On June 30, 2016, the capital of Moldova, Chisinau, hosted the High Level National Dialogue on ensuring the sustainable transition from donor to national funding of harm reduction. The event was co-organized by the Union of organizations, working in HIV prevention and harm reduction (UORN), the Ministry of Health of Moldova, Eurasian Harm Reduction Network (EHRN), UNAIDS and with the financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria through its Regional Program “Harm Reduction Works – Fund It!”.
The aim of the High Level National Dialogue in Moldova was to discuss progress and challenges which Moldova faces in working towards sustainability of harm reduction programs, as well as nd government commitments within the National HIV program and transition from donor to national funding.
The event was opened and chaired by the State Secretary of the Ministry of Health of Moldova Nicolae Jelamschi. The first session included the presentations on current status and funding sources of harm reduction programs in Moldova, results of allocative efficiency study “Optimizing Investments in Moldova’s HIV Response”, results of modeling and cost-effectiveness study of intervention packages to reduce the impact of HIV and HCV infections for PWID in Moldova, overview of perspective of national government funding sources, as well as analysis of government funding mechanisms of services, provided by NGOs in EECA region. The second session, conducted in the format of a panel discussion, was facilitated by Viorel Soltan, Director of Center for Health Policies and Studies of Moldova, and was aimed to discuss, what action steps need to be done by the Government, NGOs and donors in order to ensure the smooth transition from international to national funding of HIV response and sustain harm reduction programs.
The speakers and panel discussion participants were Nicolas Cantau, Regional Manager, Eastern Europe and Central Asia Team, The Global Fund to Fight AIDS, Tuberculosis and Malaria; Ala Iatco, President, Union of HIV/AIDS Prevention and Harm Reduction (UORN); Lucia Pirtina, National HIV/AIDS Program Coordinator; Svetlana Plamadeala, UNAIDS Country manager; Marina Semeniuc, Chief of the Direction, Ministry of Finance; Manoela Manova, Strategic Investment and Efficiency Advisor, UNAIDS Regional Office; Anna Dovbakh, Program Director, EHRN; Alexander Kurashov, Executive Director of Positive Initiative Association, and Iurie Osoianu, Deputy Director of National Company of Insurance Medicine.
Nicolas Cantau, Regional Manager of The Global Fund to Fight AIDS, Tuberculosis and Malaria for Eastern Europe and Central Asia greeted the progress of Moldova and mentioned its three achievements:
- Moldova has successfully eliminated HIV mother-to-child transmission,
- Harm reduction programs have become impactful for people who use drugs both in civil environment and in prisons,
- Moldova is ensuring strong intersectional partnership on national level to fight TB and HIV.
Moldova is among the countries, where all the elements, both programmatic and regulative, are in place for a successful transition and the sustainable progress in combatting HIV epidemic.
However, in order to scale up the response, ensure sustainability of HIV prevention programs and secure the Global Fund support in the upcoming years, it is important for Moldova Government to demonstrate the political will, to show more initiative, leadership, and responsibility for key populations, including people who inject drugs. Three key zones for development were identified: Moldova should create a working regulatory environment to develop and launch social contracting mechanisms for NGOs, implementing non-medical services for PWID; revise HIV testing guidelines and allow rapid blood testing at the community level; and Moldova also needs to pilot project of TB reform.
Ala Iatco, President of the Union of HIV/AIDS Prevention and Harm Reduction (UORN) stressed that the Government of Moldova needs to have clear and operational mechanisms to support NGOs. To fund two harm reduction projects from the government resources have been in plan for two years, and now in 2016 it is time to show concrete steps towards accomplishment of this plan.
Alexander Kurashov, Executive Director of Positive Initiative Association, underlined that NGOs and community organizations in Moldova have seriously grown – they work professionally, they have expertise, they are members of numerous committees, commissions and working groups. The time is to start treating community organizations as equal partners in the dialogue and professional implementers of quality services.
Nicolae Jelamschi, State Secretary of the Ministry of Health: Expenditures on HIV 2016 increased by 9% as compared to 2014 and total 141 mln lei. We managed to procure quick tests and we are planning much more. We will manage to show the Global Fund that we are able to implement real change… Ministry of Health cannot afford the luxury of losing partners and funding. We are going to undertake all the measures to ensure sustainability. We have just created an intersectoral group that will include government institutions and NGOs to elaborate the plan of transition regarding efficient governance of national projects and simplification of access to testing.
According to Nicolae Jelamschi, State Secretary of the Ministry of Health, this intersectoral group will gather in 1-2 weeks period to start working over the transition plan development to ensure the sustainability of HIV prevention programs for key affected populations in Moldova.
Nikolas Cantu: Addressing a concentrated epidemic within key population groups in Moldova is not a rocket science. I am coming from Nigeria where epidemic is generalized and they do not know where to start with.