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annual report 2009 2009 keeping the promise aids foundation east-west afew « -»

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1-3 afew s dance4life events in moldova 4-5 afew training in magnitogorsk russia 6 staff from afew s kazakhstan office and ngo `fakel 7-9 autumn school in almaty kazakhstan 1-3 dance4life 4-5 afew 6 afew «» 7-9 contents 1-3 4-6 7-9 message from the chairman message from the executive director epidemic at a glance where we work what we do key results 2009 our approach strategic planning 2009 a lifeline for street children kyiv drop-in centre beyond the prison gates transitional case management in kazakhstan `we are people not problems client management in russia creative power information power programme gallery what next finance and governance governance fundraising investment financial results who we are credits glossary donate to afew 4 6 7 8 9 10 16 20 6 3 37 40 4 43 48 49 5 56 63 7 73 74 2009 2009 k « » « ­ ­ !» afew!

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message from the chairman frank de wolf chairman of the board aids foundation east-west afew « -» the global efforts towards the millennium goal of universal access are yielding progress in 2009 there was a significant increase in the number of people living with hiv/aids who had access to antiretroviral drugs at the same time hiv prevention programmes have a greater geographical reach than ever before and this expansion has started to have an impact on the epidemic in africa for instance some countries are now starting to see hiv rates stabilise and even decline nevertheless at the global level the number of individuals newly diagnosed with hiv still exceeds the number of those who receive treatment in other words despite improved access to treatment and prevention the hiv/aids epidemic continues to grow eastern europe and central asia eeca is still experiencing a rapid increase in hiv cases but treatment availability still lags behind that in many other regions of the world only 22 of adults who need antiretroviral treatment actually receive it that is less than half the global average for low and middle-income countries 42 one of the founding aims of aids foundation east-west afew is to improve access to hiv prevention and treatment in cooperation with national governments and civil society in the region the ability to build community systems that tackle the epidemic from the grassroots level up is one of afew s biggest strengths afew s appointment as manager of the new unaids technical support facility tsf for 25 countries of eeca attests to this strong track record the tsf is an important next step for afew in that it will allow us to strengthen the non-governmental response to hiv and share our lessons learned with many more countries by managing the unaids technical support facility afew consolidates its position as an international provider and 4 ­ ­ 2009 22 42 « -» aids foundation east-west afew afew ­ « » afew technical support facility tsf 25 tsf ­ afew broker of technical experience knowledge and assistance in particular injecting drug use largely fuelled the hiv epidemic in eeca and is now emerging as a major factor in other regions particularly in africa and asia afew s experience is therefore highly valuable to the fight against hiv not just in eeca but also worldwide with the xiii international aids conference coming up in vienna in july 2010 i am looking forward to having the opportunity to share afew s methods and results with the wider global community in the meantime we are proud to present our 2009 results which very clearly demonstrate that we are keeping the promise to lead the hiv response in eeca and speak out for the people most affected by it these results are a tribute to the diligence and talent of our staff who continued to make progress in every aspect of our work despite financial and political setbacks maintaining such a dedicated and motivated team throughout such a difficult year is certainly one of the crowning achievements of our organisation i wish you an interesting and enlightening read afew ­ ­ afew xiii 2010 afew afew 2009 afew aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 message from the chairman 5

