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Andriy Klepikov: “Efficient methods to overcome HIV/AIDS and TB in the cities are already known”

At the start of the #InYourPower information campaign, we said that we believe in the power of political decisions in favor of people’s health, and in the immense expertise of communities whose joint efforts will help stop the HIV/TB epidemic. We promised to find examples of such successful stories, to talk about them using specific cases with decisions in favor of HIV programs with proven feasibility and efficiency.

It’s in our power. Therefore, we present the first material containing a whole collection of such cases and videos.

In Eastern Europe and Central Asia (EECA), the situation with HIV and TB remains drastic. Over 1.7 million people live with HIV in the countries of the region, and every year this figure is growing by 22-23%. The TB morbidity stands as high as 260,000, each third case is MDR-TB, this indicator is six times higher than the world level.

According to experts, focusing on two aspects: the personal responsibility of municipal leaders and an effective methodology, can reverse this gloomy record.

We talked about this issue and the specific tools for effective work with cities with Andriy Klepikov, CEO of the ICF ” Alliance for Public Health”, following his impressive presentation at the EECA Cities Leadership Forum.

Thus, speaking about the achievements and progress of the municipal response to the HIV/TB epidemics in the EECA region, he notes that one of the most effective ways to address the issue is to concentrate efforts on working with big cities. Speaking about personal responsibility and an effective methodology, he noted: “First, everyone should take the initiative in their own hands, not shifting it to other people or structures, be it NGOs, authorities or health facilities. And, second, it’s not necessary to “invent the wheel” while carrying on ineffective methods of combating the epidemic; it’s sufficient to adopt already working mechanisms, having studied the experience of others”.

Official video of the speech:

“By and large, overcoming HIV and TB is the task of cities”, emphasizes Andriy Klepikov. – Indeed, at least one third, if not half of all HIV-positive people in the country, are concentrated in cities, for example, in Sofia and Tbilisi. There are cities where more people live with HIV than in some countries. For example, in Kyiv alone there are more PLWH than in all Georgia. And therefore, the city has to single-handedly address comparable, or even more ambitious challenges than those on the country level”.

The CEO of the ICF “Alliance for Public Health” is convinced that in order to stop the HIV epidemic in Ukraine, it is enough to defeat it in 5 large cities: Kyiv, Odesa, Dnipro, Kryvyi Rih and Mariupol. And we already know how to do this.

“Our focus on cities and collaborating with mayors is key to tackling HIV/TB. As for the methodology – there is no need to invent anything, everything has already been invented. There are working principles on how to reach the level of an accelerated response to the HIV and TB epidemic. From our side, we have been working in cities for more than a year, and we are pleased to present a model that brings forth real results”, Mr. Klepikov said.

Based on his work experience in five cities of the region, the ICF “Alliance for Public Health” has developed a model for the city, which contributes to a significant improvement in the HIV/TB situation and helps to formulate a sustainable response to the epidemic by attracting municipal resources. The model itself, the examination and specific cases with a detailed description of “How to Stop the HIV/TB Epidemic in Cities” are collected in the handbook of the EECA Fast-track Cities project and published in the public domain (hurry up to grab it!) on the website for wide access to the developed expertise of all interested parties.

Andriy Klepikov emphasized that when working in cities, it is recommended to focus on three aspects: working with key populations, organizing effective services, and actively interacting with mayors, politicians, and officials – decision-makers, thus changing local politics. Therefore, active interaction with the authorities enabled achieving the development of services and improving work with key populations in a number of EECA cities. Thus, a safe drug use room opened in Sumy. In Odesa, municipal pharmacies are involved in a harm reduction program, and free syringes are now available there. And in Almaty, they created a safe space for key populations, including the community center for LGBT people.

In addition, projects relevant to a specific policy are being successfully implemented in a number of EECA cities. For example, in Almaty, with the help of rapid tests, we managed to identify one hundred and fifty cases of HIV infection and help almost all of them to start treatment – social workers did not wait for representatives of key populations in clinics, but went to where they were the most needed, using the electronic client accounting system. 

In Kyiv, artificial intelligence was used to identify the most high-risk cases with regard to HIV. And in Odesa, a Fast-Track project was implemented with close cooperation with the city administration, which resulted in a rapid increase in the TB treatment efficiency, from 52% to 71%, by providing treatment on the primary healthcare facilities level.

The Moldovan city of Balti has shown a customer-oriented approach, and now people can obtain all the services for tuberculosis treatment, counseling, ART in one facility, without the need to travel all over the city. This initiative increased the recovery rate to 78%.

In his opinion, the EECA region in 2020 already needs results. And the results are a decrease in new cases of HIV, TB, and most importantly, these are saved lives. “Based on the experience and accumulated expertise, we understand, which programs are not just operational, but produce results measured by the lives of real people”, says Andriy Klepikov. – Cities are a promising area, where we should and can invest more: both resources, and time, and our energy and efforts. And we are open to the challenge. All these developments are not for me; they are for you. Everyone who is interested in receiving support from our team is welcome, we are open. It is very important to remember that we can stop the epidemic in the country by working effectively in cities. Cities can make a difference in our countries, and not just cities as a concept, but city leaders, mayors, and we, the residents. For us, this is the way forward. This is #InYourPower, in our power!”