Feature story

Investment in HIV prevention among key populations and scale up of HIV treatment coverage key to universal access in Eastern Europe and Central Asia

29 March 2011

Minister of Heath of Kyrgyzstan, Sabyrbek Dzhumabiekov (left) and, UNAIDS Deputy Executive Director, Programme, Paul De Lay addressing participants at the universal access consultation. Kiev, 17-18 March 2011

Insufficient investment in programmes to prevent HIV infection among key populations at higher risk is hampering efforts to achieve universal access to HIV prevention, treatment, care and support in Eastern Europe and Central Asia. That’s according to participants at the regional consultation that took place in Kiev, Ukraine on 17-18 March 2011.

Government and civil society representatives from 30 countries across the region participated in the universal access consultation. The objective was to discuss gaps in the region’s response to HIV as well as identify key priorities for future action.

“Eastern Europe and Central Asia remain far from achieving universal access, in spite of significant efforts,” said Dr Denis Broun, Director, UNAIDS Regional Support Team, Europe and Central Asia.

The region has seen progress in preventing mother-to-child HIV transmission. HIV treatment coverage has been slowly increasing in recent years. Yet only one out of four people needing treatment are receiving it—the lowest coverage rate in the world.

Insufficient availability of treatment as well as prevention programmes—especially for the key populations at higher risk of HIV such as people who use drugs, men who have sex with men, prisoners and sex workers—were seen as the major gaps in the region leading to the increase of new infections. 

Eastern Europe and Central Asia remain far from achieving universal access, in spite of significant efforts

Dr Denis Broun, Director, UNAIDS Regional Support Team, Europe and Central Asia.

One of the discussions centred around the significant dependence that the region has on international financial support, specifically in the form of Global Fund grants. Participants stressed that national funding levels were low and called for countries to increase their domestic investment in the AIDS response. “Countries should not wait until funding from the Global Fund and other international donors ends. Sustainability of the HIV prevention, treatment, care and support should rely on national budgets,” stated participants in their final recommendations. “Governments should look at AIDS funding not as ‘spending’ but as investing in the economy, in the workforce and the future."  

Representatives of non-governmental organizations noted that, in general, civil society is not involved in budgetary decision-making when it comes to allocation of government funds. As a consequence, the effectiveness of the overall AIDS response remains low due to the limited capacity of the State to respond to the needs of people at higher risk of infection.

According to participants, there is a lack of sufficient HIV prevention programmes providing information to young people, raising awareness and promoting condom use to prevent sexual transmission of HIV. The existence of HIV-related travel restrictions, criminalization of HIV transmission and same-sex relations and the repressive police practices towards people who inject drugs were identified as significant barriers to establishing relationships of trust with people most-at-risk. Participants also agreed on the need to create legal environments to facilitate the intake of HIV prevention services by populations at higher risk of infection.

The recommendations made by participants will be included in the universal access progress report that will be presented at the United Nations General Assembly High Level Meeting on AIDS that will take place in New York in June 2011.

“The HIV situation in the region is critical. By contributing to the recommendations at a time when they are developed, we have a chance to ensure that the voice of people living with HIV is heard,” said Vladimir Zhovtyak, head of the Eastern European and Central Asia Network of People Living with HIV.