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annual report 2010 2010 on the road to universal access aids foundation east-west afew « -»

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1 dancers in tbilisi afew s vienna express campaign 2 svetlana valko afew ukraine s trainer/pr specialist 3 afew at the grushinsky festival in samara russia 4 moscow in 2010 afew led civil and prison projects in 10 regions of russia 5 leaving messages for delegates of the aids2010 conference 6 world aids day chisinau moldova 7 yalta final conference on the prison health project 8 central asian forum on prison health 9 dance4life volunteers in moldova 1-3 4-6 1 afew « » 2 afew 3 afew 4 2010 afew 10 5 2010 6 7 8 9 dance4life 7-9 contents introduction to afew opening words epidemic at a glance where we work snapshots of afew our approaches afew in focus human rights advocacy `vienna express 2010 towards universal access the bridge programme opening doors to life for prisoners in russia you are not alone empowering vulnerable women in tajikistan fragile trust sex work and hiv aids project in ukraine finance governance accountability statement from the board performance and strategy fundraising financial policies financial results statement of income and expenditure as of 31 december 2010 who we are credits abbreviations donate to afew 4 7 9 14 16 afew « » afew afew « 2010 » «» « !» 31 2010 afew 22 25 30 35 41 44 48 52 53 58 60 67 68 69 2 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0

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opening words the theme for 2010 was universal access after all un member states decided in 2006 to commit themselves to universal access to hiv prevention treatment care and support by 2010 since then a lot has been achieved at the global level access to treatment has improved dramatically especially in africa in the region where aids foundation east-west afew runs most of its activities eastern europe and central asia eeca there have also been major steps forward for instance enormous improvements have been made in prevention of mother-to-child transmission pmtct anti-retroviral treatment has been introduced and access is increasing harm reduction programmes are implemented in this region and pilots of opioid substitution therapy with methadone are happening civil society has developed to fill a major role in the response to the hiv epidemic afew has undoubtedly contributed to all these gains 2010 ­ ­ ­ afew we continue to take on major national-level projects in eeca and complete them successfully · in 2010 afew completed a project funded by the united nations office on drugs and crime unodc for hiv prevention and care among injecting drug users and prison inmates in the russian federation it left 5 regions of the country with specialised sustainable support services for these key populations in just one year 1,382 people became programme clients 73 had a background of injecting drug use 51 were former inmates and 36 were people living with hiv · in ukraine a pool of trainers was set up within the prison system able to train prison staff on hiv and infectious disease control in prisons our projects for sex workers and street children there provide a model for the region in how to work with these groups · in central asia afew maintains its position as the region s most authoritative voice on hiv and our work there has gained widespread acclaim from governmental ngo and international partners in the past year activi4 · 2010 afew unodc 1382 73 ­ 51 ­ 36 ­ · · afew there is however a contrast between afew s successful programmes and the lack of opportunities to fund them in the `governance and finance pages of this report we outline some of the consequences of an increasingly difficult funding situation for projects in eeca in particular we had to under take an extensive programme of restructuring and downsiz afew ing in 2010 this has helped us to cut overheads in the short « » term but has entailed the loss of talented and effective staff members as well as reducing our long-term capacity 2010 cuts in funding for hiv programmes come at a time when hiv cases in eastern europe and central asia eeca continue to rise rapidly the latest unaids figures reveal that out of the 7 countries that saw a growth of more than 25 in their hiv epidemic between 2001 and 2009 5 are from eeca in ukraine and russia for instance prevalence of hiv in the adult population has exceeded the 1 mark there are many underlying reasons for this situation but a blatant obtuse and short-sighted lack of leadership in tackling hiv by some 2001 of the region s governments certainly plays a significant 2009 25 role an important indicator for this lack of leadership is that 1 most funding for prevention among vulnerable groups in the ­ region comes from external donors not from governmental budgets in july 2010 we used the international aids conference in vienna as a platform to highlight the need to step up the hiv response in eeca in the weeks before the event afew and its partners pulled together to run a high-profile campaign `the vienna express 2010 towards universal access in 11 countries participants included the general public sports personalities like anna kournikova national celebrities journalists high school and university students and inmates of prison colonies this ground swell of popular support from introductiontoafew opening wo r d s afew ties include introduction of client management for vulnerable groups support for people living with hiv as well as sanitation and social projects aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 5

