Bringing hope to people infected with HIV/AIDS

Sergei R., 25, is optimistic about his future. He is back at work after counseling and treatment by highly trained doctors.

Living with AIDS for many years, Sergei has received free treatment and medicine under a government program financed primarily by the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM).

 The program, which is considered best practice in the Eastern Europe and Central Asia region, has helped change things for the better.

“Four or five years ago, I had to go to neighboring countries to buy medicines because they weren't imported into Moldova," recalls Igor Kilcevski, who has lived with AIDS for nine years and is the chairman of Credinta, a Moldovan association that protects people living with AIDS and helps integrate them into society.
 
"Most people living with AIDS are poor and couldn't afford proper treatment. Besides, tests were done manually, and mistakes were often made. We despaired and thought we didn't stand a chance of prolonging our lives,” he explains.

Curbing one of the fastest growing epidemics in the region

In the 1990s, the incidence of HIV/AIDS in Moldova was one of the highest in the Commonwealth of Independent States. Cases of HIV infection rose from 0.2 per 100,000 people in 1995 to 4.5 in 2002, while those among injecting drug users grew from 0.05 per 100,000 to 0.5. The incidence of TB also soared by 98 percent over twelve years.
 
Many factors drove these epidemics, including outdated lab and hospital equipment, a shortage of medicines, and a scarcity of trained doctors. Groups at risk lacked access to condoms, clean needles, and other forms of protection. National programs adopted in 2001 to prevent and control these diseases stalled, either because of a shortage of funds or sporadic funding.

World Bank assists Moldova's Government

In 2001, Moldova asked the World Bank for help in preventing the spread of HIV/AIDS and TB. The country also requested assistance to improve the treatment and care of persons living with HIV/AIDS and to strengthen its institutional capacity to respond to these epidemics.
 
Financing for the Republic of Moldova’s TB/AIDS/STI program now totals $21.4 million, with $5.5 million from an International Development Association grant and $11.7 million from the Global Fund to Fight AIDS, TB and Malaria.  The remaining financial support comes from USAID and the government.

Benefits from the program are clearly visible. New testing equipment and medicines have been purchased, working conditions for doctors improved, and staff trained. Some doctors have received training in the United States and Romania.

Providing care to HIV patients, and preventing mother-to-child transmission

The Bank-funded project involves partnering with NGOs in Moldova.

With financing from the IDA Grant, the Soros Foundation of Moldova (SFM) manages HIV/AIDS prevention activities among vulnerable groups through a network of 30 NGOs. These activities reach roughly 18,500 clients. Prevention activities include needle exchange programs in six prisons; addressing the needs of commercial sex workers, the gay/lesbian/transsexual community, truck drivers, migrants, and street children; and providing home-based care.
 
Credinta is one of the NGOs active in the AIDS Control Project. “Our goal is to restore hope to people living with AIDS so that they can live longer and be useful to society,” explains Mr. Kilcevski.

Eighty percent of Credinta’s members are HIV positive. One of their aims is to inform people living with HIV/AIDS about their rights. They also advocate for care and free access to drug rehabilitation centers for those who need it.

Active campaigns prevent spread among young people

Adolescents and young people who are out of school are especially at risk. It is essential to inform them about HIV/AIDS through well-targeted education and communication campaigns. 

The Ministry of Health supports the activities of youth-friendly health centers.

Community-based youth centers are now offering sex education, life skills, and cultural programs to young people in after-school settings.

In addition, the Moldovan Network of NGOs in the Social Field is actively contributing to the government’s policy plans related to youth, poverty reduction, and development. One of the network’s members, the Association of Youth for the Right to Live, runs the country’s only hotline for people with concerns about HIV, drug use, and sexually transmitted infections.

Another program, Community for a Healthy Life, works with the Orthodox Church on health information outreach to young people. It promotes abstinence through adherence to faith.  Community for a Healthy Life has benefited recently from a small grant extended through a World Bank program that supports grassroots NGOs.
 
"I tell people that Moldova was lucky to receive help from the GFATM and the World Bank. Although there is still much to be done, this is our chance," says Mr. Kilcevski.

View additional information and documents related to Moldova's TB/AIDS Control Project.