Moldova’s early actions to fight HIV/AIDS and tuberculosis are slowing the rise of the country’s dual tuberculosis and AIDS epidemics, the World Bank reports.
While the overall prevalence of HIV continues to increase, its spread among injecting drug users has slowed, thanks to educational and ‘harm reduction’ activities being carried out as part of a nationwide program supported by donors and the government. The sharing of dirty needles and unprotected sex are the two main ways the virus is spread.
Moldova’s overall HIV prevalence rate continues to increase; however, the proportion of injecting drug users among newly detected HIV cases decreased from about 80% in 2000 to less than 55% in 2003. Incidence of HIV cases among injecting drug users fell from 29% in November 2001 to 22% in December 2003. This drop partly reflects the effectiveness of educational and ‘harm reduction’ activities (such as provision of clean needles) in this group.
The National Program for Tuberculosis/AIDS control project is expected to lower the incidence of HIV/AIDS from 4.66 per 100,000 people in 2002 to 4.00 in 2006 and decrease the number of new, active TB infection cases from 83.6 per 100,000 people in 2002 to 64.3 in 2006.
The program is the first nationwide TB & AIDS project in an former Soviet Union country where antiretroviral drugs are being offered free of charge; it is the first state-run program to deliver prevention, treatment and care in prisons; and it is an example of concerted donor coordination by the World Bank, the Global Fund to Fight TB, AIDS, and Malaria as well as USAID and others.
The World Bank is contributing $5.5 million in grant funding through the International Development Association (IDA) toward the National Program for TB/AIDS control and is helping carry out treatment, care and prevention activities. The IDA funding was approved in June 2003.
Financing for the Republic of Moldova’s TB/AIDS/STI program now totals $14.7 million, with $5.5 million from IDA for the AIDS project and $5.2 million from the Global Fund to Fight AIDS, TB and Malaria. Remaining financial support is coming from USAID and the government itself.
A comprehensive HIV/AIDS control program is now in place, with vulnerable groups such as commercial sex workers, prisoners and young people who inject drugs receiving prevention, treatment and care.
Soros Foundation Moldova is managing HIV/AIDS prevention activities among vulnerable groups. About 11,000 clients are served by 28 NGO subprojects. About 90% of the harm reduction subproject clients are injecting drug users (IDUs) who are especially at risk. There are activities targeted at men having sex with men, commercial sex workers and Roma populations.