The Republic of Moldova’s National Health Insurance Fund has announced that it will finance HIV prevention services provided by nongovernmental organizations for two projects for key populations. The services will cover sex workers, gay men and other men who have sex with men and people who inject drugs in Chișinău and Bălți. Approximately US$ 120 000 will be provided to cover an initial one-year period.

The nongovernmental organizations Youth for the Right to Live, which is based in Bălți, and Initiativa Pozitiva, which is based in Chișinău, will implement the projects, which aim to reach around 1000 people who use drugs in Bălți and about 700 people from key populations in Chișinău.

In 2018, four projects will be supported by the National Health Insurance Fund, with a target of 60% of needs to be covered from domestic resources by 2020.

Quotes

To promote a bigger role of NGOs in the HIV response in Moldova, the League of People Living with HIV of Moldova in collaboration with UNAIDS, hosted a two-day national NGO forum in Chisinau. Credit: UNAIDS

Speaking with many voices and representing many different perspectives, the non-governmental organizations (NGOs) play a key role in the response to the AIDS epidemic in countries around the world. As key partners in the development of national AIDS responses, NGOs are well positioned to provide quantative and qualitative information to augment the data collected by governments.

To promote a bigger role of NGOs in the HIV response in Moldova, the League of People Living with HIV of Moldova in collaboration with UNAIDS, hosted a two-day national NGO forum in Chisinau in the middle of June.

Bringing together more than 120 representatives from the civil society, government and international organizations, the Third Forum of Nongovernmental Organizations of Moldova active in area of HIV and TB included 26 NGOs representing all regions of Moldova. Presenting results achieved in the past year while exchanging opinions and experiences, participants agreed that joint efforts are essential for an effective response to AIDS.

Oleg Lozan, Vice Minister of Health, said at the opening ceremony that Moldova has made progress in the AIDS response thanks to the joint efforts made by government and non-governmental organizations. “The civil society’s contribution is huge,” said Lozan, “NGOs have largely covered areas insufficiently reached by the state in the AIDS response.”

Civil society participation in responding to the epidemic has been institutionalized in Moldova through the establishment of several coordination mechanisms such as the Harm Reduction Network, the network of NGOs working in the field of HIV, and the National League of People Living with HIV.

Presenting results achieved in the past year while exchanging opinions and experiences, participants agreed that joint efforts are essential for an effective response to AIDS. Credit: UNAIDS

The government of Moldova supports the involvement of NGOs in scaling up the country’s response to HIV. NGOs are active members of the National Coordination Council TB/AIDS and its associated technical working groups and they have fully participated in the formulation of the new 2007 Law on Prevention of HIV/AIDS.

“Civil society involvement has been consolidated in the country and they have contributed to the progress made in different priority areas of the national AIDS response such as HIV prevention, adherence to ARV treatment, harm reduction, and support and care for people infected with and affected by HIV,” said Gabriela Ionascu, UNAIDS Country Coordinator.

HIV in Moldova

Moldova is classified as a country with low prevalence of HIV. According to UNAIDS 2008 Report on the Global AIDS Epidemic, an estimated 8,900 people are living with HIV in the Republic of Moldova, with 29% being women.

The main mode of transmission is the use of contaminated equipment by injecting drug users. However there are signs of HIV spreading into the general population as unprotected sex is an increasing mode of transmission in the country.

According to a national report issued by National Centre on Health Management in 2008, the proportion of Moldova women among newly reported HIV cases with sexual route of transmission is also growing (62% in 2007, compared to 57% in 2006).

Professor Lars Kallings, the UN Secretary-General’s Special Envoy for HIV in Eastern Europe, last month visited the Republic of Moldova.

Professor Lars Kallings, the UN Secretary-General’s Special Envoy for HIV in Eastern Europe, last month visited the Republic of Moldova. During his visit, which coincided with United Nations Day, he emphasized the importance of agencies joining their efforts for a more effective HIV response with enhanced visibility and impact. In a series of meetings Professor Kallings met with the Deputy Prime Minister as well as the Minister of Health, Social Protection, Family and Child and Minister of Education and Youth.

Professor Kallings welcomed the Government of Moldova’s commitments and efforts in the AIDS response and reaffirmed the UN commitment to provide technical support to strengthen the capacity of the Government, trade unions, business and civil society organizations in the national response to AIDS.

