On October 6, the first meeting of working group on development of the “Transitional plan on state financing” was held in Yerevan. The working group includes the representatives of state agencies, international organizations, as well as representatives of civil sector and activists working in the field of combating HIV.
“Unfortunately, the group lacks the representatives of the Ministry of Finance of Armenia, which, undoubtedly, can slightly hinder the process of transition plan development. This process implies the direct participation of the state representatives, as they will be major implementers of the process, and the lack of the Ministry of Finance and expert opinions will obstruct the plan evaluation and development”, – notes the member of organization “Real world real people”, Armen Aghajanov.
It is expected that Armenia will pass on complete state financing of HIV/AIDS programs in 2022. By 2018, state expenditures on HIV will rise from $ 1.91 million to $ 2.1 million.
The experts note that Armenia takes commitment to fund HIV programs in circumstances when the government undertakes radical steps by navigating the country out of financial crisis. On the background of the extremely low level of GDP growth rate (2015 – 3.2%, 2016 – 0.2%), the Government of Armenia plans for the period 2017-2019 the decrease of both the absolute amount allocated on healthcare and GDP ratio. In 2017 the state costs on healthcare amount to 1.56% of GDP, in 2018 – 1.41% and in 2019 – 1.29%. Which is much less than average by region (5.6%), and is recommended for the countries with the average level of income at 6 %. Under such conditions, it is highly important not lose those services and activities that affect key groups of the population concerning HIV/AIDS. There is a substantial probability that state will readily “sacrifice” the politically unacceptable interventions.
“The transition of HIV and TB programs and services on state/local funding in the next period is a difficult/risky due to barriers of a different character. From the viewpoint of the transition strategy planning, it is evident that realistic prospects of change have legislative, regulatory and organizational obstacles that may be settled by adopting specific managerial solutions. However, the readiness for some managerial decisions depends on political, economic and cultural context. The setting change, in theory, can occur in the long term by changing knowledge, attitudes, and behavior”, – notes the member organization “Real world real people”, Armen Aghajanov.
As a result of consultations with representatives of civil society and communities of Armenia the report “Readiness of transition of HIV programs and services on state financing after completion of the Global Fund projects” was published. The document in particular notes that the biggest problem of transition is a low priority of services and programs for KAPs in the existing state policy on HIV and TB, expressed by the lack of state funding for services and programs currently covered by the project of the Global Fund and other donors.
The civil society considers the following key reasons for this issue:
- No way to contract NGO on service provision to vulnerable groups to PLHIV under budget funds (social contract).
- Stigma and discrimination of key groups, including LGBT people, PLHIV, and the lack of anti-discrimination legislative mechanisms to countermeasures this phenomenon.
- Barriers in access of key groups and PLHIV to the service cascade: testing, treatment, care, and support, as well as provision of antiretroviral therapy (ART) follo wing the latest WHO recommendations to treat all.