ACTIVITY DATES: May 2006 - August 2009

IMPLEMENTING PARTNERS: UNAIDS

REGION(S): Moscow, Orenburgskaya oblast, St. Petersburg

PROJECT DESCRIPTION:

The project aims to expand the institutional capacity and political leadership of government and civil society partners to strengthen the application of the Three Ones Principles in Russia. The Three Ones Principles tie together strategic support to high-level policy development at the federal government level with institutional capacity strengthening for civil society organizations that play a critical role as service providers in the regions. The project has a strong focus on developing monitoring and evaluation (M&E) and strategic information management systems that connect national and regional stakeholders to improve decision making processes relating to the response to AIDS at all levels.

KEY ACHIEVEMENTS:

In 2007, UNAIDS provided expert advice to the Government of Russia on the development of the National AIDS Concept and supported a working group that developed updated regulations for improving diagnosis, treatment, and epidemiological and behavioral surveillance. UNAIDS organized a number of roundtables to review implementation of the National Project, and continued to build the capacity of civil society and people living with HIV/AIDS (PLWHA) through training and policy discussions with government.

In the two PEPFAR target regions of St. Petersburg and Orenburg Oblast, assessments of M&E activities were carried out and regional M&E workshops were convened to discuss gaps in existing data collection methods and develop strategies for better reporting.

A national conference on prevention of HIV/AIDS was conducted in February 2009.  The focus of the conference was on best practices and outcomes of prevention activities in Russia, including programs addressing most-at-risk populations.  UNAIDS provides technical support to the Russian Government's analytical M&E unit on the collection and analysis of HIV data for UNGASS reporting. UNAIDS also provided technical assistance on the establishment of the National HIV accounts monitoring system, which will allow Russia to estimate overall expenditures for HIV/AIDS programs.

ACTIVITY DATES: September 2002 - September 2009

IMPLEMENTING PARTNERS: Johns Hopkins University, Healthy Russia Foundation

REGION(S): Irkutskaya oblast, Ivanovskaya oblast, Orenburgskaya oblast, Sakhalinskaya oblast, St. Petersburg, Stavropolskiy kray

PROJECT DESCRIPTION:

This program promotes HIV/AIDS prevention, reproductive health, and substance abuse prevention among vulnerable populations, including youth.  The program promotes increased access to and use of counseling and testing services for HIV and the use of modern hormonal contraception, with a target on youth reproductive health.  Another component is a healthy lifestyles program for youth that targets vulnerable young people (aged 13-19) to prevent substance abuse, smoking, unwanted pregnancy, sexually-transmitted infections, and to encourage proper diet and exercise.  

JHU and the Healthy Russia Foundation collaborate closely with regional government counterparts, health care institutes, universities and NGOs, such as Healthy Future and the Bureau Against Drugs, to implement programs in St. Petersburg, Orenburg, Irkutsk, Sakhalin and Ivanovo Oblasts.  The Healthy Russia Foundation's healthy lifestyles program for youth in Nevinnomysk (Stavropol Krai) is supported by a Global Development Alliance partnership between Eurochem and USAID/Russia.

KEY ACHIEVEMENTS:

In 2007 alone, over 22,000 youth in Orenburg Oblast were reached with HIV prevention messages through peer education activities. 

Training on counseling and testing for HIV was integrated into continuing education programs at key medical academies in St. Petersburg and Orenburg.  Materials on HIV communication and counseling for health care providers that were developed under the program were approved for use by the Federal AIDS Center.

Over 25,000 women and men in target regions were reached with family planning and reproductive health messages through the program's "Couples Campaign." 

Comprehensive healthy lifestyles programs for youth were launched in Irkutsk and Sakhalin, and will be launched in Ivanovo in autumn 2008.  The healthy lifestyle materials - including a manual, an educational DVD, a CD with the video's soundtrack, and an accompanying guide - were approved by the Russian Ministry of Education.

