Thank you, Mr. Chair.
And thank you Dasha for, again, calling our attention to the issues and the situation of Europe, especially the Eastern European and Central Asian region.
We cannot emphasize enough the importance of sustainability of prevention, treatment and care programs, especially for those countries that are (1) transiting from international funding such as Global Fund to domestic funding. A key issue is that as the Global Fund and bilaterals ramp down, MIC’s are not rising to the occasion for one of two reasons. In some states, like Zambia, their entire health budget would not fill the treatment gap. There are other states that simply don’t care because their epidemic only impacts marginalized populations. In either case, “shared responsibility” cannot leave the world free to walk away from its responsibility to the people who will otherwise be abandoned.
Funds are one aspect of the issue, (2) existing and functioning structures are another. We have seen examples of European countries in transition not being able to ensure reliable and sustainable access to medication and diagnostics due to the lack of proper structures or procurement and budget setting.
Another worrying trend is that our governments, trying to meet international financial demands in the times of (3) austerity, tend to cut back on health and welfare budgets. As noted by Dr Mrisho from Tazania, this often results in attempting to get milk from a dead cow! This has devastating effects on those living in poverty, in need of health care and prevention services, and also on programs provided by civil society. These financial cuts might help in meeting economic indicators, but for sure they aggravate already existing gaps in societies, increasing vulnerability and marginalization, leaving hundreds of thousands of people behind and leaving us health structures that do not meet the requirements that can ensure the highest attainable health for all, jeopardizing the future of generations.
And we need to (4) fast track EVERYWHERE. We need to think of communities everywhere: smaller countries may not bring huge numbers to our statistics but without them, we will not reach the global ending of AIDS as a public health epidemic by 2030.
Finally we need to ensure funding mechanisms to (5) strengthen communities of key populations: drug users, sex workers or men who have sex with men, in countries where governments completely ignore any investment due to stigma and discrimination or existing punitive laws. In this regard, we would like to recall Dasha’s striking comparison been richer Russia and poorer Tajikistan and her call to the Joint Programme to help us open closed doors.
Thank you for your attention.