The Ministry of Health has submitted to Seimas of the Republic of Lithuania for consideration and adoption of HIV / AIDS and Sexually Transmitted Infections Prevention and Control Action Plan for 2015-2017. Comments and proposals may be submitted by institutions and the public concerned by 2 of June 2015.
Unfortunately, some of the non-governmental organizations see the lack of attention to people with HIV, the clarity regarding the implementation of the measures and financing in the Action Plan. In their view, the project is only partially in line with the needs of some of the vulnerable groups and HIV-infected people. Representatives of the Ministry of Health have promised to carefully consider and evaluate the proposals of all NGOs.
Instead of the Program - Just the Action Plan
Head of the Association „Positive Life“ Mr Jurgis Andriuška notes that the above-mentioned Action Plan emerged instead of the awaited HIV and other sexually transmitted diseases (STD) program which would provide a clear national strategy on these issues.
"Seems that there will be no national HIV and STD program but only the plan of measures for which no guaranteed state funding is foreseen. Moreover, this plan is not based on financial indicators and lacks of concreteness, and without the concreteness this plan reminds just a collection of empty phrases and, therefore, may remain unfulfilled", - such the opinion was expressed by Mr J. Andriuška.
On the other hand, even in the absence of the program or action plan the HIV / AIDS treatment, diagnosis, epidemiological surveillance and control would be carried out as it is regulated now by the earlier ministerial orders and the Schedulle of procedures for HIV / AIDS treatment.
"So why to waste so much time and use the human resources to create no effective mechanism to effectively curb the spread of HIV in Lithuania and thus to reduce the costs for the treatment of new patients in the future?" – the head of the organization unifying HIV / AIDS patients asks.
Would Strengthen What Does Not Exist Yet?
The association is concerned that this draft action plan, as the previous ones, absolutely does not address the problems faced by HIV-infected patients. There are no measures to help keeping the infected in the HIV treatment system and increasing their motivation to start and continue anti-retroviral treatment the interruption of which increases the occurance of drug-resistant HIV strains.
Mr J. Andriuška observes that only one measure of HIV / AIDS and Sexually Transmitted Infections Prevention and Control Action Plan for 2015-2017 is asigned for HIV-infected persons: „03.13. To strengthen mutual assistance among HIV patients in order to motivate them to begin antiretroviral treatment of HIV infection in timely manner and to comply with the regime of the treatment of HIV infection and to continue antiretroviral therapy.“ This measure has originated from the association‘s proposal but has been interpreted very differently.
However, services that are intended to be strengthened - Mr Andriuška notes - currently are not provided in Lithuania and there were no state funding allocated for this purpose. It is necessary to ensure the availability of the complex services - counseling, social assistance, prophylaxis and provision of information tools – for people infected with HIV, no matter which social group they belong to. Such services are foreseen in the draft Action Plan only for injection drug users.
"If HIV / AIDS patient stops using drugs, this means that he no longer receives the services which are available for a drug user?" - the head of the association draws the attention to the queer situation.
Proposes the Inclusion of a Specific Item
The Association „Positive Life“ and the Support Fund „RIGRA“ have proposed to include a specific measure in the Action Plan - to provide low-threshold advisory and social services to HIV-infected people and their relatives in five municipalities which offer specialized health services (Kaunas, Klaipeda, Vilnius, Siauliai, Panevezys); to provide safety and harm reduction measures, information materials for the HIV infected attending healthcare cabinets, according to their needs, to mediate between patients, doctors and other specialists, institutions and organizations in solving the problems caused by HIV.
If this measure is to be implemented, it would allow to increase the patient's control and awareness, to prevent situations due to which the occurance of drug-resistant HIV strains could increase. It would allow to improve the psychosocial situation, the quality of life and physical and psychological condition of people with HIV, as well as their integration into the society and the labor market.
„All Proposals Will Be Carefully Considered“
Chief specialist Mr Karolis Lebednikas of Epidemiological Surveillance Division, Ministry of Health of the Republic of Lithiuania, answers the VLMEDICINA.LT questions
The HIV / AIDS and Sexually Transmitted Infections Prevention and Control Action Plan for 2015-2017 prepared by you provides the strengthening of the HIV / AIDS patients‘ counseling. But there is no mechanism on how the counseling would be strengthened. How is it going to be financed? If there are no related provisions, how we might expect these plans would not remain only empty phrases?
The measure, aimed at strengthening mutual assistance among HIV patients in order to motivate them to begin antiretroviral treatment of HIV infection in timely manner and to comply with the regime of the treatment of HIV infection and to continue antiretroviral therapy, was included in the HIV / AIDS and Sexually Transmitted Infections Prevention and Control Action Plan for 2015-2017 (hereinafter - the Draft Action Plan) with regard to proposals of non-governmental organizations which would be the main implementers of this measure. Infectious Diseases and AIDS Centre is appointed as a coordinator of this measure, which according to its competence coordinates and methodically leads the activities of health care institutions in the field of infectious diseases epidemiological surveillance and HIV epidemiological monitoring, organizes and carries out non-formal education. The Draft Action Plan‘s measures will be implemented by the relevant authorities using their allocated total appropriations as well as funds received under other legislative acts. We would like to emphasize that more than 3 million Eur is allocated annually for HIV / AIDS prevention and treatment sphere exclusively by the Ministry of Health and the Compulsory Health Insurance Fund budget.
The Association „Positive Life“ proposes including a specific item in the plan - to provide low-threshold advisory and social services to HIV-infected people and their relatives in five municipalities; to provide safety and harm reduction measures, information materials for the HIV infected attending healthcare cabinets, according to their needs, to mediate between patients, doctors and other specialists, institutions and organizations. Will this proposal be taken into account?
All proposals received during the consultation procedure are very valuable and will be carefully considered after all proposals or comments of institutions concerned are received. The proposal of the association "Positive Life“ will be assessed respectively. However, we would like to point out that envisaged measures in the Draft Action Plan can not duplicate already adopted and implemented measures in other strategic documents. Curently, implementing the National Drug Control and Drug Prevention Programme 2010-2016, adopted by Seimas resolution No. XI-1078 on 4 November 2010, the National Drug, Tobac and Alcohol Prevention Interinstitutional Action Plan is approved according to which more than 42 thousand Eur from the national budget is allocated annually to low-threshold services. Funding is given to projects submitted by services providers and for centralized purchase of required low-threshold services.
The Ministry of Health highly appreciates the work of NGOs on HIV / AIDS issues. We hope that the cooperation and partnership of institions and social partners, including non-governmental organizations, envisaged in the Draft Action Plan will contribute to the continuity and strengthening of HIV / AIDS response in Lithuania.