During his advocacy mission, he took the opportunity to discuss the following priorities with government officials:

1. Review of legislative framework, with a focus on amending the law on HIV prevention and control of HIV which was adopted in 2007. While largely consistent with human rights standards, it contains certain discriminatory provisions which may limit freedom of movement.

2. Greater sustainability of the efforts in the context of the national AIDS response through increasing contributions from the state budget and institutionalizing mechanisms for improved management of financial resources and better resource needs estimations

3. Scaling-up efforts on HIV prevention based on a strategic framework for clearer focus on results, better accountability and enhanced coordination, with a definite focus on youth, targeted through health education institutionalized in the school curricula

4. Improved inter-sectoral coordination in the national response to HIV, and better involvement of key Ministries like the Ministry of Education and Youth and Ministry of Finance He also held discussions with representatives from the private sector, civil society and international organizations

HIV in Moldova

The Republic of Moldova is classified as a low prevalence country with HIV more likely impacting key populations including people who inject drugs

The Republic of Moldova is classified as a low prevalence country with HIV more likely impacting key populations including people who inject drugs. However there are signs of HIV spreading into the general population as unprotected sex is an increasing mode of transmission in Moldova. According to the World Bank, Moldova, as a proportion of the population, is one of the largest emigration countries in the world. Large-scale emigration by people in search of work, particularly to neighbouring countries like Russia and Ukraine mean there are many migrant workers who may be more vulnerable to HIV infection. Analysts think this may become a determinant in the future evolution of HIV in the Republic of Moldova.

The proportion of women among newly reported HIV cases with sexual route of transmission is also growing (62% in 2007, compared to 57% in 2006).

HIV prevention

Given these trends the UN Envoy emphasized the importance of HIV prevention among the general population for a successful response to AIDS.

“Efforts should be strengthened to reach every woman, every man, and every young person with general prevention information and behavior changing techniques, including HIV prevention programmes in schools and other education institutions and in the workplace,” stressed Professor Lars Kallings.

“Moldova is on the right track towards achieving the goals of the 2001 Declaration of Commitment on HIV/AIDS and the 2006 Political Declaration, and is in the fortunate position of still having a unique window of opportunity that if the HIV is recognized as the highest priority the effectiveness of the national response would be to the utmost and Moldova may become one of the countries in the region which would halt and revert the epidemic by 2015,” noted Dr Sergei Furgal, Director, a.i., UNAIDS Regional Support Team for Eastern Europe and Central Asia.

During a nine day tour of five countries of the Commonwealth of Independent States, a group of HIV advocates met with policy makers and civil society organizations to raise awareness on women and AIDS in this part of the world.

Women against AIDS tour was conceived in the
midst of a growing concern that women are
increasingly at risk of HIV infection in many parts of
Eastern Europe and Central Asia.

Women against AIDS tour was conceived in the midst of a growing concern that women are increasingly at risk of HIV infection in many parts of Eastern Europe and Central Asia. The percentage of adults living with HIV who are women has risen from 11% in 1990 to 28% in 2006.

The tour was sponsored by the AIDS Infoshare organization, UNAIDS, the Global Coalition of Women on AIDS and the United Nations Development Program. Ten AIDS advocates from the region with special guests joining at various points travelled together to learn about the realities of women and AIDS in different parts of the region and also to mobilize local policy makers to act on these issues.

In each of the capital cities of Armenia, Moldova, Kazakhstan, Russia, and Ukraine—the tour group joined with civil society organizations and groups of People Living with HIV (PLHIV) to talk about some of the most difficult issues such as stigma and discrimination and their consequences including losing children’s custody, being thrown out of the home and losing jobs.

“These are real issues,” said Deborah Landey, Deputy Executive Director of UNAIDS who joined the last part of the tour. “We have a collective responsibility to make a difference for women ,” she added.

The predominant mode of HIV transmission in the region remains through the use of non-sterile injecting drug equipment. However an increasing proportion of HIV infections — 37% of reported cases in 2005 — are estimated to occur during unprotected sexual intercourse. In Ukraine, the proportion of people infected with HIV through heterosexual transmission increased from 14% of new cases between 1999 and 2003 to over 35% of new cases in the first six months of 2006.