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epidemic at a glance every walk of life demonstrated that the public in both the east and the west is concerned about hiv and does not support cuts to hiv programming looking ahead afew will mark its 10th anniversary in 2011 we hope you will join our special events to mark this milestone in our history as we enter our second decade we thank you for your support and we pledge that we will continue to lead the hiv response in eastern europe and central asia yours sincerely frank de wolf chairman of the board aids foundation east-west afew joost van der meer executive director aids foundation east-west afew 2010 afew « 2010 » 11 ­ 2011 afew afew « -» « -» 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 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 today the epidemic is still too often overlooked by the international community epidemic at a glance « -» afew 2001 7 6 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0

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where we work hiv in the world · there are currently 33.3 million people living with · of the estimated 15 million people living with hiv in low and middle-income countries who need treatment today 5.2 million have access · tb is the leading cause of death among people living with hiv people living with hiv are 20-30 times more likely to develop tb than those without hiv · in 7 countries of the world 5 of them in eastern europe and central asia hiv incidence has increased by more than 25 between 2001 and 2009 hiv worldwide · 33,3 · 15 5,2 · 20­30 · 2001 2009 ­ 25 hiv in eastern europe central asia · the number of people living with hiv in the region has · · · almost tripled since 2000 estimated hiv cases have now reached 1.4 million people in eastern europe and central asia around 3.7 million people inject drugs an estimated one quarter of whom are living with hiv approximately 1 in 10 people living with hiv in russia are in prison in eeca only 19 of people eligible for antiretroviral treatment actually received it this is the second lowest treatment rate in the world after the middle east and way behind the world average for low and middle-income countries 30 coverage of hiv prevention programmes for injecting drug users in the russian federation fell from 23.8 in 2007 to 13.6 in 2009 · 2000 ­ 1,4 · 3,7 25 ­ · 10 · 19 2 30 · 23,8 2007 13,6 2009 ­ 2010 ­ 2010 ­ 2009 « -» afew · references unaids report on the global aids epidemic unaids 2010 tb/hiv factsheet world health organisation december 2010 data on the hiv/aids response world health organisation december 2009 aids foundation east-west afew based on figures from the russian federal prison service 8 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 9