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message from the executive director joost van der meer executive director aids foundation east-west afew « -» our road in 2009 was not a smooth one ­ we faced the inevitable challenges that accompany working in the field of hiv aids in the current financial and political climate however in taking stock of the year s results i am able to report some very strong results from our projects and advocacy efforts in eastern europe and central asia eeca in 2009 aids foundation east-west afew was able to make an important contribution to the goal of universal access in 8 countries of the region through our network of client management sites we have ensured that significant numbers of at-risk people accessed essential medical and social services that would otherwise have remained closed to them in central asia for example where afew first introduced client management approaches our network made almost 50,000 referrals over the course of the year in russia and ukraine similar networks are now reaching thousands of people and we will introduce this model to belarus in 2010 referral networks improve access communication between services providers and the quality of care for our clients thus afew s activities also contribute to strengthening health systems in 2009 afew signed new contracts with donors that brought in an approximate 9 million euros in extra funding for hiv projects in eeca not only did we receive pledges from donors for some major new programmes of our own we were also able to offer sub-grants amounting to over one and a half million euros to local partners this money means that children living on the streets of kyiv can now go to a drop-in centre to get a warm meal care and support prisoners in russia can get counselling and testing for hiv and drug users in tajikistan can change used needles for clean ones most importantly all of these people can turn 6 2009 ­ 2009 « -» afew 50 000 2010 afew 2009 afew 9 1,5 ­ ­ to trained professional staff who treat them as people not outcasts a particular milestone in fundraising efforts for at-risk people in the region was the global fund s decision to extend its globus project in the russian federation for another 2 years this is very good news because globus is making a demonstrable impact on russia s epidemic in 2008 the last complete project year the number of new hiv cases in the russian federation grew on average by 13.3 but in globus regions this figure was a much lower 6.3 we look forward to building on these results over the next two years and will continue efforts to persuade russian policy-makers of the need to invest in targeted hiv prevention for injecting drug users sex workers and the prison population the last figures are encouraging because they show that we are making an impact however they also show that there is still much more work to do eeca is one of the few parts of the world where hiv is still growing steadily in this context our continued advocacy for rights-based policies and ability to lead with models of good healthcare practice are as relevant and vital as ever «-» 2008 13,3 ­ 6,3 ­ aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 message from the executive director 7

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epidemic at a glance 1 2 dilshad a 27-year-old prison inmate from osh kyrgyzstan contracted hiv in 2005 sergey a 48-year-old prison inmate from bishkek kyrgyzstan began using drugs in 1978 and at the time of the photograph being taken was suffering from withdrawal symptoms 27 2005 48 1978 1 2 hiv in the world · there are currently 33.2 million people living with hiv worldwide · at least one third of people living with hiv are also infected with tb tb remains the leading cause of death among people living with hiv hiv in eastern europe central asia 1.5 million people live with hiv in the region 3 it has one of the fastest growing epidemics in the world hiv cases rose 66 between 2001 and 2008 3 only 22 of people in need of antiretroviral therapy actually receive it 3 the russian federation alone consumes over 20 of the world s heroin 4 fuelling a national epidemic estimated at almost 1 million people 3 ukraine has the highest hiv prevalence rate in europe at 1.6 of the adult population 3 · 33,2 · 1,5 3 66 2001 2008 3 22 3 20 4 ­ 3 1,6 3 · · · · · · · · · founded in 2001 aids foundation east-west afew was the first non-governmental organisation to focus specifically on the hiv epidemic in eastern europe and central asia eeca today the epidemic is still too often overlooked by the international community the rapid spread of hiv in this region is however a humanitarian catastrophe for the people who live there and given that hiv is no respecter of borders drawn on maps it is a potential global catastrophe that should concern people everywhere « -» afew 2001 · references 1 `aids epidemic update 2009 unaids 2009 2 tb/hiv facts 2009 world health organisation 2009 3 report on the global aids epidemic unaids 2008 4 addiction crime and insurgency un office on drugs and crime report october 2009 epidemic at a glance 1 2009 2009 2 2009 2009 3 2008 4 2009 8 aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 9

