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Introduction
Partnerships in Health initiated a First Western
Balkans regional consultation of people living with
HIV (PLHIV) in Mavrovo, Macedonia on 23-24 September
2006. This is part of its capacity building activity
of the Western Balkans Regional Programme to Fight
HIV/AIDS funded by Sida. Twenty PLHIV from Albania,
Bosnia and Herzegovina (BiH), Macedonia, Montenegro
and Serbia participated in this consultation. The
consultation aims to discuss issues of mutual
interest and identify ways forward for positive
networking and mutual support in the region. The
consultation process involved two steps. On the
first day, participants analyzed the HIV human
rights situation in the region by identifying
assets, problems and potential solutions. On the
second day, the participants identified plans to
move forward. They also elected two representatives:
One woman from Serbian and one man from Kosovo to
present their consultation recommendations at the
2nd Western Balkans Regional Conference on HIV and
AIDS scheduled for 5-6 October, 2006. Below is the
report from the consultation.
HIV, AIDS and Human Rights in Western
Balkans
HIV in Western Balkans has been a
neglected issue in most policy decisions and
resource allocation planning. However, it surely is
not denied. Unfortunately, PLHIV in Western Balkans
hardly have any voice as a direct consequence of
human rights violations of children, teenagers and
adults living with HIV. Yet these violations are not
documented at any level.
The deficiency in antiretroviral
treatment and the minimal to nonexistent social and
pension insurance contribute to “silent” death of
PLHIV in this region. Although the situations
encountered by PLHIV in the Western Balkans
countries are similar yet they can not be
generalized. We want to draw your attention, not as
sufferers, but on the vicious cycle faced by PLHIV
in this region. We have not seen any measurable
progress made to reach the Millennium Development
Goals, particularly on the 6th and 8th goals.
We reiterate that Western Balkan
countries have ratified the European Convention on
Human Rights and Fundamental Freedoms, and the
European Social Charter, which deals with economic
and social rights. We invite Council of Europe to
make sure that Western Balkan countries, which are
willing to join the EU, fully comply with the
European Social Charter, particularly Articles 11
and 13.
The guidelines on HIV/AIDS and
Human Rights, adopted at the Second International
Consultation on HIV/AIDS and Human Rights ,
stipulate that human rights and public health should
share common objectives to promote and protect the
rights and well-being as well as dignity of all
individuals. Accordingly, health and human rights
should complement and reinforce each other
particularly in the context of HIV and AIDS. Besides
ensuring a spirit of tolerance, compassion and
solidarity, Western Balkans policy-makers at
national and regional levels should formulate HIV
related policies in compliance with the universal
Human Rights mechanisms and respond to the needs of
PLHIV.
The challenges we have
identified, motivate us to network intensively and
liaise with the South East European Network to
better tackle the challenges we face. We will
support Bosnia and Herzegovina and Macedonia because
these two countries are in greater need compared to
the other Western Balkan countries. Thank you for
dedicating time on behalf of the Western Balkans
Regional PLHIV Group.
Summary of assets, challenges and
solutions analysis
|
Country |
Existing assets |
Challenges |
Solutions |
|
Albania |
r
PLHIV
organization started in 2004.
r
Free ART,
CD4 and PCR available.
r
Harm
reduction, Methadone and blood safety
available.
r
National
strategy for 2004-2008
r
HIV/AIDS
inter-ministerial committee is led by
the vice Prime Minister.
r
Law on
prevention includes rights of PLHIV.
r
Civil
societies, UN agencies and national
programs network.
r
Global Fund
agreement signed. |
r
The law on
HIV prevention not yet implemented,
excluded care and no monitoring,
enforcement of rights of PLHIV nor
protection mechanisms.
r
HIV is not a
priority in political agenda.
r
Children are
not a focus in national strategy and
there is no financial support for HIV
affected children and families.
r
VCT not yet
available in most part of the country
and lack of confidentiality on HIV
status.
r
Low HIV
knowledge, especially among youth.
r
Insufficient
funding for HIV responses and no private
sector support. |
In order to
tackle all these challenges, the Western
Balkans Regional Group unanimously
agreed on the following solutions. We
invite you to collaborate with us to
materialize them.
