Effective control of HIV and tuberculosis in the Kyrgyz Republic

Project overview:

The UNDP project "Effective control of HIV and TB in the Kyrgyz Republic", funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), aims to reduce the burden of HIV and tuberculosis in the Kyrgyz Republic by providing timely and high-quality prevention, diagnosis and treatment. The project is also working to strengthen the health system in the country, and recently also adapted its activities to help combat the new Covid-19 pandemic as part of an additional grant.

Introductory information:

HIV and TB epidemics remain an acute problem for the Kyrgyz healthcare system. In the period from 2013 to 2019, the number of registered HIV cases in Kyrgyzstan doubled (9135 in 2019). The HIV epidemic in the country continues to concentrate among key population groups, while the growth of the disease among women is increasing. 70% of reported cases are associated with sexual transmission. As for tuberculosis, Kyrgyzstan is one of the 30 countries with a high burden of drug-resistant tuberculosis, where about 29% of newly reported cases and 68% of previously cured cases are drug-resistant (according to WHO). These problems became even more urgent during the COVID-19 pandemic, which scientists warned would have a negative impact on tuberculosis and HIV control programs around the world.

The 3rd Sustainable Development Goal set by the UN is to ensure a healthy lifestyle and promote well-being for everyone at any age, including ending the epidemics of AIDS and tuberculosis by 2030. To this end, UNDP has been effectively implementing GFATM grants in the Kyrgyz Republic since 2011.

Main areas of activity:

HIV: within the framework of the project, high-quality medicines for people living with HIV. The project works with 17 NGOs and 2 state medical organizations to prevent HIV in key population groups (men who have sex with men, sex workers, people who inject drugs, people living with HIV and their partners, prisoners). Activities include providing counseling and psychological support, free and regular rapid HIV testing among communities, providing preventive materials (condoms, syringes), methadone therapy and stay centers for the most vulnerable; conducting behavior change activities; promoting advocacy, protecting rights and reducing stigma and discrimination.

TB: The project purchases high-quality medicines for the treatment of MDR/XDR-TB (tuberculosis with multiple or broad drug resistance), which allows the healthcare system to provide free treatment to all patients in Kyrgyzstan. UNDP ensures timely ordering and delivery of medicines, their safe storage and distribution. The project also supports case managers to help patients receiving treatment for MDR/XDR-TB, and thus reduces the number of patients interrupting their treatment, provides motivational payments to TB patients and promotes alternative treatment methods such as video-controlled treatment. The project aims at early detection of tuberculosis, including in children, by supporting activities such as computed tomography (CT) and contact tracing. In addition, the project supports laboratories throughout the country and a system for the transportation of sputum and anti-tuberculosis drugs for the timely detection of tuberculosis and monitoring of treatment to ensure the best results. As in the HIV component, the program also supports advocacy activities in the field of tuberculosis, changes in legislation, reducing stigma and protecting the rights of patients.

Covid-19: The project quickly adapted to the Covid-19 pandemic by purchasing the necessary equipment for the healthcare system and helping partners adapt their HIV and TB responses in this context. The program continues to reduce risks among TB and HIV services and helps them continue their work.

Expected results:

The overall goals of the HIV and TB Program include the following:

(a) minimize the impact of the HIV epidemic by reducing morbidity and mortality by 50% by 2023 compared to 2015 as a step towards eliminating the epidemic in Kyrgyzstan by 2030;

(b) to increase the success rate of treatment of drug-resistant forms of tuberculosis to 75% by 2023.

The objectives of the Program include the following:

a) reduce the number of new cases of HIV infection, especially among key population groups ("KGN"), by 70% by 2023 compared to 2015;

(b) ensure that 90% of people living with HIV (PLHIV) are aware of their HIV status;

(c) Cover 90% of PLHIV with antiretroviral therapy ("ART") and achieve a reduction in viral load in 90% of people receiving ART by 2023;

(d) reduce mother-to-child transmission of HIV to less than 2%, which will lead to its elimination;

(e) reduce the level of stigma and discrimination to zero in government organizations providing services related to HIV, REN and PLHIV;

(f) to reduce to zero the number of laws, other regulations and practices that discriminate against PLHIV and KGN;

(g) Ensure coordination and sustainable financing of the HIV response by gradually increasing the share of public funding for HIV prevention and treatment programs to 60% by 2023;

(h) Ensure universal access to timely and quality diagnosis and treatment of all forms of TB, including MDR and extensively drug-resistant TB (XDR).