ACTIVITY DATES: August 2006 - September 2010

IMPLEMENTING PARTNERS: International Research and Exchanges Board (IREX), SANAM Foundation

REGION(S): Moscow, Orenburgskaya oblast

PROJECT DESCRIPTION:
The SANAM Foundation works to prevent the spread of HIV among vulnerable populations, including sex workers, through outreach to at-risk populations and better diagnosis and treatment for sexually transmitted infections (STIs).  Using SANAM's Moscow clinic as a resource center, the project aims to improve the access of vulnerable populations to HIV services in the PEPFAR target region of Orenburg by training health care providers on how to work with vulnerable populations.  SANAM is also partnering with a regional health facility to establish low-threshold services in Orenburg.

KEY ACHIEVEMENTS:

The non-profit SANAM Foundation was created and registered at the launch of the project.  Since then, over 7,000 sex workers have been reached with HIV prevention messages and 1,500 sex workers have received STI and HIV diagnosis, counseling and support services at the SANAM clinic. 

SANAM's Moscow clinic provided technical assistance to the Orenburg Regional Dermatological/Venereal Health Center to establish low-threshold services for vulnerable populations.  The clinic also conducted trainings for health care providers in St. Petersburg and Orenburg on effective outreach among most-at-risk populations, counseling and service provision, and monitoring and evaluation. 

IREX is providing financial management and organizational capacity building support to strengthen the institutional development of the SANAM Foundation.

ACTIVITY DATES: May 2006 - October 2009

IMPLEMENTING PARTNERS: Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria

REGION(S): Moscow, Orenburgskaya oblast, St. Petersburg

PROJECT DESCRIPTION:

This project promotes policy dialogue, advocacy, and information for Russian policymakers on the state of Russia's HIV/AIDS epidemic and best practices in prevention, care and surveillance. Advocacy and information activities also focus on the impact of current AIDS-related policy and legislation on service delivery, prevention, treatment, human rights, privacy, stigma and care for people living with HIV/AIDS (PLWHA).

The Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria (GBC) also mobilizes policy leaders and senior officials on the federal and regional levels in the fight against HIV/AIDS by facilitating their participation in HIV/AIDS awareness activities and empowering the Russian Parliamentary Working Group on HIV/AIDS.

The project creates a platform for the broad participation of civil society in HIV-related policy formulation and raises social awareness about HIV/AIDS through the media to help reduce stigma.
GBC supports the development of HIV/AIDS non-discrimination policies in the workplace, with an emphasis on workplace education and prevention programs for HIV/AIDS, alcohol and substance abuse.

KEY ACHIEVEMENTS:

Policy briefs were developed and presented to federal and regional policy makers and the Parliamentary Working Group on HIV/AIDS on the following issues: the HIV/AIDS epidemic in Russia and measures, including funding measures, to avert its further spread; prevention and treatment of HIV infection among most-at-risk populations; and HIV/AIDS in Orenburg, Saint Petersburg and Samara.

In 2009, GBC supported two meetings of the Parliamentary Working group with government officials and representatives of the NGO community.  Two important resolutions were adopted on the importance of HIV/AIDS education for policy makers and on the need to continue HIV prevention activities among most-at-risk populations under the National Priority Project.

GBC reached over 100 new employees through its Health@Work seminars.  A new module on alcohol and substance abuse prevention was developed and presented to companies.  In Orenburg, GBC and the Orenburg Branch of the Union of Industrialists and Entrepreneurs conducted an HIV/substance abuse-related survey of local companies, which was presented at the regional level.

In 2008-2009, GBC facilitated the creation of a national association of Business for a Healthy Society, which includes both Russian and international companies.  A survey of 150 Russian companies was conducted by the Russian Association of Managers with GBC's assistance, and the results were presented at a meeting of the Business for a Healthy Society association.

In Orenburg, GBC developed a partnership with TNK/BP and Gazprom. Both projects are aimed at substance abuse and HIV prevention policies and capacity building in local companies.

The Russian Media Partnership leveraged $54 million of in-kind contributions from 40 media companies to support an HIV awareness media campaign. 