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where we work moldova hiv situation population ukraine belarus hiv situation population hiv situation population 3,567,000 45,963,000 9,672,000 estimated adult hiv prevalence estimated adult hiv prevalence estimated adult hiv prevalence 0.4 range 0.3-0.7 registered hiv cases by the end of 2009 2009 1.6 range 1.2-2 registered hiv cases by the end of 2009 2009 0.2 range 0.1-0.3 registered hiv cases by the end of 2009 2009 5,625 estimated hiv cases 161,119 estimated hiv cases 10,690 estimated hiv cases 8,900 range 6,000-15,000 newly registered cases in 2009 2009 440,000 range 340,000-540,000 newly registered cases in 2009 2009 13,000 range 10,000-19,000 newly registered cases in 2009 2009 704 19,842 afew s in-country expenditure afew 1,072 afew s in-country expenditure afew afew s in-country expenditure afew 160,416 415,499 0 projects · scaling up access to prevention treatment and care under the national programme for the prevention and control of hiv/aids/stis funded by ucimp tb/aids as principal recipient of a grant from the global fund to fight aids tuberculosis and malaria · mobilising cultural resources for hiv and aids prevention education in the republic of moldova funded by unesco moscow office · micro-capital agreement hiv prevention among youth in schools in the transnistria region of moldova funded by undp · heart connection tours funded by dance4life international · ucimp tb/aids · · · « » dance4life international projects · hiv/sti prevention health promotion among street children in kyiv ukraine funded by aids fonds aidsfondet johnson&johnson · information consultation and hiv-testing as a basis for quality hiv services in ukrainian penitentiary institutions funded by the international hiv/aids alliance · institutionalisation of health promotion and hiv prevention in the educational system of the ukraine state department of corrections funded by the matra programme the ministry of foreign affairs of the netherlands · sex work and hiv/aids project in ukraine funded by sida · workshop in bulgaria on meaningful participation of civil society in global fund grants organised by afew ukraine funded by management sciences for health · «aids fonds» «aids-fondet» « » · · «» · sida · « » afew «management sciences for health» afew s harm reduction project in belarus ended in 2008 but afew returns to belarus in 2010 with the project `introduction of a client-based approach to hiv care which is funded by the matra programme the ministry of foreign affairs of the netherlands 2008 2010 afew « » «» 10 aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 where we work /

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russian federation kazakhstan hiv situation population kyrgyzstan hiv situation population tajikistan hiv situation population uzbekistan hiv situation population sources source cis interstate committee for statistics december 2009 national aids centres january 2010 `report on the global aids epidemic unaids/who july 2008 2009 2010 ­ 2008 hiv situation population 141,904,000 15,777,000 5,276,000 7,374,000 27,555,000 estimated adult hiv prevalence estimated adult hiv prevalence 1.1 range 0.8-1.6 registered hiv cases by the end of 2009 2009 0.1 range 0.1-0.3 registered hiv cases by the end of 2009 2009 estimated adult hiv prevalence estimated adult hiv prevalence estimated adult hiv prevalence 0.1 range 0.1-0.3 0.3 range 0.1-0.6 registered hiv cases by the end of 2009 2009 0.1 range 0.1-0.3 registered hiv cases by the end of 2009 2009 registered hiv cases by the end of 2009 2009 516,167 estimated hiv cases 13,784 estimated hiv cases 2,718 estimated hiv cases 1,853 estimated hiv cases 12,816 estimated hiv cases 940,000 range 630,000-1,300,000 newly registered cases in 2009 2009 12,000 range 7,000-29,000 newly registered cases in 2009 2009 4,200 range 2,300-7,700 newly registered cases in 2009 2009 10,000 range 5,000-23,000 newly registered cases in 2009 2009 16,000 range 8,100-45,000 newly registered cases in 2009 2009 44,491 afew s in-country expenditure afew 2,081 afew s in-country expenditure afew 687 afew s in-country expenditure afew 431 afew s in-country expenditure afew 3,404 afew s in-country expenditure afew 3,396,231 605,338 648,504 1,010,209 535,821 projects projects · scaling-up access to hiv prevention and care programmes for injecting drug users and in prison settings in the russian federation funded by unodc · stimulating an effective national response to hiv aids in the russian federation funded by focus media and ohi as principal recipient of a grant from the global fund · technical support facility for eastern europe and central asia funded by unaids · · «» · tsf · access project hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands · arv adherence training package funded by unicef · empowering community-based organisations and the social integration of people living with hiv in kazakhstan funded by the european commission · enhancing access to hiv prevention treatment care and support services for highly vulnerable populations in central asia funded by caap · integrated psycho-social support for hiv positive children and their families in southern kazakhstan funded by the kazakhstan aids centre as principal recipient of a grant from the global fund · «» · · · caap · ­ projects · access project hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands · enhancing access to hiv prevention treatment care and support services for highly vulnerable populations in central asia funded by caap · friendly policemen for hiv prevention programmes funded by the soros foundation kyrgyzstan · social support for families affected by hiv in the osh region kyrgyzstan funded by unicef · new guidelines on hiv prevention for staff of the ministry of internal affairs funded by osi · «» · caap · ­ · · « » projects · access project hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands · enhancing access to hiv prevention treatment care and support services for highly vulnerable populations in central asia funded by caap · improving basic health systems in the khatlon and soghd provinces of tajikistan funded by the european commission · pamir against aids project hiv prevention care in gbao tajikistan funded by oxfam novib · soghd health psycho-social support project funded by the european commission · «» · caap · · «oxfam novib» · projects · access project hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands · enhancing access to hiv prevention treatment care and support services for highly vulnerable populations in central asia funded by caap · improving hiv related medical and social services in uzbekistan european commission · «» · caap · aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 where we work 3

