In-depth

HIV / AIDS

A young soldier reading about HIV.
A young Kyrgyz soldier is reading about HIV / AIDS.

The Kyrgyz Republic remains a country with a low prevalence of HIV. However, the number of new cases of infections has grown dramatically in recent years, ranking Kyrgyzstan among top seven countries with the most rapid rate of epidemic growth in the world, according to WHO and UNAIDS. The number of registered HIV cases increased by 19 percent: from 3,887 in 2011 to 4,611 in 2012. According to the WHO SPECTRUM programme assessment, there are an estimated 12,040 people living with HIV in the country.

The increase in new HIV cases registered is related not only to the continued spread of the infection, but also to improved detection rates as a result of expanded HIV testing among all groups of the population.

The Kyrgyz government is strongly committed to combat the HIV epidemic, but many programmes for prevention, treatment and care in civil and penitentiary sectors fall short of finance due to economic difficulties. Required mechanisms for integration of activities of various related state structures and civil society organizations implementing preventive and social support programmes for vulnerable groups are not yet in place. Existing regulations of the HIV-prevention work are not aligned with international standards, while systems that provide access to preventive and health services are still underdeveloped. Fearing of existing stigma, many members of vulnerable groups are afraid to address their needs through harm reduction programmes, as well as through public health institutions. Especially this holds true for those who live in rural areas.

All these facts, along with absence of a state system funding and frequent changes of managers and key individuals in government structures, pose a threat to sustainability of prevention programmes.


UNDP in Kyrgyzstan became a primary recipient of Global Fund grants on HIV, TB and malaria in 2011 and started implementing consolidated programmes in all areas. The programme on HIV aims at reducing the incidence of HIV in Kyrgyzstan via expansion of services available to vulnerable populations and improving universal access to treatment care and support.

One of the main objectives is to increase access of vulnerable groups to HIV prevention and treatment services through assistance to community and non-government organizations that have direct access to vulnerable groups (people living with HIV, drug users, sex workers etc.). Another major area of work is preventive measures among people at high risk: convicts and injecting drug users. Harm reduction programmes plan to cover 60 percent of estimated number of injecting drug users, while more prisons will be covered by methadone substitution therapy.

Preventing spread of HIV and increasing life expectancy and quality of life of people living with HIV are top priorities of the programme. This requires increased access to quality prevention, treatment, care and support services for people living with HIV. Early start of anti-retroviral treatment, timely counseling, special attention for women and children at risk, treatment of opportunistic infections, fighting stigma and discrimination are among measures undertaken to reach the objectives.

Tuberculosis

At a photoexhibition devoted to TB day.
Visitors at a photo exhibition on the World TB Day organized by UNDP as part of the Global Fund grants.

Tuberculosis (TB) re-emerged in Kyrgyzstan as a major public health problem and its burden remains high in the country. There are about 5,000 cases of new infections are registered annually and Kyrgyzstan ranks fourth among 53 countries of the WHO European Region in terms of infection rate.

While there are substantial improvements under the national efforts to fight the diseases, the situation remains challenging due to substantial financial gaps. One of the most pressing problems is resistance to anti-TB drugs. The 2011 Drug Resistance Survey identified very high multi-drug resistant TB forms in 26.4 percent of new smear cases and 51.6 percent among previously treated cases.

One of the most important sources of funding for the programme to control tuberculosis in Kyrgyzstan is the Global Fund to Fight AIDS, Tuberculosis and Malaria administered by UNDP. The grant aims at reducing incidences and mortality rate of tuberculosis by consolidation of DOTS (Directly Observed Treatment, Short-course) framework with a special focus on drug-resistant forms of tuberculosis.

UNDP works with state healthcare institutions, TB service staff, non-government organizations and general population to help prevent new infections, detect new cases as early as possible and treat them effectively. Key institutions are provided with required medical and their staff is trained on latest diagnostic and treatment techniques. The programme also works on improving laws and regulations so that patients have full and timely access to effective counseling and treatment.

Malaria

In the Kyrgyz Republic malaria is characterized as a disease often confined to some focal areas in the country. Overall situation is a mixture of repeatedly emerging and resistant cases and the problems linked with it.

In 2011 there were no cases of malaria or a carrier parasite registered in Kyrgyzstan.  This is a significant achievement for the country. However, these achievements are unstable and over 1.5 million people living in areas bordering with Uzbekistan and Tajikistan remain prone to disease outbreaks.

Sustaining such impressive results depends not only on the quality of treatment and preventive measures, but also on high awareness of populations at risk. Health education and involvement of population in anti-malarial activities decrease administrative costs and guarantee success of prophylactic measures during malaria season. 

The goal of the programme on malaria is to create a supportive environment for cessation of local transmission of malaria and transition to its elimination in Kyrgyzstan by 2015. UNDP works with community organizations, local government authorities and rural healthcare committees to raise awareness of local people about malaria.

An estimated 2.5 million people are in the target group of the programme. As part of preventive measures people living around areas prone to malaria receive mosquito nets and their houses are treated with chemicals. National and local healthcare institutions are trained on early diagnostics and proper response in case of outbreaks.