ACTIVITY DATES: August 2006 - August 2009

IMPLEMENTING PARTNERS: World Vision

REGION(S): Orenburgskaya oblast, St. Petersburg

PROJECT DESCRIPTION:
This project is implementing a comprehensive sensitization, empowerment, mobilization and capacity building strategy for faith-based organizations (FBO) in St. Petersburg and Orenburg Oblast.  The project encourages FBO clergy and laity leaders to act as agents of transformation and supports the Russian Orthodox Church, which recently released a concept paper describing their commitment to engage in the struggle against HIV/AIDS, as an agent of social activism.  A strong emphasis is placed on promoting positive behavior among youth through the message that abstinence and fidelity are the primary means of reducing HIV/AIDS risk and vulnerability among children and youth.

KEY ACHIEVEMENTS:

In 2006-2009, World Vision (WV) reached out to local churches/FBOs, local governments and other NGOs in Orenburg and St. Petersburg.  Two WV methodologies-Channeling Hope and Abstinence and Risk Avoidance for Youth-were adapted to the Orthodox Christian context for use in training activities.

WV mobilized 12 faith leaders and active congregation members in Orenburg and in St. Petersburg to be directly involved in the Channeling Hope project, and 12 social workers were trained to team with the mobilized faithful in project implementation.  About 46 trainings were conducted for about 700 participants on mobilization and sensitization, planning the future, and combating HIV with faith.  WV also organized exchange visits of priests and NGO representatives between project sites, as well as mentoring and other forms of technical assistance.

Twelve Responsible Youth Centers (RYCs), each consisting of one faith leader/active congregation member and one social worker, were established.  About 2,100 youth aged 15-19 have been reached with Abstinence/Be Faithful HIV prevention programs during a three-month curriculum.  An HIV/AIDS prevention newspaper was launched and is distributed among NGOs, congregations, FBOs, and other organizations.

World Vision organized 7 youth forums, several poster and essay contests, 2 brain rings, and 12 round tables for youth and priests. In February 2008, a conference of priests and religious activists from project sites, as well as from other regions and countries, held a 2-day lessons learned conference in St. Petersburg.  Conference participants discussed the HIV Abstinence and Risk Reduction methodology, issues of stigma, and the participation of the Russian Orthodox Church in social programs.

ACTIVITY DATES: September 1998 - September 2008

IMPLEMENTING PARTNERS: American International Health Alliance (AIHA)

REGION(S): Moscow, Orenburgskaya oblast, St. Petersburg, Saratovskaya oblast

PROJECT DESCRIPTION:

This partnership program includes several distinct components:

•  Collaboration on curriculum development and training with the Russian Ministry of Health and the AIDS Training and Education Center;
• Two regional HIV/AIDS treatment and care partnerships - the St. Petersburg AIDS Center with Yale University (New Haven, CT) and the Orenburg AIDS Center with Mt. Sinai Hospital (New York City, NY);
• The Volga River Alliance with the AIDS Healthcare Foundation (AHF) in Saratov and Togliatti; and
• A Global Development Alliance with GlaxoSmithKline (Moscow).

KEY ACHIEVEMENTS:

AIHA and its partners trained over 1800 specialists on HIV treatment, care and support topics during 2007.  AIHA worked closely with the Russian Ministry of Health and Social Development to develop a new curriculum on HIV treatment and care. Eight modules-including anti-retroviral therapy (ART) for adults-were developed or adapted by AIHA.  In summer 2007, the Ministry approved the curriculum and distributed it to all postgraduate medical schools in Russia.  

AIHA worked with the St. Petersburg Medical Academy to open an AIDS Training and Education Center (ATEC).  This facility is providing critical training for medical providers across Russia on HIV/AIDS care and treatment. 

