The National Women’s Forum on HIV and AIDS was recently held July 8-10 in Ukraine under the auspices of UNAIDS, UNODC and UN Women. Members of the forum developed a Resolution regarding the serious emergency that HIV and AIDS currently present in Ukraine. The Resolution urges for greater participation and leadership of women in the response to the epidemic, stressing that women who live with HIV or who are vulnerable to it do not fully participate and are not sufficiently involved in the formation of the Ukrainian response.
This Resolution comes less than two months before the United Nation’s release of the 2015 Sustainable Development Goals (SDGs), which has evoked criticism despite not having been formally approved yet. Many of the women’s networks that participated in creating the Resolution are also a part of the United Nations Major Groups, which has warned that the SDGs lack accountability and implementation strategies. This Resolution is particularly poignant because it emphasizes the provision of global, regional, and national indicators that are currently lacking from the SDGs. For these reasons, the document will be presented as an important piece at the United Nations General Assembly (UNGA) meeting on the Post-2015 agenda this September.
One of the participants from this conference, Tatyana Khan from ITPCru, visited the Brazilian Interdisciplinary AIDS Association (ABIA) office in Rio de Janeiro, Brazil for an interview on the HIV response in Russia. The interview is included below.
1) Can you please briefly describe your organization?
I am working for the International Treatment Preparedness Coalition in Eastern Europe and Central Asia (ITPCru). ITPC is a global movement of people united with common goal to ensure a universal access to treatment of HIV and co-infections, mainly hepatitis C and tuberculosis.
ITPCru works in three main directions: community mobilization, access to treatment and human rights advocacy and educational programmes with access to treatment activists in 13 countries of Eastern Europe and Central Asia.
2) What does the HIV epidemic look like in Russia?
Eastern Europe and Central Asia has the most fast [sic] growing HIV epidemic in the world. Russia is one of three “leading” countries (Ukraine and Estonia are in that list too) in regards to newly registered HIV-cases. Official number of people living with HIV in Russia is more than 700 thousand (cumulative data); more than 177 thousand [have] died and mortality has been growing. Number of newly registered cases is more than 85 thousand in 2014 (growth is +9.4% comparing to 2013). Number of people receiving ARV-therapy is 175 thousand; estimated number is about two times more.
3) What is most problematic about epidemiological data?
Perhaps, it is exact data on HIV among vulnerable groups; the absence of official data on hepatitis C is a problem.
4) Is this data complete or are there problems in the way they are publicized?
There is no problem with official data. There is a concern about a gap between official data and estimated numbers. In 2009 Russian and international experts were saying [there are] about 1.5 million of PLWH in Russia and 820 thousand people [are] in need to receive treatment.
5) How does the epidemic affect the most vulnerable populations?
In 2014 57.3% of new cases of HIV-infection were diagnosed among people using injecting drugs. Second way of HIV-infection was heterosexual contact (40.3%). Also men who have sex with men is a vulnerable group; in 2014 1.2% of new cases among MSM were registered. Mother-to-child transmission is rare (0.1% in 2014).
6) In which ways does the population have access to treatment and prevention?
ARV-treatment is free of charge in Russia and covered from federal and regional budgets. National clinical guidelines on HIV-treatment are updated according to the recent recommendation of WHO. It is indicated that every HIV-positive person can get treatment especially if CD4 is lower than 500.
7) How is access to medication? What are the main problems?
According to the results of monitoring of ARV-procurement conduct[ed] by ITPCru [the] main problem in 2014 was high prices on ARV; sometimes price on generic [is] the same or higher as a price of brand name drug; low fraction of drugs not included in Essential Drugs List (for example, fraction of tenofovir and tenofovir-containing drugs was approximately 4% in 2014); procurement [of] monocomponents in spite of fixed dose combinations. Due to all [of these] issues there were a lot of cases of deficit of ARV-drugs and treatment interruptions.
8) In your opinion what is the importance of this peer-to-peer program?
Peer-to-peer programmes are an effective and fast way for knowledge and experience exchange. [My] Visit to Brazil was important to see how NGOs work in the field of access to treatment; unite[d] efforts of NGOs from different areas to expand access to HIV and hepatitis C treatment was inspiring to me; thanks for this opportunity.