The event 'Addressing HIV and TB Challenges: from Donor Support to Sustainable Health Systems'

has brought together representatives of the health and financial ministries of the EU, the Balkans and Eastern Partnership countries, representatives of the European Commission, the World Health Organization (WHO), among other international organizations, as well as community representatives and institutions involved in funding programs and offering services aimed at tackling HIV and TB, according to a Ministry of Social Affairs press release.

"The spread of HIV and TB continues to be a problem in Europe," said Minister of Health and Labour Jevgeni Ossinovski (SDE), who opened the meeting on Tuesday. "It is a great concern in Eastern European countries, where the situation is the most critical and the availability of treatment is among the worst in the world. In these countries, vital services to fight these diseases have often been built on donor support. With the aim to achieve sustainable and effective services, we now have to find ways to finance these services from state funding and integrate them into national health systems."

Ossinovski highlighted that Estonia has valuable experience to share with Eastern European countries. "When it comes to HIV services, we switched from the funding of foreign donors to state funding nearly ten years ago," he said. "We have reached a political agreement that this is a priority issue, and therefore we have steadily increased state funding. In the recently developed HIV action plan, we have set the ambitious goal of significantly reducing the number of new HIV infections in the coming years."

According to National Institute for Health Development (NIHD) director Annika Veimer, the main challenge lies in finding the most efficient way to prevent and treat HIV and TB without losing focus.

"Despite efforts, the number of new HIV infections has not significantly decreased in recent years, and in the European context, it is still very high," Veimer admitted. "The number of new TB cases is falling but there are still twice as many cases as in Nordic countries. Also, Estonia and the rest of the world are struggling with the spread of multi-drug-resistant TB. This field is extremely complex and various problems are intertwined. For example, one tenth of TB sufferers are also HIV-positive, and over half of them have problems coping in society. These are factors that we must take into account."

At the two-day meeting, being held in Tallinn in connection with the current Estonian presidency of the Council of the EU, participants will seek ways to transition smoothly from foreign aid program-based funding to sustainable state funding. Experts from Estonia and abroad will outline best practices, challenges, opportunities and risks related to integrating HIV and TB programs into a national health system. Discussions will also include the role and responsibility of various institutions and organizations in halting the HIV and TB epidemics.

In Eastern Europe, the fight against these diseases has been funded largely through international organizations, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Local HIV services in Estonia were likewise built up on funding from the Global Fund, including harm reduction services for drug addicts, which has proven pivotal in reducing the number of new cases of HIV. this kind of funding is not sustainable in the long term, however, and according to the ministry, the new challenge is a smooth transition to sustainable funding so as to ensure that the work of HIV and TB programs can continue after foreign aid ceases.

The two-day meeting of senior officials, which will include specialists from Estonia, Lithuania, the Netherlands, the U.K., Romania, Moldova, Serbia, Bulgaria, Montenegro, Ukraine and Russia, was organized by the Ministry of Social Affairs in cooperation with the NIHD, the WHO Regional Office for Europe, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Joint United Nations Programme on HIV/AIDS, and representatives of community organizations.