Advocates warn of escalating TB and HIV crisis in Eastern Europe and Central Asia if funding drops

07 November 2013 - Geneva - As the Global Fund’s 30th Board Meeting opens, health advocates have warned that projected reductions in funding for tuberculosis (TB) and HIV in Eastern Europe and Central Asia (EECA) could leave the region with rising rates of HIV and drug-resistant TB.

The report Bridging the Gap, released by RESULTS UK, ACTION, Global Health Advocates and the TB Europe Coalition, calls on the donor community to work collectively to address this challenge. The organizations call on the European Commission to scale up its contribution to the Global Fund to 450 million Euro for 2014-2016. They also call for the Global Fund to re-evaluate its eligibility criteria and to scale up resources for the EECA region, given its high burden of drug-resistant TB.

The Global Fund has been the largest and most important international donor for TB and HIV in Eastern Europe and Central Asia, the report says. To date, programmes financed by the Global Fund have found and treated more than 380 000 people with TB and at least 64 000 people living with HIV are currently receiving life-saving antiretroviral therapy.

However, under new eligibility criteria, the Global Fund is set to shift funding from middle-income to low-income countries. This will cut funding to Eastern European and Central Asian countries by half, the report says.

"A country’s income status does not reflect the number of people who are able to access health services, particularly among marginalized or vulnerable populations," said Aaron Oxley, Executive Director of RESULTS UK. "Donors expecting to gain ground against TB and HIV cannot ignore those who live in the greater European region."

The expected cuts have been met with concern from health workers in the region. "Romania is already struggling to manage its drug-resistant TB cases," said Jonathan Stillo, a medical anthropologist who has researched TB in Romania since 2006. "Currently, only 16 percent of patients with drug-resistant TB are successfully treated - one of the lowest rates in the world. A cut in funding from the Global Fund would certainly lead to an increase in transmission rates, not just in Romania but for the whole European region."

In a separate statement, organizations representing civil society and affected communities, have also expressed their concern about proposed changes to Global Fund policy regarding funding for middle-income countries, particularly those in the Eastern Europe and Central Asia, Latin America and Caribbean and Middle East and North Africa regions.