Transitioning away from Global Fund support is about money, of course, but it is much more about the readiness of national systems to take over all services currently covered by the programs financing by the Fund.
This was one of the themes that emerged from the “The Road to Success,” a high-level dialogue on successful transition to domestic funding of HIV and TB responses in Eastern Europe and Central Asia. Organized by the Eurasian Harm Reduction Network, the dialogue took place in Tbilisi, Georgia on 28-30 September. The dialogue was a follow-up to a similar event in Istanbul in July.
Although the EECA has achieved significant progress towards combating HIV and TB since 2002, the region still has the highest rates in the world of new HIV infections and new cases of multiple-drug-resistant TB. This explains the emphasis placed on transition planning by organizations like the EHRN.
The aim of the three-day dialogue was to facilitate discussions among civil society organizations, communities, ministries of health and internal affairs, the Global Fund and other international donors concerning the major challenges to transitioning – policy and financial – and to discuss potential solutions. More than 300 delegates from about 30 countries participated.
Participants identified another important ingredient for successful transitioning – the integration of HIV and TB systems into the health systems of countries and, in the process, the transformation of vertical systems into horizontal ones.
In addition, said Gennady Roshchupkin, co-founder and board member of European Coalition on Male Health (ECOM), “it would be very useful to define core elements of the transition and make them standard for each country. This would help people understand what transition is and how it should be implemented and monitored.”
One of the three days of the dialogue was devoted to a meeting of CSOs. The topic of advocacy was high on the agenda. Participants agreed on key advocacy messages for discussions with government representatives, focused on liberalizing restrictive drug policies, retaining prevention services for key populations and creating enabling environment for sustaining community-based organizations.
Vitali Rabinciuc, leader of the Union for HIV Prevention and Harm Reduction in Moldova, said that there is a need to move from aggressive street advocacy to constructive advocacy methods, which implies understanding the mentality of government officials and trying to propose balanced and practical solutions.
Participants said that the emphasis should be not only on the human rights of PWID, but also on the negative public health impacts of pushing drug use underground. Participants said it was also important to support efforts targeting youth that are based on the youths’ own negative experience of drug use because, quite often, governments representatives misinterpret their advocacy efforts as promoting drug use.
Sergey Votyagov, Executive Director of EHRN, said that the dialogue successfully continued a process started with the EHRN’s regional grant. “Harm Reduction Works, Fund It,” whereby advocacy around harm reduction is mostly done at a regional level.
Meanwhile, following the Istanbul meeting, the EHRN has developed a draft concept of the framework for sustainable transition.