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

EHRN/Lina Fisheye

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

Dr Zsuzsanna Jakab, WHO Regional Director for Europe, visited Georgia on 29–30 September to take part in the meeting and to hold bilateral meetings, including 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 accelerate in countries in eastern Europe and central Asia. The meeting discussed the key challenges, including:

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

Overview of TB 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 and lower than in other WHO regions, our Region has one quarter of all cases of the multidrug-resistant form of TB that occur 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 meeting.

Discussions on TB centred on the 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 issues including:

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

Outcome

Member States are committed to sustainably tackle TB and HIV infection and to improve harm reduction care through an integrated, 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.