Towards domestic funding of HIV and TB response in eastern Europe and central Asia

WHO/Europe, the Eurasian Harm Reduction Network (EHRN) and other partners organized a high-level regional meeting in Tbilisi, Georgia from 28–30 September 2015, to address regional challenges and discuss ways towards a successful transition to domestic funding of national responses to HIV and tuberculosis (TB) epidemics in countries of eastern Europe and central Asia (EECA).

Dr Zsuzsanna Jakab, WHO Regional Director for Europe visited Georgia from 29–30 September to take part in the meeting and to hold bilateral meetings, including meeting with David Sergeenko, Minister of Labour, Health and Social Affairs of Georgia. 

HIV/AIDS overview in the WHO European Region

HIV infection remains a major public health challenge in the WHO European Region and the epidemic continues to grow at an accelerated pace in EECA countries. The meeting discussed the key challenges including:

• responding to the increasing numbers of newly diagnosed HIV cases – especially in the East of the Region;
• reducing the number of undiagnosed and late HIV diagnoses;
• scaling up access to antiretroviral therapy (ART) and retention in HIV care to narrow the treatment gap;
• providing ART to all persons living with HIV irrespective of CD4 count; 
• increasing comprehensive care and support for key populations (especially harm reduction for people who inject drugs);
• building on the successes in the elimination of mother-to-child transmission (MTCT) of HIV; and
• integrating HIV with other services, particularly TB, hepatitis and drug dependence.

TB overview in the WHO European Region

"While the burden of drug-susceptible TB in the WHO European Region is one of the lowest in the world compared with other WHO Regions, our Region bears one quarter of the multidrug-resistant form of TB that occurs globally. So there is no reason to be complacent about the TB situation. More needs to be done to ultimately eliminate TB," said Dr Zsuzsanna Jakab, WHO Regional Director for Europe in her speech to the delegation.

Discussions on TB centred on the Tuberculosis action plan for the WHO European Region 2016–2020, endorsed at the 65th WHO Regional Committee in September 2015, which builds on the progress made in the previous action plan and addresses the challenges ahead including:

• high rates of MDR-TB and the insufficient treatment success rate of MDR-TB patients;
• introduction of new medicines and better research into new TB-relevant tools with more effective treatment regimens;
• addressing inequities in health services and TB/HIV coinfection;
• providing guidance on expanding patient-centred care;
• strengthening social protection and psychosocial support for patients by reaching out to vulnerable groups; and
• reducing TB stigma and human suffering and improving treatment adherence and treatment success.

Outcome

Member States are committed to sustainably tackle TB, HIV and harm reduction care through an integrated and patient-centred approach with support from international partners including WHO/Europe. Countries intend to develop action plans to ensure that the transition to domestic funding of HIV, TB and harm reduction programmes is responsible and ethical.