• ATEC received a grant from the Global Fund to Fight Tuberculosis, Malaria and HIV/AIDS to implement ART curricula in 12 Russian regions. By fall 2007, ATEC had trained 360 professionals, including 41 medical school professors as trainers, and a total of 8,734 HIV-infected patients benefited from improved provider skills at 18 sites across 15 Russian regions.
• In Jan 2007, ATEC conducted regional trainings on preventing mother-to-child transmission of HIV (PMTCT) for almost 200 medical school professors. ATEC used the U.S. Center for Disease Control/World Health Organization generic training package, which was adapted for Russia by AIHA, and received support for the trainings from the Government of Russia's National Priority Project.

In Orenburg and St. Petersburg, institutional strategies for adherence to anti-retroviral therapy (ART) as part of HIV treatment were developed that include some key elements from U.S. adherence program models. New York's Mt. Sinai Hospital works with the Orenburg AIDS Center, while Yale University partners with the one in Saint Petersburg. AIHA also hosted palliative care discussions in both regions, and trained 40 professionals in regional case management of PLWHA.  The U.S. partners from Providence, Rod Island, offered mentoring in the organization of social support for PLWHA. 

From October 2006 to September 2007, AIHA leveraged support from the AIDS Healthcare Foundation to implement the Volga River Alliance.  Under this initiative, 24 facilities in Togliatti and Saratov participated with a total of 77 specialists trained on ART and opportunistic infection management, including on-site mentoring.

A Global Development Alliance with GlaxoSmithKline was launched in fall 2007 that trained 18 regional clinicians to become expert "champions" in ART treatment and care.

ACTIVITY DATES: March 2004 - September 2010

IMPLEMENTING PARTNERS: University Research Co. (Health Care Improvement Project)

REGION(S): Orenburgskaya oblast, Samarskaya oblast, Saratovskaya oblast, St. Petersburg

PROJECT DESCRIPTION:

The Health Care Improvement Project conducted an analysis of the system of care delivery for people living with HIV/AIDS (PLWHA) through which more than 400 health care and social service providers analyzed their own systems. 

The priority areas identified for improvement form the basis of this project:

• Access to health and social services and retention of patients in the system
• Clinical patient management and antiretroviral treatment
• Care coordination and referrals
• Detection and treatment of TB/HIV co-infection

KEY ACHIEVEMENTS:

In June 2005, local providers designed a system to refer patients and exchange treatment and care information.  As a result, the following improvements occurred during 2005-2006:

• The turn around time for HIV test results was reduced from 14 to 4 days.
• Training on Voluntary Testing and Counseling was institutionalized for local care providers.
• The numbers of patients receiving pre-test counseling increased.
• The system for referrals and communication among health facilities was reorganized to ensure patient confidentiality and encourage rentention of patients in the system.
• Case management functions were adapted and integrated into health and social services;
• Polyclinics designed a system for patient follow-up and screening for TB.
• The number of PLWHA tested for TB increased by 30 percent.

Since 2007, the project has supported the St. Petersburg and Orenburg Health Care Committees' initiatives in scaling up these successful practices throughout their regions.  These efforts are in line with National Health Project objectives to:

• increase the coverage of PLWHA regarding medical follow up and antiretroviral treatment;
• decrease the incidence of TB and mortality from TB among PLWH; and
• improve the competence of primary care providers at polyclinics in the area of HIV infection and clinical patient management.

During the first year of the scale-up effort, the number of newly diagnosed HIV+ patients in St. Petersburg that received regular medical examinations increased from 51% to 75 percent.  The health authorities also adopted a policy to shift follow-up medical care from AIDS Centers to infectious disease specialists and nurses at municipal polyclinics.  This decentralization helped increase access to medical treatment and care.

ACTIVITY DATES: September 2005 - March 2010

IMPLEMENTING PARTNERS: PSI

REGION(S): Orenburgskaya oblast, St. Petersburg

PROJECT DESCRIPTION:

To prevent the spread of HIV in Russia, PreventAIDS works closely with local NGOs and governments in St. Petersburg and Orenburg to: 1) reduce high-risk behaviors and increase awareness of HIV/AIDS among risk groups; 2) improve communication and coordination between governments and NGOs, reinforcing referral systems to improve access for target populations to services; and 3) develop and implement replicable HIV prevention services. 

