Zaza Karchkhadze: "In the coming year, we are not expecting changes. But they will come later…"

23 September 2015

Zaza Karchkhadze is the Founder and Chairman of the community organization of people who use drugs "Rubiconi", Member of the Coordinating Council of the Eurasian Network of People who Use Drugs (ENPUD) and Board Member of the Georgian Network of People who Use Drugs (GeNPUD).

Zaza expects from Regional Dialogue an answer to the question what will happen to the Georgian organizations of people who use drugs: "Currently the global Fund supports their work. But what will happen next?"

- With the Global Fund support we got substitution therapy. And as regards HIV and hepatitis C, most people began to learn about these diseases and viruses while participating in the OST programs. They started to do tests and refer for counseling. And I would like to say that the results have been very, very bad: almost every other person tested positive for hepatitis C. The number of HIV cases was also quite high.

- That is, until OST became available in Georgia there was no extensive testing?

- Needle exchange programs were working, but they did not have good coverage. I will tell you about my city, Kutaisi. Only one needle exchange program that worked in Kutaisi was insufficient. And most drug dependent persons learned about their status after the start of OST programs. These programs are based at substance abuse treatment clinics.

At the beginning, the first OST program in Georgia was funded by the Global Fund. Immediately there was a queue. It became easier when a second OST program was opened that is partly funded from the national budget and partly paid for by the patients themselves. And so far this is the only harm reduction program that receives some financial support from the state. All the rest is funded by the Global Fund including needle exchange and even the work of AIDS centers, when it comes to drugs and diagnostics.

- The Global Fund is leaving and no funding for harm reduction is allocated in the national budget. Do you have concerns about this?

- So far I am not concerned, because the Global Fund will continue working in Georgia for another three years. But it has reduced funding, and we see that the state is taking on some expenses. Prevention programs including needle exchange, counseling and testing are still funded by the Global Fund. And we do not expect significant changes next year. Changes will begin later, after the Global Fund leaves the country. Then survival of prevention programs will be questionable. And we doubt that government will fund needle exchange programs.

- What does the Georgian authorities say? “We are going to preserve all” [the programs]?

- Negotiations have just begun. And now, at this Forum, may be not in the final form, the government’s position will become clearer . Anyway, they will say what they intend to do. For now the trend is as follows: the state will finance the treatment of HIV and hepatitis C. Treatment of hepatitis has already begun for five thousand patients, mostly those in serious condition: stage 4 fibrosis, early cirrhosis. But over time, as promised, treatment will be available to all in need of treatment.

Substitution treatment services will probably remain available to patients for a fee. It is unlikely that the state will take on full funding of OST programs.

But what will happen to the community organizations of people who use drugs? Now the Global Fund funds them. What will happen to them? Perhaps the government will try to integrate all these programs into the healthcare system. But we would like to hear a clear answer to this question on this issue.

But what will happen to the community organizations of people who use drugs? Now the Global Fund funds them. What will happen to them? Perhaps the government will try to integrate all these programs into the healthcare system. But we would like to hear a clear answer to this question on this issue.

Zaza Karchkhadze

 

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