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moldova hiv situation population ukraine belarus hiv situation population hiv situation population russian federation kazakhstan hiv situation population kyrgyzstan hiv situation population hiv situation population 3,567,000 12,000 12,000 45,778,500 290,000 350,000 9,481,000 6,300 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 officially registered hiv cases by december 2010 2010 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 officially registered hiv cases by december 2010 2010 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 141,900,000 430,000 16,455,000 1,800 5,478,000 <1000 9,800 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 officially registered hiv cases by december 2010 2010 17,000 6,404 185,147 officially registered hiv cases by december 2010 2010 980,000 13,000 11,759 officially registered hiv cases by december 2010 2010 officially registered hiv cases by december 2010 2010 afew s in-country expenditure afew 195,882 in 2010 160,416 in 2009 195 882 2010 160 416 in 2009 afew s in-country expenditure afew 843,075 in 2010 415,499 in 2009 843 075 2010 415 499 in 2009 afew s in-country expenditure afew 568,000 15,318 3,232 128 593 in 2010 0 in 2009 128 593 2010 0 in 2009 afew s in-country expenditure afew afew s in-country expenditure afew 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 · school4life and campaign4life funded by dance4life · mobilising cultural resources for hiv and aids preventive education in the republic of moldova funded by unesco · public awareness and education for development in europe funded by dance4life as principal recipient of a grant from the european commission · hiv prevention among school youth in the transnistrian region of moldova funded by undp · ucimp tb/aids · school4life campaign4life dance4life · · dance4life · projects · hiv/sti prevention health promotion among street children ukraine funded by aids fonds · support for the drop-in centre for street children in kyiv ukraine aids-fondet denmark money collected under humour against aids · institutionalisation of health promotion and hiv/aids prevention in the educational system of the state department of corrections of ukraine funded by the matra programme the ministry of foreign affairs of the netherlands · sex work and hiv/aids project in ukraine funded by the swedish international development cooperation agency · information consultation and hiv-testing as a basis for qualitative hiv-servicing in penitentiary institutions of ukraine funded by international hiv/aids alliance in the framework of global fund activities · «aids fonds» · «aids-fondet ­ » « » · «» · ­ sida · projects introduction of a client-based approach to hiv care funded by matra ministry of foreign affairs of the netherlands · «» 2,621,573 in 2010 3,396,231 in 2009 2 621 573 2010 3 396 231 2009 projects · scaling-up and improving access to hiv/aids 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 the open health institute ohi as part of the globus project funded by the global fund to fight aids tuberculosis and malaria · pmtct the mother s school project funded by eureko achmea foundation · rost project responding to hiv through organisational support and technical cooperation in eeca funded by aids action europe as principal recipient of a grant from aids fonds viiv healthcare positive action programme levi strauss foundation foundation open society institute · · · «eureko achmea» · ­ « » «aids fonds» « » «viiv healthcare» «levi strauss» « » 686,353 in 2010 605,338 in 2009 686 353 2010 605 338 2009 afew s in-country expenditure afew 650,895 in 2010 648,504 in 2009 650 895 2010 648 504 2009 projects · access project hiv/aids and hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands · mobilising and promoting the active involvement of people living with hiv in kazakhstan funded by the european commission · enhancing access to hiv/aids prevention treatment care and support services for highly vulnerable groups in central asia funded by the uk department for international development and the world bank under caap · usaid dialogue on hiv and tb project funded by population services international as principal recipient of a grant from the united states agency for international development usaid · arv adherence training package funded by unicef · «» · · ­ caap · « » ­ psi ­ usaid · projects · access project hiv/aids and hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands · enhancing access to hiv/aids prevention treatment care and support services for highly vulnerable groups in central asia funded by the uk department for international development and the world bank under caap · friendly policemen for hiv prevention programmes funded by the soros foundation kyrgyzstan · social support to families affected by hiv in osh region of the kyrgyz republic funded by unicef · usaid dialogue on hiv and tb project funded by population services international as principal recipient of a grant from the united states agency for international development usaid · «» · ­ caap · ­ · · « » ­ psi ­ usaid 10 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 where we work 11