Russia's epidemic is driven largely by injecting drug use, so HIV prevention is targeted to most-at-risk populations (MARPS)-injecting drug users (IDUs), sex workers and their partners, and vulnerable youth.  The project uses a range of interventions, including street and venue-based outreach, hotlines, referrals, counseling, peer education and training, and informational materials.  Special emphasis is placed on improving the access of MARPS to health-and social care services, through a referral network, to coordinate the provision of services between government and NGO providers, and the introduction of individualized Case Management (CM), to bring together prevention, treatment and care services for most at-risk clients.

KEY ACHIEVEMENTS:

The program has reached 33,000 core transmitters (injecting drug users and sex workers) and nearly 30,000 individuals at-risk (clients of sex workers, partners and relatives of IDUs, vulnerable youth).  Approximately 750 health and social service providers have been trained and over 80 workshops and conferences have been conducted between government and NGO service providers.  More than 20 NGOs received HIV-related capacity building assistance and over 170 governmental institutions participated in Referral Network activity.

The Peer-Driven Intervention (PDI) approach was piloted among IDUs in both target regions, allowing for deeper penetration into IDU communities, higher coverage of IDUs, and increased access to new users (those using drugs for less than one year).  Three youth training prevention centers were created in St. Petersburg, in cooperation with youth consultations and the city administration.  Substance abuse prevention activities targeted at vulnerable youth were launched in Gatchina, an economically-depressed suburb of St. Petersburg. 

Four case management projects for MARPs were established in St. Petersburg, Orenburg and Orsk.  Since their inception, more than 3,500 target individuals received services.  In four regions, PSI has been working on the integration of family planning/reproductive health services and HIV prevention services targeted at MARPS, particularly sex workers.  NGOs and government service providers have strengthened their collaboration to provide a package of services to people in need.

ACTIVITY DATES: July 2004 - September 2010

IMPLEMENTING PARTNERS: HealthRight International

REGION(S): St. Petersburg

PROJECT DESCRIPTION:

Through this project, HealthRight International (formerly Doctors of the World) is working with the St. Petersburg City Government and local NGOs to develop medico-socio-psychological services for street and neglected children and youth, including those who are HIV-positive, to facilitate their rehabilitation and their transition from living on the street to living with a family or independently as an adult.  The project supports outreach activities, drop-in centers and shelters, crisis wards, and a half-way house, as well as youth vocational training and employment activities, a foster parent program, and a school for volunteers.

KEY ACHIEVEMENTS:

Over 5,000 clients have been served since the inception of the project, with 720 children returning to their families and 153 children placed in foster care. In addition, 62 young people have received job training and 29 have found stable employment.     

The first municipal emergency center for HIV-positive children and youth was established at the social welfare center of Frunzenky District and served 645 clients.  Another 45 adolescents became residents of the first half-way house, opened in partnership with the Kalinisky District Administration.  A training module for foster parents of HIV-positive children was introduced into the curriculum of the School for Foster Parents.  In addition, a halfway house for HIV+ youth with drug-use problems has been opened.

A Unified Family Assessment Protocol was developed for the Social Protection Committee of St. Petersburg to conduct risk assessments of children in crisis families and to determine appropriate family interventions or criteria for placement in a shelter or foster care.  A pilot training program was developed to strengthen the professional capacity of 400 specialists from municipal social care facilities in Kalinisky District and 125 social workers in local NGOs.

The second international conference of services providers was conducted in March, 2009 to share best practices and lessons learned in support for homeless and neglected children.

