Russia – FY 2010 Approved Funding by Program Area, Agency and Funding Source*
*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.
In Russia, IDUs remain the key driver of the epidemic, accounting for nearly two-thirds of newly reported cases. FY 2010 funds will be used to focus on prevention and care and support for MARPs, with a particular focus on IDUs. PEPFAR has previously focused on developing and implementing model programs, particularly in the areas of prevention and care for MARPs, with the idea of replicating and disseminating effective models. FY 2010 funding is meant to build on this approach, promoting stronger Government of Russia (GOR) emphasis on prevention and care programs for IDUs through a focused effort to garner Federal-level endorsement of HIV prevention and care packages for IDUs that can be widely disseminated through the National Priority Project (the national AIDS program) and adopted in the regions. The approach will be one of engagement with the GOR to provide targeted TA to help the Russians develop and implement their programs. Continued PEPFAR leadership and collaboration with the GOR is especially important as the support for prevention and care programs for IDUs through the Global Fund phase down. While the GOR has recognized the importance of working with MARPs, the transition and ownership of such programs remains a challenge. PEPFAR assistance will help foster this process, facilitating the appropriate pathway for this transition and a sustainable approach.
The PEPFAR team will concentrate FY 2010 resources to address prevention among IDUs and their sexual partners, allocating over half of the total FY 2010 budget for this area. A key component will be a new prevention program which will build on previous efforts to develop model programs, identifying approaches with proven efficacy and defining an essential minimum package of HIV prevention for IDUs. Such a package will likely incorporate a range of interventions, including peer outreach services and case management for HIV prevention that have been previously piloted with PEPFAR support, as well as efforts to integrate HIV prevention into substance abuse treatment services. In addition, FY 2010 PEPFAR funds will support the United Nations Office on Drugs on Crime (UNODC) to continue the dialogue with government officials on substance abuse treatment, including the integration of HIV prevention into substance abuse treatment, expanding the spectrum of drug treatment services, and MAT.
PEPFAR will also focus on care and support for HIV-infected clients, particularly MARPs. To improve the access of IDUs and other MARPs to HIV/AIDS care, the PEPFAR program will use FY 2010 funds to engage with GOR to replicate the model of decentralized care for PLWHA, successfully piloted with PEPFAR support. Decentralizing HIV/AIDS care and treatment from AIDS centers to primary care clinics has helped the PEPFAR focus regions of St. Petersburg and Orenburg achieve important successes in increasing the number of PLWHA – most of whom are IDUs – in care and treatment. Engaging with the GOR to endorse this model so that it can then be used as a basis for regional strategies on HIV/AIDS care will help ensure the sustainability of the PEPFAR investments to date in this area.
PEPFAR continues to include a focus on HSS, strategically using relatively limited PEPFAR funding to work on building the capacity of government, at both national and local levels, and building the capacity of civil society. PEPFAR also continues to work with NGOs and faith-based organizations to strengthen their capacity to deliver appropriate prevention and care interventions for MARPs, and to strengthen partnerships between these organizations and national and local governments.
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