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HEARING OVERVIEW:

A Regional Public Hearing, “AIDS and Drug Addiction: Myths, Reality and Actions,” was held in Krasnoyarsk on July 04, 2005. The Hearing aimed at providing an overview and analysis of the region’s HIV/AIDS epidemic and policy, social and economic consequences of HIV/AIDS and drug use in Krasnoyarsk Kray. The hearing also aimed to identify current HIV/AIDS policy priorities and develop recommendations to effectively address HIV/AIDS and drug use in the region.

The Hearing was co-organized by the Krasnoyarsk Kray Center For Prevention and Fight Against AIDS and STDs and Transatlantic Partners Against AIDS, under auspices of the Krasnoyarsk Kray Interagency Commission To Address Drug Use, Alcoholism and AIDS and the GLOBUS project. For its part, Transatlantic Partners Against AIDS provided technical and analytical support to the Hearing, and developed a Policy Brief, “HIV/AIDS Epidemic in Krasnoyarsk Kray,” that was distributed in conjunction with the event.

The Hearing, chaired by Krasnoyarsk Kray Vice-Governor on Social Issues, S. Kozachenko, was organized at the Krasnoyarsk Kray Administration and drew unprecedented attention from senior federal and regional authorities to HIV/AIDS. Key speakers included:V.Zubov, Russian State Duma Deputy representing Krasnoyarsk Kray and Member of the Interfactional Deputies’ Working Group on Prevention and Fight Against AIDS; E. Korchagin, Head of Healthcare Department of Krasnoyarsk Kray Administration; S.Natarov, Chair of the Healthcare Commission of Krasnoyarsk Kray Legislative Assembly; L.Ruzaeva, Head of Krasnoyarsk Kray Center For Prevention and Fight Against AIDS and STDs; and, J. Tedstrom, President of Transatlantic Partners Against AIDS. The Hearing gathered over 200 participants, including officials representing Krasnoyarsk Kray and City administrations and legislative assemblies, representatives of the Federal Service on Drug Control, officials from Krasnoyarsk Kray regional municipal administrations, leaders of non-governmental organizations, and experts in the field of public health and social development.

KEY AREAS OF DISCUSSION:

During the Hearing and press conference, keynote speakers identified and discussed a range of key HIV/AIDS policy issues in the Russian Federation and Krasnoyarsk Kray, including:

The status of the regional HIV/AIDS epidemic. Dynamics, tendencies and consequences of the epidemic’s growth and development; interrelation of HIV/AIDS and drug use.
Prevention of HIV/AIDS: focus on vulnerable groups, especially injecting drug users (IDUs). Harm reduction programs (including needle exchange and methadone substitution therapy) as effective strategies to prevent the further spread of HIV/AIDS.
Legislative response to HIV/AIDS in Krasnoyarsk Kray. Overview and analysis of Krasnoyarsk Kray sub-program “Anti-HIV/AIDS” for 2005-2007 and its implementation strategy.
National and regional policies to fight HIV/AIDS. Effective policy implementation strategies at federal and regional levels and current HIV/AIDS policy priorities in Krasnoyarsk Kray.

V.Zubov and J.Tedstrom highlighted the need for political leadership and recommended the establishment of a high level Committee empowered with responsibility and authority for coordinating AIDS policy across ministries and with regional officials, and development of mechanisms for stable funding of HIV/AIDS projects based on the country’s resources.

The other major issue discussed was firm governmental commitment to international best practices in public health, including harm reduction programs and substitution therapy. Harm reduction programs have been administered in select regions of Krasnoyarsk Kray since 1999, but there remains an urgent need to introduce these programs in the parts of the region most affected by HIV and allocate funding from the regional budget to support these interventions.

OUTCOMES

As a result of the Hearing, a draft Resolution was discussed and adopted unanimously by Hearing participants. This resolution will serve as the framework for the development of a Krasnoyarsk Kray HIV/AIDS regional strategy. The finalized version of the Resolution will be submitted on behalf of Krasnoyarsk Kray Interagency Commission to Address Drug Use, Alcoholism and AIDS to the Governor, relevant Kray and City Administration departments, Legislative Assemblies and published in mass media.

The major Resolution conclusions and recommendations call for:

Further strengthening of Krasnoyarsk Kray’s regional strategy to fight HIV/AIDS by ensuring that it includes measures aimed at prevention, scaling up access to ARV treatment, support and care for people living with AIDS (PLWHA), and observance of human rights. Prevention measures should focus at both general population and vulnerable groups, including injecting drug users and sex workers.
Coordination of HIV/AIDS programs in Krasnoyarsk Kray implemented by both governmental and non-governmental organizations. Interagency Commissions on HIV/AIDS should be established at municipal levels in regions of Krasnoyarsk Kray and chaired by heads of local administrations. Municipal level HIV/AIDS programs need to be developed and implemented.
Expansion of already established harm reduction programs in Krasnoyarsk Kray and introduction of new programs in regions of Krasnoyarsk Kray most affected by HIV/AIDS .
Cross sector collaboration in fighting HIV/AIDS and building NGO sector capacity to implement HIV/AIDS and drug use prevention programs. Krasnoyarsk Kray Social Grant Program should include HIV/AIDS and Drug Use Prevention as program priorities.
Establishment of Deputies’ Working Group on HIV/AIDS within Krasnoyarsk Kray Legislative Assembly to ensure effective legislative response to HIV/AIDS and that the existing regional sub-program “Anti-HIV/AIDS” corresponds to the HIV/AIDS situation in the region.
Development of sustainable mechanisms for HIV/AIDS program funding out of Krasnoyarsk Kray regional resources. Increasing the role of local businesses in supporting HIV/AIDS programs.
Development and introduction of HIV/AIDS training programs for regional and municipal administration leadership, management and staff, as well as for broad range of specialists in the fields of public health, education and culture.

EVALUATION

Based on the analysis of evaluation forms completed by a sub-set of Hearing participants, the following conclusions can be drawn:

100% are certain that the scope of the Hearing’s topics was important for the region. It was emphasized however that more detailed and practical discussion of concrete measures in areas of prevention, treatment, care for PLWHA would be highly valuable for future sessions.
The key speakers were rated as fully relevant for the forum. At the same time, 62% of participants believed there should be a larger representation of people affected by HIV/AIDS, as well as experts/professionals practically dealing with related issues.
83% are convinced that the Hearing resolution will have a highly positive impact on regional HIV/AIDS policies.
Among the priorities in fighting HIV/AIDS epidemic in Krasnoyarsk Kray, the following top three positions were identified:
1. Prevention measures aimed at general population;
2. Development of a comprehensive strategy against HIV/AIDS;
3. Securing sustainable funding for prevention and treatment programs.

90% of respondents found that the Hearing was useful and reached the stated goals.