ACTIVITY DATES: October 2007 - October 2010

IMPLEMENTING PARTNERS: American International Health Alliance (AIHA)

REGION(S): Irkutskaya oblast, Moscow, Orenburgskaya oblast, St. Petersburg

PROJECT DESCRIPTION:

This partnership initiative, which is part of the 2005 Bratislava Presidential HIV/AIDS Initiative, consists of two main components:

• Third Country Capacity Building: the short-term deployment of Russian health professionals, primarily laboratory specialists, to third countries to provide technical assistance to strengthen the capacity of laboratory services to address HIV/AIDS, TB and other infectious diseases, and
• Strengthening Russian Medical Educational Institutions: the development of training capacity in HIV/AIDS and other infectious disease in Russia through improved training curricula and the establishment of AIDS Training and Education Centers (ATECs) at regional sites in Russia. These regional ATECs can also serve as resource centers for other countries in the Commonwealth of Independent States.

KEY ACHIEVEMENTS:

A Russian partner (MedBusinessConsulting company) was chosen to manage selection and logistical support for the deployment of specialists to third countries.  Russian laboratory experts have been sent to assist in Tanzania, Ethiopia and Namibia. A needs assessment trip was conducted in Botswana.

An agreement on cooperation in the development and approval of three educational courses on HIV-related topics for postgraduate education was signed with Moscow University of Medicine and Stomatology (MMSU) on February 3, 2009.  Specialists from Belarus, Uzbekistan, Moldova and Ukraine have trained at the regional ATECs.  The Sechenov Moscow Medical Academy and AIHA are currently in the process of finalizing a new manual on HIV for students.

ACTIVITY DATES: August 2006 - August 2009

IMPLEMENTING PARTNERS: United Nations Development Programme

REGION(S): Orenburgskaya oblast, St. Petersburg

PROJECT DESCRIPTION:

Russian faith-based organizations are well-placed to make a significant contribution to Russia's HIV prevention and care programs.  Through this initiative, UNDP provides expert technical advice and support to leaders of the Russian Orthodox Church and other religious groups to promote appropriate policies and programs in response to HIV/AIDS.  Activities with individual churches and with government authorities also aim to reduce stigma and discrimination regarding the disease. 

A small grants program implemented under the project will enable local groups to carry out prevention efforts, with a special emphasis on prevention among vulnerable youth, and to deliver palliative care, including psycho-social and spiritual support, to people affected by or living with HIV/AIDS.   

In this effort, UNDP collaborates closely with the Russian Federal Service on Surveillance for Consumer Rights Protection and Human Well-being and the Department for External Church Relations of the Moscow Patriarchate of the Russian Orthodox Church.

KEY ACHIEVEMENTS:

A position paper on HIV/AIDS was developed by the Russian Orthodox Church and was widely presented and disseminated to dioceses across Russia.  HIV/AIDS concept policies were developed by the Baptist and Catholic Churches in Russia.  The Inter-Christian Council on HIV/AIDS held bi-monthly meetings to coordinate Christian initiatives and it established web resources at http://www.icc-aids.ru/. 

Four faith-based resource centers on HIV prevention for vulnerable youth were established.  The centers offer palliative care and psycho-social support for people living with HIV/AIDS (PLWHAs) and drug-free rehabilitation.

Institution-based educational programs on HIV and substance abuse prevention for vulnerable youth (aged 14-15) were developed and piloted in Orenburg and St. Petersburg.  A faith-based social hostel/halfway house for HIV-positive drug users was established in St. Petersburg.

Guidelines on palliative care for HIV/AIDS patients were developed by the Russian Orthodox Sisters of Mercy.  More than 40 nurses were trained in palliative care and psycho-social support for PLWHAs and 20 clerical specialists and community representatives were trained in faith-based psychological support for PLWHAs.

Two drug-free rehabilitation programs for intravenous drug users, including those who are HIV-positive, were launched in St. Petersburg.

