Brussels,24th March 2016: On the occasion of World TB Day, the TBEurope Coalition (TBEC) is alarmed by the withdrawal of donor support to TB& HIV programmes in Eastern Europe and Central Asia, dealing a catastrophicblow to patients. While joint efforts from all stakeholders is needed to ensurewe do not recede on progress made so far, TBEC calls on the European Commissionto play a stronger political convenor role in the region to help achieve asustainable and effective transition to domestic funding of health systems.
As the economies of countries in Eastern Europe andCentral Asia (EECA) grow, international donors withdraw support. Yet externalfunding for TB and HIV services is critical in the region. Progress made in TB& HIV services is dangerously at risk if governments don't stepup to the plate. EECA is home to the fastest growing HIV epidemic and thehighest rates of multi-drug resistant tuberculosis (MDR-TB) in the world, oftenfocused on key populations who are frequently the hardest to reach.
Civil society is central to the TB/HIV response,often being the only players able to reach and ensure access to medical andsocial services for key populations.. Yet, it is these critical services thatare most at risk as international donors withdraw and domestic financing isslow to appear. For example, in Serbia when the Global Fund's supportended in 2014, the government did not fillthe funding gap. Since then programmes serving 3,000 people who injectdrugs have cut or stopped services. The 2015 national HIV budgetallocated just 3 percent for HIV prevention, with no funds for keypopulations.
Similarly, USAID support to TB programmes and GlobalFund’s support to HIV prevention programmes in Romania stopped in 2007 and 2011respectively. As a result, the country saw the number of new HIV infectionsdouble from 2009 to 2012.
“In Romania, domestic funding of the TB response isstill extremely low. Moving from international funding to local resources is awork in progress. While the TB National Strategy for 2015 – 2020 does have amultiannual budget which should significantly be covered from domestic sources,neither the Government nor the local authorities seem ready to take over frominternational donors.” said Silvia Asandi, General Manager of the RomanianAngel Appeal Foundation.
Too often countries in the region are also facingdifficulties in providing full and complete access to TB treatment to patientsin need, due to complex regulatory frameworks. When facing transition, a countrymust ensure that there are no legal barriers in place for the purchase andimport of medicines required to complete treatment. There is a desperate needfor planned and well-executed transition processes in order to maintainservices for the people who need them.
"Successful transition can happen, Croatia is agood example. Yet, this process needed strong political commitment and lengthyplanning. It demands programmatic, governance and fiscal reforms whichcannot be done overnight" said Fanny Voitzwinkler, Coordinator of theTB Europe Coalition. “All stakeholders, including donors, civil society,technical agencies and governmentsneed to work together if we are to be successful, but we shouldn’tunderestimate the political role that the EU institutions can play in thisprocess“, she added.
The EU has a framework of bilateral cooperation withmany countries in the region, including those which aspire to join the EU. Thus EUinstitutions are in a key position to play a political convenorrole.
"The European Union should accept that abruptwithdrawal of support to middle income countries is not the way and comeup with concrete political strategies to ensure sustainability of aid. The issue is made more relevant when considering that the TB and HIV epidemicsin our region are threats of a cross-border nature." says Timur Abdullaev a TB activist from Uzbekistan.
The TB Europe Coalition calls on the EU to appoint atransition focal point across European Commission services. This would be animportant first step in ensuring dialoguebetween EU country delegations, civil society and donors to identify political solutions andensure sustainability of TB/HIV services.
The TBEC together with the Eurasian Harm ReductionNetwork, the Stop Aids Alliance and AIDS Fonds specifically call on theEuropean Commission to convene a Partnership Meeting by the end of the year,bringing together all stakeholders to discuss and agree on concrete roadmapsfor a successful transition to domestic funding.
Editors Notes:
- Tuberculosis retainsthe unwelcome distinction of being the world’s single deadliest infectiousdisease. In 2014 alone, the epidemic killed 1.5 millionpeople worldwide. A far cry from the image of a disease consigned tothe past, TB remains a painful reality for millions across the world and inEurope. In particular, countries from Eastern Europe and Central Asia (EECA)are those who harbour the greatest percentage of multi drug-resistant TB(MDR-TB) cases. Fifteen out of the world’s 27 countries hardest hit by MDR-TBare situated in EECA.
- The TB EuropeCoalition is an informal advocacy network of non-governmentalorganisations and individuals that share a commitment to raising awareness ofTB and to increasing the political will to control the disease throughout theWHO European Region and worldwide.
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