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what we do 1 opening of the autumn school in almaty kazakhstan 2 candelight vigil organised in amsterdam 3 training participants in magnitogorsk russia 4 rooms at afew s partner the aman-plus drop-in centre in kyrgyzstan 5 laboratory testing for tuberculosis in kyrgyzstan 6 street campaign for world aids day in kazakhstan 7 autumn school solidarity training 8 musicians at the red ribbon awards ceremony in moldova 1 2 3 4 «-» afew 5 6 7 8 « » key results 2009 2009 in 2009 afew had 27 projects under its management in 8 countries of eastern europe and central asia below we detail a few results that demonstrate how afew s programmes have helped build the region s response to hiv/aids 2009 results for each project are listed at www.afew.org · in central asia afew supported 35 social bureaus in 4 countries which served 6,048 clients 5,520 were new in 2009 these clients received 49,390 services over the course of the year · 2,127 sex workers received support through afew s client management programme in 3 social bureaus in ukraine · in the russian federation 1,182 new clients enrolled on afew s client management programme in 19 social bureaus · 5,500 young people in moldova participated in hiv awareness and prevention activities as a part of the dance4life project · afew s central asia office distributed sub-grants totalling 738,622 to 71 local organisations enabling them to create new projects for key populations · by the close of afew s pmtct project in the russian federation over 3,500 children born to mothers living with hiv had been enrolled on the pmtct scheme and received milk formula 2009 afew 27 8 afew afew 2009 www.afew.org · afew 35 6048 5520 49 390 · afew 2127 · 19 1182 · 5500 dance4life · afew 71 738 622 · 3500 4 aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 keyresults 2 0 0 9 2 0 0 9 5

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our approach dushanbe tajikistan an informational session held by afew s partner ngo `vita afew ­ «» afew s mission is anchored on millennium development goal 6 which calls upon the global community to step up efforts to reverse the spread of hiv and aids and achieve universal access to treatment for these conditions by 2010 all the programmes in our extensive portfolio are founded on the principle of universal access and exemplify an approach based on human rights and social justice put simply the starting point is that everyone should have equal access to hiv/aids treatment prevention and care including services that reduce harm from drug use or other risky behaviours afew positions itself as a partner organisation as such the organisation participates actively in several of the foremost international consortia dealing with hiv and aids as well as building grassroots networks of service providers and local ngos afew s unique value as a partner lies in its extensive experience of working in local healthcare infrastructures combined with its international-level expertise especially on harm reduction and prison health afew 6 2010 afew ­ afew « » ­ ­ our approach what is client management client management is a comprehensive system of hiv prevention treatment and care that starts with the patient and then builds service provision around their needs through counselling motivational interviewing proactive referral networks and maintenance of centralised client records for all medical and social services in a region vitally client management does not address hiv as an isolated `problem or risk but seeks to address it in the context of other issues such as substance abuse sti treatment mental health and social and cultural factors in particular voluntary counselling testing vct encourages the adoption and maintenance of safer behaviours and appropriate treatment for clients with complex problems 6 aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 7