ACTIVITY DATES: May 2006 - September 2010

IMPLEMENTING PARTNERS: United Nations Office on Drugs and Crime (UNODC)

REGION(S): Orenburgskaya oblast, St. Petersburg

PROJECT DESCRIPTION:

UNODC provides expert advice and support to local government authorities and NGOs in St. Petersburg and Orenburg to help them deliver effective HIV and drug abuse prevention, treatment and rehabilitation-especially for injecting drug users (IDUs) and people living with HIV/AIDS (PLWHA), who are in or were recently released from detention.  Local partners in the two regions provide a range of pre- and post- release services, including referrals to HIV testing, relapse prevention counseling, pre-release preparation, and individual post-release case management.  Case workers help link post-release individuals to a wide range of medical, psychological, social and legal support services, including employment training and counseling.

UNODC also provides expert technical advice to Russian federal policymakers on international best practice for substance abuse treatment.

KEY ACHIEVEMENTS:

More than 80 staff members at penitentiary institutions (psychologists, social workers, security guards, and mentors) have been trained on effective HIV/AIDS and drug abuse prevention and treatment programs. 

Networks of pre-and post-release service providers have been developed in both regions-with 12 organizations participating in the St. Petersburg network and 9 participating in Orenburg.  An internationally recognized Addiction Severity Index was introduced in two substance abuse centers in the target regions. 

About 180 officers from the Russian Federal Drug Control Service were trained in HIV-related policy development.

ACTIVITY DATES: September 2001 - September 2010

IMPLEMENTING PARTNERS: International Federation of Red Cross and Red Crescent Societies (IFRC)

REGION(S): Adygeya Republic, Belgorodskaya oblast, Khabarovskiy kray, Khakasiya Republic, Pskovskaya oblast, Yevreyskaya autonomous oblast

PROJECT DESCRIPTION:

This project is designed to assist Russia in the fight against a growing epidemic of tuberculosis (TB), including multi-drug resistant TB, by contributing to Russian efforts to implement internationally recognized, efficient approaches to TB control and the Global Stop TB Strategy.  The project is establishing comprehensive TB programs in 6 target regions, with a focus on community involvement in TB prevention and treatment.  The project model will be replicated in 20 bordering regions with support from a Global Fund for AIDS, TB and Malaria (Round 4 TB) grant.

To complement to the Russian government's TB control service, the IFRC is developing sustainable and effective outreach and follow-up services through the Russian Red Cross and other NGOs.  Services include social, psycho-social and legal support to TB patients from vulnerable groups and families.  The project also provides technical assistance to TB dispensaries and community groups, and targets current and newly-released prisoners with TB.  Activities aim to increase early detection of TB, correct diagnosis of TB, patient adherence to treatment, and community involvement. The project also seeks to strengthen the capacity of local Red Cross branches to provide services for both TB and HIV/AIDS-related concerns.

A project subcomponent was added in 2005 under which the IFRC works in cooperation with the Russian Red Cross to increase HIV prevention efforts in the penitentiary system.  Activities aim to increase HIV awareness among inmates and prison personnel, provide psychological support to prisoners with HIV, enhance HIV+ prisoners' access and adherence to ARV treatment, and promote effective cooperation between the penitentiary system and civil society.

KEY ACHIEVEMENTS:

A model of psychosocial support to TB patients to ensure treatment adherence has been established at all 6 program sites, and replicated in 20 bordering sites through a Global Fund Round 4 TB grant.  More than 1,000 health professionals and about 800 Red Cross workers have been trained in TB control.

Psychological, social and legal support has been provided to more than 12,000 patients.  Treatment compliance has increased at all sites, with treatment interruptions registering in only in 2-4% of cases among civilian population (versus the country average of 11%) and in 10-15% of cases among ex-prisoners (the country average is 45-50%).

The International Green Light Committee has approved multi-drug resistant TB treatment for a total of 824 patients in Khakassia, Belgorod and Pskov Oblasts.  The approval for treatment in Khabarovsk Krai is pending.

Since receiving official recognition from the Federal Service for Sentence Execution, the sub-project has provided HIV prevention training to 996 penitentiary system officers and Red Cross workers, as well as 7,354 inmates.  Pre- and post-testing counseling services have been provided to 11,028 inmates and 10 "Living with HIV" training cycles (consisting of 5 workshops each) have been conducted for 131 people.