Ending HIV and TB in a city: experience from the EECA region

Alliance for Public Health (APH, Ukraine) together with AFEW International (The Netherlands), licit and Stop TB Partnership(Switzerland) under the technical guidance of UNAIDS EECA office with funding from the Global Fund to fight AIDS, TB and Malaria, have initiated a regional project to support city responses to HIV and TB in key populations in the cities of EECA.

The project conducted strategic operational research to inform EECA city models to improve outpatient tuberculosis treatment (Odesa, Ukraine), collaborative HIV/TB interventions (Bălți, Moldova), and increased uptake of antiretroviral therapy by key populations based on a case management model (Almaty, Kazakhstan).

Project activities included city situation assessments; establishing City Task Forces (or strengthening existing City Coordinating Councils); developing City Improvement Plans; advocating and approving city budgets; establishing funding allocation mechanisms for NGOs; exchange with Western European peers, and advocacy on local resource allocation.

As a result of the project, we have arrived at a city model that brings significant improvements in the HIV/TB situation and helps sustain the response through municipal resources.

Notes, the project, Fast-track TB/HIV Responses for Key Populations in EECA Cities (EECA Fast-track Cities), was implemented throughout 2017– 2019 in order to develop efficient and sustainable city models of HIV/TB responses that would reduce AIDS and TB mortalities in the project cities and increase the allocation of city funding to HIV/TB interventions for key populations. Support for the models has been provided from Bern and Amsterdam, the project’s partnering cities, whose municipalities and civil society have committed to share experience and support their peers from EECA.

Five cities were selected for the project based on disease burden, the ability and commitment of municipalities to release resources (financial or in-kind), and the feasibility of effective implementation of the pilot project. They are: Almaty (Kazakhstan), Bălți (Moldova), Odesa (Ukraine), Sofia (Bulgaria) and Tbilisi (Georgia). The project also provided some technical and financial support for interventions in other cities in the five countries, such as a safe injection room in Sumy (Ukraine).

In each city a partner civil society organization coordinated activities: Initiative for Health Foundation and Health Without Borders in Sofia (Bulgaria); the Centre for Information and Counselling on Reproductive Health ‘Tanadgoma’ in Tbilisi (Georgia); AFEW Kazakhstan in Almaty (Kazakhstan); the Youth for the Right to Live in Bălți (Moldova), and the Youth Centre for Development in Odesa (Ukraine).

Importantly, regional key populations networks — the Eurasian Network of People who Use Drugs, the Eurasian Coalition on Male Health, the South Caucasus Network and Sex Workers’ Rights Advocacy Network — were engaged to prioritize involvement of key groups in the project both on regional and city levels.