Logo On the occasion of World TB Day, the TB Europe Coalition (TBEC) is alarmed by the withdrawal of donor support to TB & HIV programmes in Eastern Europe and Central Asia, dealing a catastrophic blow to patients. While joint efforts from all stakeholders is needed to ensure we do not recede on progress made so far, TBEC calls on the European Commission to play a stronger political convenor role in the region to help achieve a sustainable and effective transition to domestic funding of health systems.

As the economies of countries in Eastern Europe and Central Asia (EECA) grow, international donors withdraw support. Yet external funding for TB and HIV services is critical in the region. Progress made in TB & HIV services is dangerously at risk if governments don’t step up to the plate. EECA is home to the fastest growing HIV epidemic and the highest rates of multi-drug resistant tuberculosis (MDR-TB) in the world, often focused 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 and social services for key populations.. Yet, it is these critical services that are most at risk as international donors withdraw and domestic financing is slow to appear. For example, in Serbia when the Global Fund’s support ended in 2014, the government did not fill the funding gap. Since then programmes serving 3,000 people who inject drugs have cut or stopped services. The 2015 national HIV budget allocated just 3 percent for HIV prevention, with no funds for key populations.

Similarly, USAID support to TB programmes and Global Fund’s support to HIV prevention programmes in Romania stopped in 2007 and 2011 respectively. As a result, the country saw the number of new HIV infections double from 2009 to 2012.

“In Romania, domestic funding of the TB response is still extremely low. Moving from international funding to local resources is a work in progress. While the TB National Strategy for 2015 – 2020 does have a multiannual budget which should significantly be covered from domestic sources, neither the Government nor the local authorities seem ready to take over from international donors.” said Silvia Asandi, General Manager of the Romanian Angel Appeal Foundation.

Too often countries in the region are also facing difficulties in providing full and complete access to TB treatment to patients in need, due to complex regulatory frameworks. When facing transition, a country must ensure that there are no legal barriers in place for the purchase and import of medicines required to complete treatment. There is a desperate need for planned and well-executed transition processes in order to maintain services for the people who need them.

“Successful transition can happen, Croatia is a good example. Yet, this process needed strong political commitment and lengthy planning. It demands programmatic, governance and fiscal reforms which cannot be done overnight” said Fanny Voitzwinkler, Coordinator of the TB Europe Coalition. “All stakeholders, including donors, civil society, technical agencies and governments need to work together if we are to be successful, but we shouldn’t underestimate the political role that the EU institutions can play in this process“, she added.

The EU has a framework of bilateral cooperation with many countries in the region, including those which aspire to join the EU. Thus EU institutions are in a key position to play a political convenor role.

“The European Union should accept that abrupt withdrawal of support to middle income countries is not the way and come up with concrete political strategies to ensure sustainability of aid. The issue is made more relevant when considering that the TB and HIV epidemics in 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 a transition focal point across European Commission services. This would be an important first step in ensuring dialogue between EU country delegations, civil society and donors to identify political solutions and ensure sustainability of TB/HIV services.

The TBEC together with the Eurasian Harm Reduction Network, the Stop Aids Alliance and AIDS Fonds specifically call on the European Commission to convene a Partnership Meeting by the end of the year, bringing together all stakeholders to discuss and agree on concrete roadmaps for a successful transition to domestic funding.

Editors Notes:

  • Tuberculosis retains the unwelcome distinction of being the world’s single deadliest infectious disease. In 2014 alone, the epidemic killed 1.5 million people worldwide. A far cry from the image of a disease consigned to the past, TB remains a painful reality for millions across the world and in Europe. 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-TB are situated in EECA.
  • The TB Europe Coalition is an informal advocacy network of non-governmental organisations and individuals that share a commitment to raising awareness of TB and to increasing the political will to control the disease throughout the WHO European Region and worldwide.

For more information:
Fanny Voitzwinkler
Coordinator, TB Europe Coalition
+32(0) 485352385
fvoitzwinkler@ghadvocates.org


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