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tajikistan hiv situation population 7,595,000 4,100 9,100 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 officially registered hiv cases by december 2010 2010 · · «aids fonds» · « » ­ psi ­ usaid uzbekistan hiv situation population georgia hiv situation population all countries · technical support facility for eastern europe and central asia funded by unaids this project was managed from afew s russian office and expenditures are included under those for `russian federation · `the vienna express 2010 towards universal access funded by the netherlands ministry of health welfare and sport the netherlands ministry of foreign affairs hivos unaids unodc foundation open society institute ­ fosi expenditures were split between all afew countries · tsf · « 2010 » «hivos» « » afew 27,767,100 <1000 4,436,400 1,200 3,500 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 estimated hiv cases 2001 2001 estimated hiv cases 2009 2009 officially registered hiv cases by december 2010 2010 28,000 2,336 afew s in-country expenditure afew 283,992 in 2010 535,821 in 2009 283 992 2010 535 821 2009 projects · improving hiv-related medical and social services in uzbekistan funded by the european commission activities were suspended in july 2010 · access project hiv/aids and hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands activities were suspended and funding reallocated to other central asian countries expenses in uzbekistan in 2010 were half those in 2009 due to downsizing of the office and preparation for closure in 2011 project activities were suspended due to difficulties in re-registering the country office · 2010 · «» afew 2010 2009 2011 2,676 afew s in-country expenditure afew 1,514,720 in 2010 1,010,209 in 2009 1 514 720 2010 1 010 209 2009 afew s in-country expenditure afew 23,756 in 2010 0 in 2009 projects projects · access project hiv/aids and hiv/tb collaborative activities in central asia funded by the ministry of foreign affairs of the netherlands · enhancing access to hiv/aids prevention treatment care and support services for highly vulnerable groups in central asia funded by the uk department for international development and the world bank under caap · improving basic health systems in the khatlon and soghd provinces funded by the european commission · pamir against aids project hiv/aids prevention care project in gbao tajikistan funded by oxfam novib · strengthening the supportive environment and scaling-up prevention treatment and care to contain the hiv epidemic in the republic of tajikistan funded by undp · status of hiv and tuberculosis among prisoners in tajikistan funded by aids fonds · usaid dialogue on hiv and tb project funded by population services international as principal recipient of a grant from the united states agency for international development usaid · «» · ­ caap · · «oxfam novib» · strengthening and coordination of local nsas to address drug use and hiv prevention in the kakheti region georgia funded by public association bemoni as principal recipient of a grant from the european commission · «» cis interstate committee for statistics december 2010 except for georgia ­ national statistics office of georgia december 2010 and uzbekistan ­ the state statistics committee of the republic of uzbekistan december 2009 `report on the global aids epidemic unaids/who july 2010 national aids centres figures only reflect the numbers of officially registered cases and therefore underestimate the true infection rates 2010 ­ 2010 ­ 2010 ­ 2010 references 12 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 where we work 13

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snapshots of afew « » afew 1 2 3 4 5 6 7 8 the vienna express campaign took place in 11 countries public awareness event in moldova chisinau s dance team tb day in almaty kazakhstan vienna express in russia aids memorial day in tajikistan tb day in bishkek kyrgyzstan project rost training for social workers ukraine 1 2 3 4 5 6 7 8 « » 11 « » 6-8 1 hiv seminar for prisoners in st petersburg 2 homeless youth at a squat in kyiv 3 russian prison colony preparing for world aids day concert 4 vienna express photo booth aids2010 conference 5 writing messages for aids2010 kyiv 6 abandoned apartment kyiv 7 anke van dam afew programme director 8 participant of street youth project 1-2 3-5 1 2 «» 3 4 « » 2010 5 2010 6 7 afew 8 6-8 1-2 3-5 14 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 what we do 15

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our approaches participants of the project rost training in ukraine afew s mission is anchored on millennium development goal 6 which calls upon the global community to step up efforts to halt the spread of hiv and aids and achieve universal access to treatment for these conditions 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 afew ­ afew ­ ­ 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 16 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 our approaches 17

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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 handson 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 afew afew afew afew 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 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 18 programming meaning that each project activity comes with afew a clear strategy for its eventual handover to local authorities governments or civil society groups afew the people we reach injecting drug users afew expenditure on programmes for injecting drug users 921,607 in 2010 1,261,257 in 2009 at the core of afew s effort to reduce the exceptionally high level of hiv transmission among injecting drug users in eeca is the support for harm reduction and the set-up of national harm reduction networks these networks comprise afew training centres for professionals needle exchange points 921 607 2010 and provision of less harmful alternatives to injecting drugs 1 261 257 2009 afew prisoners afew expenditure on programmes for prisoners 3,054,029 in 2010 1,404,197 in 2009 afew works together with ministries of justice prison health experts inmates and local ngos to build local capac ity and ensure that prisoners have the same access to infor mation and services as those living outside prison walls this policy is in line with the internationally accepted principles afew 3 054 029 of the world health organisation who given the high rate 2010 1 404 197 2009 of injecting drug use in the prisons in the region this implies afew that afew also advocates for provision of needle exchange and opioid substitution therapy in prisons another major component of afew s prison work is the development of transitional client management to ensure continuity of care ­ for released prisoners a system has been developed that afew prepares prisoners for release and guides them to medical and social assistance outside of prison afew vulnerable women afew expenditure on programmes for vulnerable women 880,643 in 2010 1,444,231 in 2009 power and economic imbalances related to gender can increase the vulnerability of women this vulnerability com bined with stigma against female drug users and sex workers leave women with reduced access to harm reduction and drug treatment services women living with hiv also require separate attention if only because of the issue of prevention of mother-to-child transmission see below and child care afew activities for sex workers aim to create non-discriminatory 880 643 2010 1 444 231 2009 non-judgmental and user-friendly medical and psycho-social services including hiv prevention counselling and testing services people living with hiv afew expenditure on programmes for people living with hiv 942,305 in 2010 964,545 in 2009 ­ our approach aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 19

