Montenegro

Fifth annual review of the programme for national response to HIV and timely diagnosing and treatment of AIDS in Montenegro: Significant progress achieved, additional efforts pending

Bečići, 17 – 20 October 2011

Further strengthening of multi-sectoral approach, building sustainable services with high quality personnel and investing special effort in the period to come in order to meet the targets set in the agreement with GFATM and successfully apply for the funds for the Phase II of the Round 9 Grant – those were the most important messages sent from the Fifth Annual Review Meeting that saw the participation of Montenegrin health sector representatives, UNDP, GFATM, media and NGO representatives.

These programmes have received the best mark (A1) from the donor, and as such have been recommended as a good practice example when compared to the regional practice.

The programme of the national response to HIV and timely diagnosing and treatment of AIDS in Montenegro is designed as multi-sectoral response involving various Ministries such as those of health, education, internal and foreign affairs etc. and is financially supported by the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM). In the Round 5 funding cycle GFATM provided grant in amount of 2.4 million Euro for programme “Support to implementation of the HIV/AIDS Strategy in Montenegro”; 1.3 million Euro for programme “Establishing and pursuing a high quality of Tuberculosis Control Programme in Montenegro” in Round 6; and in Round 9 grant in amount of 4.8 million Euro for programme “Scale up of the HIV response among most at risk populations in Montenegro”.

Dr. Miodrag Radunovic, Minister of Health of Montenegro, in his opening speech, pointed out that the available data show that HIV and TB are present in Montenegro, but that they are also kept under control. However, he also added that the diseases’ infective potential and social factors contributing to epidemics are calling for caution and requiring more time and efforts to be invested in the fight against the diseases. In his speech, the Minister placed a special focus on the fact that Montenegro, taking part in a global process of prevention, has been on a track to meet goals envisaged in this response.

First activities in the fight against HIV in Montenegro started in 1985. Although it started quite some time ago, the process gained a strong swing thanks to cooperation with the GFATM and UNDP. The first HIV/AIDS Strategy was formulated for the period 2005-2009 and in 2006 the first tranche of GFATM financial support occurred.

In 2006, the new National Plan for the area of TB prevention and suppression was adopted and it was aimed at providing an enhanced and more comprehensive monitoring of tuberculosis, improvement of diagnostics and treatment and proactive involvement of community.

Dr. Boban Mugosa, Director of the Institute for Public Health, presented achievements done so far in the abovementioned area. Comparing early activities that carried some weaknesses with what is being done in the present, he noted that a radical improvement has been achieved in terms of improving tools used in fight against the diseases. Surveillance system has been strengthened, diagnostics and monitoring of HIV status have been improved, outreach prevention programs among most-at-risk population established etc. In addition, a subject Healthy Lifestyles for primary schools has been introduced and now the work is being done to introduce this subject in high schools, as well. Also, laboratory services have been improved, protocols and guidelines for treatment have been prepared, medical staff goes through continuous education, Law against Discrimination is being implemented during daily work, and a network of counseling centres for those who feel discriminated  has been established. It was pointed out that the psychosocial work is still a weak component in the overall system while being necessary component in work with all the most-at-risk groups and especially with people living with HIV. In addition, huge efforts have been invested in the harm reduction programme and fight against stigma within the society. Fortunately, financial security for the period up to 2015 has been solved with the involvement of GFATM.

Rastislav Vrbensky, UN Resident Coordinator and UNDP Resident Representative, and Valery Chernyavskiy, GFATM Portfolio Manager for Montenegro, both pointed out good impressions about work being done in Montenegro in this field and also stressed a few specificities in the fight against the diseases. Mr. Vrbensky compared Montenegrin example with the one from Tajikistan, country of his previous post, and concluded with saying that malaria was considered to be the disease of the past, tuberculosis the disease of the present, while the HIV/AIDS was considered to be the disease of the future.

Mr.Chernyavskiy expressed his satisfaction with the obviously good collaboration of the governmental and civil society sector which resulted in high quality performance and measurable improvement in the HIV and TB prevention and treatment. He stressed the importance of capacity building of all the relevant actors in the HIV and TB response and creating the sustainable services independent of external financial support, meaning that most of the services should be built within the existing health and other systems.

It was noted that, when it comes to work in the field, the largest burden was carried by NGO sector and organizations such as CAZAS, JUVENTAS, ZAŠTITA, SOS PG and MONTEVITA, because they have been conducting a work with hard to reach populations (injecting drug users, men who have sex with men, sexual workers…). In this context, the importance of drop-in centres for the abovementioned populations and counseling centres for merchant marines was emphasized. NGOs working with these populations are crucial partners when conducting the bio-behavioral surveys as a most significant part of the HIV surveillance system.