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methods through constructive engagement with governments and civil society in the countries where it works afew advocates for the basic human right to health and demonstrates why it must be extended to reach the most marginalised stigmatised groups in society recognising that civil society can be effective in filling voids in the health and social systems of the eeca region afew assists local organisations with technical support hands-on training and customised consultations so that they can reach more people and serve them more effectively working directly with those who live at the sharp end of the epidemic afew empowers key populations at higher risk with targeted accurate information and assistance in building their own support networks where basic treatment and care for instance antiretroviral drugs care for pregnant women prevention tools etc are absent or inadequate afew supports the development of direct services to key populations in particular different departments of the healthcare systems in eeca i.e tuberculosis clinics aids centres drug rehabilitation centres often work in isolation from one another leading to gaps in care for people with complex issues afew s client management models and hiv/tb collaborative activities bridge these gaps and help service providers to better structure their responses finally long-term sustainability lies at the heart of afew s programming meaning that each project activity comes with a clear strategy for its eventual handover to local authorities governments or civil groups afew afew afew afew afew afew sex workers activities for sex workers aim to create nondiscriminatory non-judgmental and user-friendly medical and psycho-social services including hiv prevention counselling and testing services men who have sex with men through ground-breaking community-based initiatives afew equips men who have sex with men ­ one of the most `invisible groups to healthcare services in the region with targeted information and outreach support services what is harm reduction harm reduction programmes support people who are engaged in risky behaviours such as alcohol or drug use with services that prevent the most damaging effects to their health needle exchange points provide drug users with clean needles to reduce the risk of hiv and other injection-related illnesses targeted distribution of condoms helps people to reduce their risk of contracting hiv through sexual contact methadone or buprenorphine replacement therapies are effective in reducing illicit drug use and its associated harms including hiv and improving access to health care harm reduction is much broader than simple provision of tools it also includes education training and information delivery that equip people with the skills knowledge and support that they need to live safer healthier lives these strategies are closely tailored to specific categories of behaviour demographic groups and local settings ­ «» afew the people we serve injecting drug users at the core of afew s drive to reduce the exceptionally high level of hiv transmission among injecting drug users is the set-up of national harm reduction networks these networks comprise training centres for professionals needle exchange points and provision of less harmful alternatives to injecting drugs afew people living with hiv stigma and discrimination towards people living with hiv remain prevalent in the countries of eeca even within the very services that they rely on for treatment and care breaking through the wall of mythology and prejudice directed at this group is vital to addressing the hiv epidemic and is therefore a priority area for afew education training and advocacy within state services are combined with mobilisation and support of communities of people living with hiv our approach 19 8 aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9

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prevention of mother-to-child transmission of hiv pmtct is tackled through a `family-oriented approach that links up women their children wider families and community groups of women living with hiv to existing/potential service providers prisoners afew works together with ministries of justice prison health experts inmates and local ngos to build local capacity and ensure that prisoners have the same access to information and services as those living outside prison walls street children activities focus on developing support systems for children who are deprived of family care and protection drop-in centres provide all-round safe havens where children can receive basic services such as a shelter food warmth clothing recreation family mediation and health services youth through mass media campaigns and cultural events afew mobilises young adults encouraging them to take responsibility for their own health play an active role in the global response to hiv and forge future societies based on tolerance and respect for human rights in addition afew develops informational materials outreach programmes and peer training initiatives for most at risk adolescents mara we invite you to read more about afew s projects past and present on our website at www.afew.org «» ­ afew ­ afew afew ­ afew afew afew afew www.afew.org `training in action skills-building for frontline medical and social staff in ukraine « » 20 aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 our approach /

