The HIV/AIDS challenge for Tajikistan*: The HIV/AIDS challenge for Tajikistan* *Presentation to Principals‘ Meeting 29 October 2005


Dynamics of HIV/AIDS infection growth in Tajikistan: Dynamics of HIV/AIDS infection growth in Tajikistan An estimated 10,000 cases are foreseen by end of 2005 By 2008 HIV/AIDS infection will reach 1% of adult population Epidemic is spreading among drug users, sex workers, detainees, labour migrants and youth. There are only 454 officially reported cases


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Factors fueling the epidemic: Injecting drug use Unsafe sexual behavior Unsafe medical practices Low awareness Stigma and discrimination Factors fueling the epidemic


Current government response : Current government response National Strategic Framework (2002-2005) Priority groups of the National Strategic Plan are: Youth (11-25 years old) i.e. andgt; 50% of the country population Intravenous drug users Sex workers National Coordination Committee since 1997 Multisectoral Revised in June 2005 19 members and Chaired by Deputy PM Ministry of Health, national and regional AIDS centers - AIDS centers – HIV test and implement NSF


Current donor focus: Current donor focus Harm reduction programmes Control of STI among sex workers Youth HIV prevention programmes HIV Testing Vs Voluntary Counseling and Testing Antiretroviral therapy Condom Supply and Promotion


Harm Reduction : Harm Reduction It is estimated 20-30 thousands IDUs in Tajikistan Increase number of young people initiating DUs in the country There are 25 trust points in the country


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Sex Workers programmes: Sex Workers programmes Increasing number of sex workers e.g. it is estimated 8,000 sex workers in the country (UNAIDS 2003) GFATM is currently providing STI treatment and HIV prevention information to SWs and MSM in 8 friendly clinics in the country


HIV prevention programmes: HIV prevention programmes UNICEF, UNFPA, GFATM, CAPACITY project, DDRP, OSI, IFRC with Red Crescent society, have got youth HIV prevention interventions. 60 pilot schools introduced Healthy Life Style subject HIV education is not integrated into the school education programme


HIV testing : HIV testing Inadequate HIV test supply in the country before GFATM project started GFATM provided training of laboratory technician and equipment in 13 laboratory HIV testing centers are not integrated into the Primary Health Care (National AIDS Center and some blood transfusion stations are testing HIV) Inadequate VCT services in the country


Antiretroviral Therapy : Antiretroviral Therapy GFATM will launch its ARV Therapy project by end of 2005 for 50 patients. GFATM will treat 500 patients in the coming 5 years 60 Doctors were trained on ARV and OI management. CD4 laboratory equipment was supplied to the National AIDS Center laboratory


Condom promotion and supply: Condom promotion and supply Sources of condom in Tajikistan - UNFPA imports around 2 million condoms/year - GFATM - 6 millions/year - PSI – social marketing Tajikistan need 100 Million condom/year Condom is not widely available and accessible in the country.


Challenges: Challenges Lack of government ownership and leadership in the implementation of the NSF Increasing number of regional HIV/AIDS projects with lack of local ownership Inadequate coordination at all levels, which lead to competition among local partners Lack of national progress indicators e.g. almost all projects report coverage only.


Challenges (continued): Challenges (continued) Lack of confidentiality, and high level Stigma and discrimination of PLWHA esp. among health providers Lack of scale up of HIV prevention intervention in the country due to limited capacity of government and civil society to implement effective preventive responses, HIV and AIDS issues are not addressed in the schools


Financial gaps in donor assistance: Financial gaps in donor assistance Currently we have 5 Million per year until 2009 coming from Government and donors together. But we need 40 million focusing on scaling up the national response at local Level.


HIV project gaps: HIV project gaps Prisons Migrants Capacity Development Substitution therapy Scaling up of the national HIV/AIDS response at local levels


Recommendations : Recommendations To strengthen country ownership and leadership by increasing the support to and developing of the capacity of the government and civil society Scaling up of the implementation of the national HIV prevention programme To increase support of People Living with HIV and AIDS, so they can advocate on behalf of HIV prevention and care and eventually reduce stigma and discrimination