r
Create a
e-hub to support each other (the
beginning of e-groups)
r
Develop
national & regional networks and to link
with European and Global networks with
regular meeting and rotating
secretariat.
r
PLHIV to
elect their own country PLHIV
representation with institutional
backing and not to be selected by
others.
r
Invite the
All-Ukrainian Network for technical
assistance.
r
The
secretariat should develop communication
channels between PLHIV, relevant
ministries and officials at national and
regional levels.
r
Launch joint
action to advocate reduction of ARV
prices with similar cost in each country
and for the region.
r
Act to
advise and build capacities of PLHIV,
public officials and other stakeholder.
r
Develop and
launch peer education (experience
exchange from elderly to younger
generations). For public speech (without
media coverage), all countries exchange
their peers to protect individual
speakers.
r
Request FPH
to organize a treatment literacy and
trainer skills training.
r
Develop a
regional mechanism for advocacy, human
rights protection and promotion with
expert input.
r
The
secretariat to put pressure on
governments to be accountable in
fulfilling their commitments to ensure
PLHIV can enjoy their rights.
r
The
secretariat creates a regional emergency
stock of ART.
r
The
secretariat brings together all decision
making bodies at national level to work
jointly.
r
Strengthens
collaboration between PLHIV, migrants,
victim of trafficking and human rights
organisations.
r
Promote
regional collaboration between medical
establishment
r
Promote HIV
prevention of populations at tourist
hotspots.
r
PLHIV to
mobilise funds on their own (through
local actions, cultural events, etc.)
involving private sector
|
|
Bosnia
and Herzegovina |
r
PLHIV have
free treatment and health insurance
covering all expenses.
r
PLHIV NGO
started in 2004. |
r
Incorrect/inappropriate behaviour of
medical personnel and certain public
institutions towards PLHIV.
r
No separate
inpatient HIV section all infections are
managed at the same premise.
r
General
public lack HIV information.
r
Lack
financial support, proper food at the ID
hospital for PLHIV.
r
No CD4 count
at the clinic of infectious diseases
although available at other clinics. |
|
Kosovo |
r
PLHIV NGO
starts in 2006.
r
Has free
access to HAART.
r
PLHIV
represented at Kosovo CCM |
r
Long term
supply of ART uncertain, high cost and
procurement Problematic.
r
Stigma and
discrimination by health care personnel.
r
High cost
for CD4 and VL with no laboratory
infrastructure. |
|
Serbia |
r
2 PLHIV
self-help groups exist for prevention,
psycho-social support, capacity
building, social inclusion.
r
PLHIV
educate medical staff and journalists on
STD.
r
There is
harm reduction program in Nis and
Belgrade.
r
Prevention
of maternal infant transmission
available. |
r
Access to
HAART through only one HIV treatment
centre.
r
National
AIDS strategy developed without PLHIV
input and not implemented.
r
Law, social
affairs, methadone programme do not
function well.
r
High number
of PLHIV and high social stigma.
r
Lack of
support for PLHIV groups. |
|
Macedonia |
r
MoH provides
ART for one year with CD4, VL
infrastructure.
r
NGOs provide
food, clothing, psycho-social assistance
and OI medications
r
PLHIV
involved in PHCP training, projects and
CCM. One PLHIV kept job in a public
institute.
|
r
No PLHIV
self-help group and lacking information
on health promotion.
r
Strong
stigma and discrimination, lack of
accountability on violation of
confidentiality which negatively
affected other PLHIV.
r
Health
insurance system does not protect PLHIV
confidentiality.
r
HIV not on
political agenda.
r
Long term
funding for ART not ensured.
r
Lack of
shelter and support for PLHIV and
inadequate social insurance or pension
scheme. |
|
Montenegro |
r
Has pre- and
post test psycho-social assistance with
support of infectious diseases clinic
and free CD4 and VL monitoring but in
Belgrade
r
HIV in
public discussions. |
r
Health care
personnel knowledge lacking with strong
stigma and discrimination against PLHIV.
r
No PLHIV
self-help group.
r
Law and
regulations on HIV are not respected.
r
No
laboratory for diagnostics and therapy
monitoring in Montenegro. |
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