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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 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 mobilization and support of communities of people living with hiv prevention of mother-to-child transmission of hiv pmtct is tackled through a `familyoriented approach that links up women their children wider families and community groups of women living with hiv to existing/potential service providers afew 942 305 2010 964 545 2009 most-at-risk adolescents mara afew expenditure on «» ­ afew programmes for most-at-risk adolescents 260,636 in 2010 ­ 889,255 in 2009 through mass media campaigns and cultural events afew mobilizes 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 afew develops informational materials outreach programmes and peer training initiatives especially afew for young people living in high-risk circumstances activities 260 636 2010 889 255 2009 for street children focus on developing support systems for afew 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 afew governmental and non-governmental organisations national and international afew afew expenditure on programmes for international and na tional governmental and non-governmental organisations 889,618 in 2010 808,532 in 2009 as part of afew s sustainability strategy afew builds the capacity of local governmental and non-governmental partners afew provides technical support in order to equip staff with the right knowledge to provide hiv prevention treatment care and support that is up-to-date and of good quality afew for instance afew trains prison staff in hiv prevention and creates a resource centre and a pool of trainers to make such 889 618 2010 808 532 2009 a training programme sustainable organisational development comprises training in management skills administrative afew and financial skills monitoring and evaluation and fundraising these skills promote the sustainability of our partners and hence the sustainability of the approaches that we introduce afew we invite you to read more about afew s projects past and present on our website at www.afew.org 20 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 afew afew www.afew.org bishkek kyrgyzstan teenagers meet `living books ­ ngo staff medical staff and activists ­ to learn more about hiv and tb « » ­ our approach 21

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afew in focus /afew human rights advocacy `vienna express 2010 towards universal access « 2010 » 1 afew s executive director joost van der meer hands michel sidibe executive director of unaids messages collected from people in 11 countries 2 photo exhibition `life triumphs kirovograd ukraine 3 the documentary `balka covered the issue of women s access to antiretro-viral therapy in ukraine 4 afew s director of communications ilona van de braak gives an interview at the vienna conference 5 michel kazatchkine executive director of the global fund receives wishes 6 `vienna express street performance in latvia 7 volunteers from dance4life hold an event for international day against drug abuse and trafficking tiraspol trans-dniester 8 dance show during the vienna express tour of georgia 1-2 3-5 1 afew 2 « » 3 «» 4 5 6 7 dance4life 8 « » 6-8 once every two years the international aids society organises the world s biggest aids conference where scientists activists and policy-makers gather to share experiences and formulate policy on hiv and aids aids2010 aimed to focus on universal access in the context of broader global development goals the deadline for universal access to hiv prevention treatment care and support passed in 2010 and the conference took stock of the achievements and challenges regarding universal access with the conference slogan `rights here right now the conference also took a strong human rights perspective the event presented a precious opportunity for afew to draw the attention of the 25,000 conference delegates and global decision-makers to the rapid spread of hiv and poor access to hiv services in eeca afew took the initiative to launch a major international campaign `the vienna express 2010 towards universal access the campaign focused on injecting drug use as a driver of the epidemic in eeca and the need to increase access to services for injecting drug users and other marginalised populations together with our many partners and volunteers we held 28 public events in 11 countries of western europe eastern europe and central asia the event schedule was as diverse as the countries we visited including roundtables film evenings street campaigns rap concerts press conferences site visits for journalists and school seminars an online blog www.viennaexpress.org press and social media campaigns promoted the campaign along the route participants sent their messages for delegates of the aids2010 conference on special wish leaves tens of thousands of these leaves were eventually hung on the east-west wish tree at the conference and delivered to the heads of the global fund international aids society and unodc ias 2010 2010 « » afew 25 000 « 2010 » « » afew 28 11 « » www.viennaexpress.org « » « » «» « -» 2010 ias 22 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 afew in focus afew 23