“We must look at every AIDS plan and strategy and ask whether it works for women,” emphasized Ms Landey. “This is our chance to curb the epidemic in this region,” she added.

The Women Against AIDS also produced a set of
issues to be considered and recommendations when
developing national AIDS strategies in the region.

The tour ended where it started, with women. Sergei Golovach a renowned photographer and a guest on the tour took photos of his fellow advocates for an exhibit to be held called Love, Live and Dream. Through portraits h e wanted to emphasize that it does not matter who is HIV-positive.

“Just look at this photo,” said Ms Landey, remarking on one of the portraits of a mother and her daughter that has been turned into an advocacy poster. “It is all about a mother’s love—which has nothing to do with one’s HIV status.”

Moved by these portraits and what she learned from the tour participants, Elena Vasilieva, Editor in Chief of the Russian Cosmopolitan magazine promised to publish an article about the Women Against AIDS tour in the November edition. To help break down stereotypes she said “a glossy magazine is the right place to raise socially important topics.”

The Women Against AIDS also produced a set of issues to be considered and recommendations when developing national AIDS strategies in the region. Highlighting the critical importance of translating these recommendations into actions, Anna Dubrovskaya, from 'Golos anti-SPID' in Russia said “our wonderful recommendations will not work if there is nobody to demand from policy makers that they keep their promises. The most important thing is to not let this initiative die.”

All photo credit: UNAIDS/Serge Golovach

Links:

View photo gallery
Listen to interview with UNAIDS Deputy Executive Director Deborah Landey
Visit the Global coalition on women and AIDS' web site
Visit UNDP's web site
Visit AIDS Info Share's web site

Women against AIDS tour was conceived in the midst of a growing concern that women are increasingly at risk of HIV infection in many parts of Eastern Europe and Central Asia. The percentage of adults living with HIV who are women has risen from 11% in 1990 to 28% in 2006.

The tour was sponsored by the AIDS Infoshare organization, UNAIDS, the Global Coalition of Women on AIDS and the United Nations Development Program. Ten AIDS advocates from the region with special guests joining at various points travelled together to learn about the realities of women and AIDS in different parts of the region and also to mobilize local policy makers to act on these issues.

Moscow, 27 May - The team is at Sheremetievo Airport. Could not wait to look at the posters and unpacked them right before flying to Almaty (Kazakhstan).

Kazakhstan, 27-28 May - Elnara Kurmangalieva (State Centre for Healthy Life Style) informing about HIV prevention programmes among youth.

Kazakhstan, 27-28 May - Group photograph.

Armenia, 29-30 May - Oganes Madoyan (Real World - real People) opens the discussions. None of the HIV positive women from Armenia was ready to talk openly and express the needs of the community.

Moldova, 30 May-1 June - Aleksander Shishkin (actor and DJ) first on the right side, joined the round table discussions to support implementation of gender specific programmes in Moldova. He also reiterated the need to carry out information campaigns on HIV prevention for young people.

Moldova, 30 May-1 June - Igor Kilchevski (Credinta) offers to discuss the recommendations of the project participants. High stigma and discrimination is perceived by women living with HIV in Moldova.

Ukraine, 2-5 June - Welcoming remarks by Anna Grekova (All-Ukrainian Network of PLHIV) at a press event.

Ukraine, 2-5 June - A cameraman filming for the national TV channel. The media can play a critical role in reducing stigma and discrimination towards women living with HIV.

Moscow, 6 June - UNAIDS Deputy Executive Director Debbie Landey plays a key role in addressing gender dimension to the response to HIV. She actively participated in the Tour.

Moscow, 6 June - Round table participants: (from left) Natalia Ladnaya (Federal AIDS Centre), Sergei Golovach (Photographer), Anna Dubrovskaya ('Golos Anti-SPID' NGO, Ufa, Russia), Elena Tamazova (UNAIDS, Russia), Anna Grekova (All-Ukrainian Network of PLHIV), Debbie Landey (DExD, UNAIDS), Vladimir Pozner (President of the Russian TV Academy), Lyudmila Untura ('Childhood for All' NGO, Moldova), Maria Ivannikova (AIDS Infoshare, Russia), Tatiana Stupak ('Victoria' NGO, Kazakhstan), Larisa Dementieva (Federal Service for Protection of Consumer Rights and Human Wellbeing)

All photo credit: UNAIDS/Serge Golovach

Brochures, posters, calendars, and other informational materials
that are being distributed throughout the country as part of the
media campaign to end stigma and discrimination.

