According to Ms. Aida Ismayilova the MP the number of people in need of treatment is constantly growing and additional financing of treatment, care and support programs for the PLHIV is required. The MP added: “We in the Parliament are ready to support and promote prevention programs and will continue working on increasing the share of government funding for the prevention of HIV and tuberculosis”.
On behalf of development partners, Mr. Alexander T. Goliusov, the director of the sub - regional UNAIDS office highlighted the issue of regulatory regulation of prevention programs:
“Adoption of the state program on stabilization of HIV infection for 2018 - 2021 will allow Kyrgyzstan to outline the priorities for the further development of prevention programs in the context of achieving the global goals of 90 - 90 - 90”, he said.
The past conference will be remembered by the participants not only by the figures, facts and new approaches to treatment, but also by the emotions that were caused by the speech of Ms. Baktygul Shukurova. In her report Baktygul officially disclosed her HIV status and became the first woman in Kyrgyzstan to do that in public.
According to Baktygul, she was tired of being afraid and her only desire was that she wanted to have confidence in the future and feel secure for herself and her family:
“There are more and more people like us every day. We are all different - women and men, there are many children infected in medical institutions. We have different concerns in life: to earn a living, to grow and teach our children, to communicate with relatives, neighbors and friends. We have learned to live with the disease, but many of us unfortunately do not know yet that they are sick and there are more than 8 thousand such people in Kyrgyzstan. Six years ago I started the therapy. I knew people who failed to survive until this day and died from AIDS. When I think about that I feel fear and pain. At the same time I am grateful to all those who supported me in difficult times, I am grateful to the international organizations and the state, that there are medicines that provide me with a full life.”
Baktygul added that she was very much concerned with the future of treatment programs, in view of the reduction in funding:
“The main thing that causes my anxiety and concern among hundreds of HIV - positive people in Kyrgyzstan is whether medicines will be available? Will the state be able to provide all necessary conditions to help the people with HIV avoid death. We see that in some countries there are interruptions in medicines’ supplies, we also remember that in 2014 due to lack of medicines more than 500 people had to wait in queue for the treatment of resistant tuberculosis. According to the UNAIDS predictions if adequate funding were not in place by 2020 there will be several thousand deaths among people living with HIV. I do not want to be one of them. Me and my friends are ready to fight for their lives. We also do not want the number of people with HIV be increased therefore preventive programs should continue. We want to believe that the leadership of the country will confirm and demonstrate its thorough political will to take all measures in the field of combating HIV and tuberculosis.”
Baktygul separately stressed on the issue of discrimination towards people living with HIV. “Discrimination remains a serious problem and due to that people do not want to apply for medical services. They are forced to conceal the disease, and this often causes their early death.”
During one of the panel discussions Mr. Marat T. Kaliev, the head of the Fund for Mandatory Medical Insurance announced that the Fund is ready to support the integration of prevention programs in the primary healthcare level.
The second day of the conference was dedicated to the development of programs in the field of state social contract.
Mr. Aibar Sultangaziev, the head of the Public Council at the Ministry of Healthcare told the participants about the available resources and optimization of financing for the programs to combat HIV infection.
The work of the conference ended with the adoption of a resolution, which included the following four main areas:
1. The state should increase the financing of programs to counteract HIV and TB epidemics.
2. There is a need to introduce mechanisms of medicines’ and tests procurement through international organizations.
3. There is a need to accelerate the implementation of State Social Contract in the healthcare system and allocate funds for its realization.
4. Effective services and achievement of the goals “90 - 90 - 90” are possible only provided that an enabling environment exists with reduced stigma and discrimination against PLHIV, SW, MSM and IDU.
In conclusion, representatives of the civil society expressed their hope that such a large - scale event would become a real impetus to positive and profound changes in prevention programs against HIV and tuberculosis.
It should be noted that the conference was organized by the Ministry of Health of the Kyrgyz Republic with the support of development partners: UNAIDS, UNODC, UNDP, AFEW and PEPFAR.
For reference: According to the Republican “AIDS” Center as of September 1, 2017, there were 7264 HIV - positive persons officially registered in the country. Cases of HIV infection were registered in all regions of the country.
Despite the low prevalence of HIV infection, the country entered the second i.e. the concentrated stage of the epidemic. According to the Department of the Epidemiological Surveillance of 2016, the prevalence of HIV infection in key groups was: among the IDU in 2016 it made 14.3 % compared to 12.4 % in 2013, among the SW 2 % in 2016 compared to 2.1 % in 2013, among the MSM 6.6 % in 2016 compared to 6.3 % in 2013 and among the prison inmates it made 11.3 % in 2016 compared to 7.6 % in 2013.
The data shown above proves that the spread of HIV among key groups of citizens is more than 5 % which means that the infection entered the general population.