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1 2 3 4 5 6 7 8 9 young volunteers in georgia open-air rap concert in dushanbe the 2nd all-russian conference `hiv in the mirror of the mass media film night in skopje s old bazaar in macedonia a press conference on the vienna express and hiv epidemic in ukraine was held in poltava the walking tour of dortmund in germany covered the history of hiv/aids and solidarity public campaign for youth and the general public in taldykorgan kazakhstan afew staff at the vienna conference matryoshka painting at afew s stand in vienna 4-6 1 2 3 4 5 6 7 8 9 1-3 « » « » ­ 8 afew 7-9 the bridge programme opening doors to life for prisoners in russia «» project the bridge transitional case management programme july 2010-december 2011 «» 2010 ­ 2011 in partnership with local non-governmental organisations and the federal penitentiary system of the russian federation locations republic of tatarstan krasnoyarsk region st petersburg nizhegorod region and tomsk region and tver region « under the project `stimulating an effective national response to hiv » 14 2004 ­ 31 2011 aids in the russian federation 14 august 2004 31 december 2011 funded by ­ the globus project donor the global fund to fight aids tuberculosis and malaria principal recipient ­ open health institute 18 for 18-year old roma the world around has presented only a series of firmly closed doors his mother and grandmother ­ died during his early adolescence ­ with no other relatives his family support was gone he found schoolwork difficult and dropped out ­ another door closed among his circle of friends drug use was an everyday occurrence roma is far easier to pick up off the streets than the powerful people who run the drugs trade and drive around the city in top of the range cars and so roma was arrested and sentenced to two years in prison ­ and so inevitably another door on society closed 24 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 the bridge programme 25

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prisoners in a russian penal colony participate in a world aids day concert the bridge project the bridge project is a programme of social medical focusing on hiv prevention treatment care and support and psychological assistance for prison inmates at the release stage this approach is called transitional case management and project bridge is the first of its kind in russia an inmate enrols on the programme 3 months before release and begins a series of individual and group sessions with a social worker focusing on family liaison living and work arrangements after prison and strategies for coping with medical issues like hiv drug use alcoholism etc that same social worker meets the inmate at the prison gates on his or her release and continues to support them for another 3 months this can involve partner rehabilitation centres legal services and counselling `when roma left prison last month he had absolutely no relatives or social connections on the outside he has no documents no passport containing a `propiska or permanent residence stamp which means he cannot prove his right to live in his apartment what is there for him he can only go back to prison somehow all the education and care needed to make him ready for life never happened nobody has ever bothered with him if our social worker lena had not met him at the prison gates he would either end up dead or back in prison `imena «+» is a local charity which works with people living with hiv and people at risk of hiv in st petersburg supported by afew s bridge project the small team opened a social bureau for former prisoners in a small back-room of a cultural centre on the outskirts of the city bureaus like this one play an irreplaceable and unique role in the lives of vulnerable people ­ a role that has no equivalent in the state services their success is based on trust and empathy with clients independent status and role as monitors of prison conditions today we are meeting the bureau s three social workers who are based partly at the bureau and partly in the prison colonies together with roma roma talks about the first months on the outside he is living in a rehabilitation centre where he gets clothing food and a bed for the night he has his first job at a warehouse stacking boxes his social worker «» «» ­ ­ «» ­ « » «+» ­ «» afew 27 26 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 the bridge programme /