“I cannot get infected, because I don’t live in Africa,” says Mihai, a 35-year-old man living in the capital of the Republic of Moldova, Chisinau . “Also, I don’t do drugs, I don’t practice sex for money, and I’m not gay. So, I cannot get infected”, he adds.

Alexandru, 23 years old, remembers: “One of my schoolmates is HIV-positive. After the class reunion, we continued our discussion at my place. When everybody left, I tried to remember which objects he had touched; I didn’t know what to do with the dishes he had used.”

These testimonials are part of a recently launched national campaign to promote solidarity with people living with HIV in Moldova. Extracted from real life examples, they reveal deeply rooted misconceptions about AIDS in Moldova.

“In 2005, we discovered with great concern the results of a survey on the attitude toward people living with HIV” said Mrs. Gabriela Ionascu, the UNAIDS Country Coordinator in Moldova. “We had to address stigma associated with HIV in Moldova urgently”.

The survey conducted by the AIDS Foundation East-West revealed that 74% of the respondents believed that people living with HIV should not be allowed to attend medical and social facilities used by the rest of the society. 64% of people surveyed said they experienced a certain degree of fear toward HIV-positive people, 45% expressed disgust, 37% felt anger, while 41% were totally indifferent.

Cooperating with UNAIDS, the Moldovan National Coordination Council, the Ministry of Health and Social Protection, as well as the Moldovan Orthodox Church—the AIDS Foundation East-West developed a concept for a large scale national campaign. The group raised sufficient funds to produce four video clips for national television, short radio messages and outdoor advertisement billboards. With financial support from the Swedish International Development Cooperation Agency (SIDA), the campaign aims to overcome groundless fears and negative attitudes toward people directly affected by HIV and debunking some of the myths around AIDS by conveying accurate information about HIV transmission.

Under the slogan “Because they are no different from you. Just be supportive!” the campaign will run, over four months, in five regions: Chisinau, Baltsi, Edinets, Comrat, and Tiraspol. A number of social events are also planned to encourage interactions and debates.

The campaign gives voice to people living with HIV who tell their stories of injustice and rejection by other members of their communities. It also allows HIV-negative people to speak about their fears regarding HIV as well as how they managed to overcome them. Every effort is made to facilitate identification with the characters in the campaign and to go against the idea that AIDS is a far distant problem.

“This campaign is unique”, says Elena Voskresenskaya, Regional Director of the AIDS Foundation East-West, “because for the first time such an activity involves people living with HIV. This is their first attempt to tell the society about their feelings, fears, problems, and dreams, thus striving to elicit a more tolerant attitude toward HIV and AIDS”.

According to the latest official figures, approximately 3 400 people are living with HIV in 2007 in the Republic of Moldova.

AIDS Foundation East-West (AFEW)  is a Dutch nongovernmental humanitarian organization working in the field of public health to reduce the impact of HIV in Eastern Europe and Central Asia. AFEW works in all areas of prevention and treatment, and has gained valuable experience in conducting informational campaigns. AFEW is guided by international best practices which take into account and use the specific mentalities and traditions of the people in every country.

Links:

View the videos
UNAIDS Moldova website
AIDS Foundation East-West (AFEW) website

GENEVA, 22 June 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) applauds the legislative reforms by the Republic of Moldova to lift its restrictions on entry, stay or residence based on HIV status. With these reforms, the Republic of Moldova joins a growing list of countries that are aligning national HIV legislation with international public health and human rights standards.

“This decision by the Republic of Moldova is a concrete win in our global efforts to secure freedom of movement for people living with HIV,” said UNAIDS Executive Director Michel Sidibé. “Restrictions that limit movement based on HIV-positive status alone are discriminatory and violate human rights,” he added.

In addition to removing the country’s travel restrictions, the recent legislative reforms in the Republic of Moldova strengthen prohibitions on HIV-related discrimination in the workplace and remove mandatory HIV testing for non-nationals and for couples before marriage.

After the removal of the Republic of Moldova’s restrictions, UNAIDS counts 46 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV based on their HIV status. At least 130 countries have no such restrictions.