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strategic planning 2009 2009 afew sets out its long-term targets for development and expansion in its `strategic plan 2008-2010 these longerterm targets are translated into annual plans that provide the organisation with specific goals and objectives for each year afew « 2008 ­ 2010 .» afew funding the deepening economic global crisis was a constraining factor in almost every area of fundraising and afew did not obtain sufficient core funding to achieve all of the organisational objectives in its strategic plan i.e maintaining staffing levels in russia hiring new staff for key positions and implementing a human resources development policy nonetheless by the end of the year afew had garnered a very good level of funding for new project activities around 9 million compared to 2 million in 2008 a particularly welcome development was the return of funding for afew s activities in belarus a new project `introduction of a client-based approach to hiv care will be launched in 2010 with funding from the ministry of foreign affairs of the netherlands in the early part of the year afew russia faced a particularly bleak outlook global fund support for the 5-year globus project the first major hiv prevention project in the russian federation ended in august and the russian government did not honour its promise to take over funding of project activities against this backdrop afew took the difficult decision to significantly downsize its moscow office later in the year following a high-level advocacy campaign by afew and its partners the global fund agreed to bridge the funding gap with a two-year extension to the original grant new contracts and contract extensions were also 1 available online at www.afew.org signed with donors such as unodc we are pleased to report that we enter 2010 with a solid financial basis for our project activities in russia and some new region-wide projects that will be run from the moscow office unaids technical support facility and the rost project see www.afew.org for more details «» ­ www.afew.org afew 2008­2010 ­ 75 2009 58 2008 ­ 46 afew 2010 25 afew afew 2009 afew 9 2 2008 afew 2010 « /» 2009 afew ­ afew ­ afew unodc 2010 1 www.afew.org programming strategy one of afew s priorities for the period 2008-2010 is to target at least 75 of its expenditure on work with populations identified as being worst affected by hiv in eeca current and former prisoners injecting drug users and sex workers in 2009 58 of resources were spent directly on activities with these groups representing a significant increase on 2008 46 afew also aims to include an hiv/tb component in at least 25 of new projects in each region by the end of 2010 while this target has been exceeded in central asia where the majority of projects include such a component it has not yet been achieved in other regions in order to boost engagement with hiv/tb issues afew is now developing an `hiv/tb strategy for its managers which will offer guidance on programme development and grant applications 2009 afew afew «» afew afew 3 geographical expansion in 2009 afew s efforts to expand into other countries of the region began to bear fruit the european commission approved a funding application from afew and its local partner bemoni for a project on drug use and hiv/aids prevention and education in the republic of georgia afew also began investigating the possibilities for work in turkmenistan but in light of the local political situation the management team decided not to commit resources to the aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 strategic planning 20 09 20 09

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country in the foreseeable future finally due to difficulties in re-registering the country office afew s activities in uzbekistan were put on hold activities will resume as soon as the legal issues with the authorities are resolved communications communications in 2009 had two particular aims increasing the effectiveness of our messages to key stakeholders and supporting our staff with a positive enabling corporate culture the communications department recruited and trained a team of 5 regional and international staff and conducted an ambitious decentralisation drive this process was begun in late 2008 and has resulted in regionally inspired communications and media strategies for each of afew s countries of operation afew also improved its communication with stakeholders through a new website launched in march 2009 publications regional newsletters and press work in addition the department started to develop a strategy for integrating social media social networking sites and weblogs into its activities 2009 2008 afew afew 2009 afew 2009 afew harp afew 2009 afew afew 23 afew tsf 25 afew 2010 2009 psi «» « » afew 2009 afew 60 75 ­ 70 ­ advocacy and networking afew s amsterdam office aims to substantially improve awareness of the eeca hiv epidemic in dutch society and the european union in 2009 there were signs that afew is becoming an increasingly important player in international harm reduction policies through its membership of the netherlands harm reduction platform afew was invited to join the dutch governmental delegation to the high level segment of the ungass on drugs in vienna in january afew also conducted a high-profile campaign around the harm reduction donor conference in amsterdam activities included a candlelight vigil in the city centre and a public debate in which leading representatives of international and national donor organisations participated afew also collaborated on the development of a prevention treatment and care programme for 23 countries of the world through its membership of the international hiv/aids consortium the netherlands in eeca afew was appointed co-manager of the new unaids technical support facility which will provide qualityassured technical support to hiv-related programmes in 25 countries of the region as mentioned above afew also continues to play a leading role in the globus consortium with a busy schedule of new activities set for globus phase iii in 2010 in central asia afew s most recent partnership agreement on the launch of a health outreach project in four countries was signed at the end of 2009 with population services international project hope and the kazakh union of people living with hiv and aids through this project afew will strengthen the capacity of its ngo partners enabling them to extend their hiv prevention work and introduce such new components as tb prevention and care altogether in 2009 afew worked with more than 60 local partners in ukraine moldova and belarus more than 75 in the russian federation and more than 70 in central asia 4 research afew carries out research into epidemiological and behavioural trends in project regions surveys of target groups are conducted to get a better understanding of motivational factors and needs in various settings in 2009 a stakeholder survey was also conducted to research the demand for different types of technical support at the end of the year afew reached an agreement to undertake research on hiv and tb prevalence in prisons in tajikistan which will focus on assessing inmates knowledge and access to care this initiative will be implemented in cooperation with stanford university in the united states afew 2009 afew afew monitoring evaluation the quality management unit qmu conducts regular internal audits to verify that projects are being implemented in line with afew s own procedures in 2009 there were internal audits of the russian regional office the ukraine regional office and the international office the unit has also started to assist each department in developing progress indicators these indicators will be used to assess performance in a more systematic way furthermore the qmu has further developed project monitoring tools such as databases for client management programmes and preand post-training evaluations afew 2009 afew ­ aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 strategic planning 20 09 20 09 5

