FUNDING Combat HIV/AIDS IN EUROPE AND NEIGHBOURING COUNTRIES : PILOT PROGRAM IN THE RURAL AREA OF EASTERN EUROPE 15 th, May, 2006 EUROHIV

Program Background

HIV infections newly diagnosed, reported in 2003 characteristics of cases by geographic area WHO European Region In East Europe, newly diagnosed cases of the young and women are growing Program Background

Predicted HIV infections 01’ – 30’ Eastern Europe and Russia (Base and pessimistic scenarios) Source: World Bank The epidemiological and economic impact of HIV/AIDS in ECA 2002 Program Background

Future scenario: Epidemic impact on society A generalized HIV/AIDS epidemic among economically active age groups could have the following impacts: l Economic growth rate decline by percentage point l Health expenditures could increase by percent due to need for more care activities l The dependency ratio could rise, putting a strain on social protection systems, especially to countries experiencing declining fertility rates. l Household size and composition could change due to increase in single parents households, reinforcing the ”poverty trap” since children may be forced to drop out of school Source: World Bank 2003, Averting the AIDS Crisis in Eastern Europe and Central Asia Program Background

New aid paradigm for the Eastern Europe l The Eastern Europe and Central Asia Region is experiencing the world’s fastest growing HIV/AIDS epidemic. l Many of young generation in East Europe who are economic workers die young l Prevention is most important but the economic and social problem after their death could be very serious as well. Especially in some rural area where there is lack of social resources. Need of new program about HIV/AIDS in Eastern Europe Program introduction

Target Area: What facts do we have about Central Eastern Europe and HIV/AIDS? l Few reliable statistics exist on the rural communities in the respective countries due to various causes (underreporting, difficulties in data collection, fear of discrimination, no stratification on ethnicity). l Health is regarded as one the main policy areas most neglected to date in many CEE countries. l Both serological and behavioral surveillance are weak in most CEE countries. l Currently available information neither support program planning nor help define the dynamics of the epidemic in CEE countries. Program Descript

l Due to lack of competitive and marketable skills the economic and social transition to the market economy in CEE has aggravated the socially disadvantaged situation of ???. l Due to tightening opportunities and their low level of competitive skills demanded in formal economy ??? are comparatively active in the informal economy. l Because of their high official unemployment rate and low rate of involvement in formal economic activities ??? are often found excluded from public health insurance schemes l The ??? population is returning to semi-nomadic patterns due to the post– Communist restitution and its disproportional negative social effects on Roma l A sharp increase in STIs throughout the region has been noted in the entire CEE in the past decade Target Area: What facts do we have about Central Eastern Europe and HIV/AIDS? Program Descript

Rationale and drives for action l Countries committed to the Millennium Development Goals, which include the fight against HIV/AIDS and poverty. l An uncontrolled epidemic could have devastating consequences on health and development in CEE. l Global experience shows that early and effective action can limit the spread of HIV/AIDS (Brazil and Thailand) l The drive for EU membership provides a new promising starting point for addressing Roma issues reflected by the current level of activity and interest Program Descript

Target groups Rural Area Youth (10-24) including young people and adolescents Women Orphans The rural area of Eastern Europe Focus on the vulnerable and poorest groups of young people, especially girls Widows and left orphans Program Descript

Recommendations I l Hasten the process of Romani equality into all aspects of public life and citizens services l Ensure equal access to health insurance for Roma l Monitor and evaluate the extent to which Roma are involved in high risk activities regarding IDU/drug trafficking, CSW, MSM and prisoners l Support peer education activities among Romani youth for HIV/AIDS and related topics including IDU (as the formal education system sometimes fails to reach to them)

Recommendations II l Statistical authorities and national health systems should build capacity to develop instruments for monitoring health status disaggregated by socio-economic background and where possible ethnicity l Ensure Romani participation in all programs and activities designed to improve the status of health, education, and welfare of their community. l Roma groups must be involved in the development, implementation and analysis of surveys and other kinds of data collection activities

Linkages Goals / adolescents and young people Goal 1: Eradicate extreme poverty and hunger Goal 2: Achieve universal primary education Goal 3: Promote gender equality and empower women Goal 5: Improve maternal health Goal 6: Develop independent group Goal 8: Develop a global partnership for development UNGASS Declaration of Committment –25% reduction in percentage of young people who are HIV infected by 2010