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ID: HR19-883

Presenting author: Tetiana Deshko

Presenting author biography:

Tetiana Deshko has 20 years of experience in establishing, bringing to scale and sharing internationally HIV programs for key populaitons, using the example of Ukraine. She works for Alliance for Public Helath in Ukraine as Director of International Programs.

Harm reduction programs sustainability at city levels: lessons from EECA

Tetiana Deshko, Ievgen Kushnir

Eastern Europe’s main donor for harm reduction, the Global Fund to fight AIDS, Tuberculosis and Malaria, has started to pull out of the region.
Analysis of the EECA HIV situation shows that half of HIV cases are from the capital cities, similar to other countries: the HIV epidemic is highly urbanized.
In Western European cities, HIV responses are to a significant part funded by city or regional budgets, especially when it comes to low-threshold programs for marginalized groups. For example, in Bern more than half of the funding NGOs receive for harm reduction comes from the local budget of the canton and city of Bern, the rest from the national budget and the medical insurance.
One of the main transition strategies is that cities in Eastern Europe should be co-funding their interventions for key populations. An initiative of Alliance for Public Health jointly with licit and AFEW-international to support EECA cities has reached good interim result in this.
Two of participating cities – Belts in Moldova and Odesa in Ukraine – have adopted city level HIV/TB programs allocating municipality’s 60 thousand USD and 2.5M USD respectively for HIV/TB interventions for key populations. Other three cities are in active advocacy for the city programs in 2018 and budget release – Almaty, Tbilisy and Sofia.
One of the major challenges is persuading the city’s political positions like Mayors and MPs to allocate resource for harm reduction. A substantive advocacy effort and campaign targeting both national and local authorities should be active in Global Fund transiton countries with a substantive city focus. Alliance for Public Health led consortium is starting a new EECA regional program to support transition in 2019-2021 in 14 EECA countries, involving some of the cities in EECA.