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explains `at this stage we have to take him by the hand go places with him and stand up for him he has so many problems that trying to get out of them all at once on his own is impossible he couldn t get his passport and apartment stamp restored they just turned him away at the passport office lena went there the second time and presented herself as his social worker they started talking in a completely different way and now we know the next steps to getting his apartment back « » `grab their attention win their trust the meeting is warm and friendly more like an informal teaparty between friends there is no sense of a barrier or invisible line between the `professionals on the one side and `clients on the other to understand how unique this is one only need consider the world within a russian prison the prison population is largely housed in large colonies in which life is organised around regiments the prisoners go to the toilet in regiments wash in regiments work in regiments eat in regiments and go to sleep in regiments there is no personal space or privacy « » « ­ » «» «» «» «» « the ngo workers say that are often viewed as people who can be trusted and who will observe client confidentiality `they have ­ absolutely no trust in the authorities everyone even prison psychologists wear military uniforms with epaulettes on the shoulders inmates will never give information about themselves to someone in uniform because confidentiality is often breached but they see us as independent when we have our first sessions « with inmates they just want to talk and talk it s as if they have ?» ­ a mass of problems that have been getting deeper and deeper » for a very long time sometimes i can t stop them talking ­ it s like a dam has burst sometimes i meet inmates who have lived with hiv for several years and they say `they told me i have hiv i ll die soon so what s the point what do you want from me the first thing is to grab their attention and win their trust without that the information will not get through 2010 building pressure for universal access 15 000 30 4500 ­ the independent status of the ngo staff also places them in a position to monitor conditions in prison uncover cases of de nial of treatment and speak out on policy according to official estimates there were on average 15,000 people living in prison colonies in the st petersburg region in 2010 and just below 30 4,500 were living with hiv this is a very large hiv-positive population of a very large prison population ­ it is estimated one in four russian men will be incarcerated during their life-time revealing gaps in access to prevention treatment and care of infectious diseases is an important function of ngos in russia one 28 aidsfoundation ea s t we stannualreport 2 0 1 0 « » 2 0 1 0 partner ngo-worker explained the many ways that ngos can con « tribute to improving human rights observance in state services 28 `they are supposed to test inmates for hiv every 28 weeks but there are no resources laboratories equipment or nurses trained « to take blood from drug users some medical sections just say `why » do they need testing if they get positive results their mothers will start calling us so we take on this work ­ we test inmates take the samples to the laboratory and take them back to the colony the prison authorities fear to give real information to the ministry they just say everything is fine and everyone who needs it gets treatment we know that this is not true we know many -cases where people have died because they have been sent to the medical sections for treatment waited days or just been sent back without treatment we have to try and get through the layers of officials who are all pre-programmed to fulfil orders when they re asked on tv what « they plan to do about hiv they say things like `let s build reserva tions in siberia there s lots of space there that s the mentality » we come up against we place pressure on them we take part in international conferences radio shows tv programmes i am also a member of the commission on human rights for temporary detainees we prepare reports that go to legislators in the state duma » key results first 6 months july-december 2010 · 6 social bureaus for newly released prisoners were opened staffed and equipped · 1,914 prison inmates were trained in prevention of hiv and other infectious diseases · 724 newly released prisoners are clients of the bridge programme · 132,000 leaflets on hiv and harm reduction during drug use were distributed among prison inmates · 212 employees of the federal penitentiary service were trained in infectious disease control in prisons and hiv co-infections · almost 6 million roubles in small grants were provided to partners for staff salaries training events medical supplies and client support key contacts elena teneta senior project manager elena_teneta@afew.org irina krasheninnikova regional advisor irina_krasheninnikova@afew.org ­ 2010 · 6 · 1914 · 724 «» · 132 000 · 212 · elena_teneta@afew.org irina_krasheninnikova@afew.org 29 the bridge programme /

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