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a lifeline for street children kyiv drop-in centre activity kyiv drop-in centre for children launched february 2009 in partnership with kyiv city social services for families children and youth charitable foundation `child s hope at project sites in kyiv ukraine under the project hiv/sti prevention health promotion among street children in kyiv donors aids fonds the netherlands aids-fondet denmark johnson&johnson 2009 « » «aids fonds» «aids fondet» « » i earned 28 hryvnia yesterday from begging i had to pay for medicine and sausages for the dog we sleep in stairwells of buildings and when the dog gets hungry she howls and people throw us out onto the street sergey 13 years old ­ 28 13 a lot of my friends get off their heads with drugs and stuff i know people who ve fallen down somewhere in the winter and frozen to death by morning if you lie down somewhere sick one of your friends will call an ambulance if you don t have friends then that s it sasha 14 years old ­ 14 the street children of ukraine live in derelict buildings metro and train stations in stairwells of apartment blocks or in manholes that house central heating pipes very little 6 «» ­ alifelineforstreetchildren aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 7

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afew s ukraine office organised an excursion for street children and children from crisis families on 2nd june 2009 world children s day afew accurate data exists on this `invisible population but they are estimated to number in the thousands in the city of kyiv alone we also know that at least one in five of these children live with hiv one result of the ready availability of drug injecting sex work and other risky behaviours that are so often a part of life on the streets the spectrum of neglect ranges from those who run away from home for a few days to those who must survive entirely on their own resources for years at a time deprivation of life essentials such as food warmth and shelter mean that the risk of hiv goes hand-in-hand with health conditions such as lice and scabies tuberculosis hepatitis pneumonia and serious psychological trauma while medical services are supposed to be free under ukrainian law very often children can only access very basic emergency services first aid for wounds or fractures while testing and treatment for more complex issues are available only at a price over the past two years afew has worked with the kyiv city government state medical and social services and charitable foundations to create a network of service providers that specialise in reaching these children training education and public information are all priorities in building a safety net for disadvantaged children in february 2009 afew opened a drop-in centre for street children in kyiv to offer direct support services and counselling to at-risk and disadvantaged children by finding ways to deliver services to one of the hard-to-reach and neglected groups in the region afew is making an important contribution towards fulfilment of universal access to prevention and treatment under millennium goal 6 2 based on the findings of a 2006 study of street children that was conducted by afew and unicef/ukraine in the cities of kyiv and odessa ­ ­ ­ ­ afew 2009 afew ­ afew 6 2 afew 2006 8 aidsfoundation ea s t we stannualreport 2 0 0 9 « » 2 0 0 9 alifelineforstreetchildren 29

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