Two years after the end of the HIV prevention programs for key populations funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the services started again with governmental funding. This long awaited moment will re-establish the contacts between the non-governmental organizations and the most vulnerable communities among which the epidemic was kept at low levels for many years thanks to the daily hard work.
The new activity is possible thanks to the implementation of a public procurement tender of the Ministry of Health announced at the end of 2018. In Sofia the tender winner is Consortium I.Z.I. – a union of three non-governmental organization with extensive experience in working with key populations – Association “Health without Borders”, Initiative for Health Foundation and I Foundation.
It is envisaged that for a period of 12 months 800 people who inject drugs will receive safer injecting services (clean injecting equipment); 2100 MSM and 400 women and men sex workers will be reached with condoms and safer sex consultations. It is planned that 3.300 free and anonymous HIV tests will be provided in the three groups through outreach mobile services and in the Center for Sexual Health CheckPoint Sofia. The program includes also testing for syphilis and hepatitis C as well as specialized counselling and support for 100 people living with HIV. The contract amount is 166,310 BGN without VAT.
The renewal of the HIV prevention programs for key populations in Sofia is a very positive fact for several reasons. On one hand, without specialized services these populations stay outside of the health system and for some of them the outreach teams are the only connection with the health and social services helping them to receive counselling, referrals and support for many other health and social problems. In the last two years thanks to private funding it was possible to maintain the testing and indoor prevention services for men who have sex with men in CheckPoint Sofia, as well as support for people living with HIV. But due to the lacking outreach work for people who inject drugs and sex workers the spread of HIV in these groups is unknown at the moment. On the other hand, after the long years of solely international funding which made these programs possible, the starting of prevention services with governmental finances is an essential precedent bringing hope for the sustainability of the results achieved with the GFATM support.
The representatives of Consortium I.Z.I. evaluate positively the state support for HIV prevention in key populations, although they believe that the way to sustainability hasn’t been found yet. The period for which the services will be covered is short and the funding for Sofia is approximately ¼ of what was provided before by the GFATM. The deepest concern is related to the lack of a real sustainable mechanism for social contracting. The public procurement tender as a form of funding is a temporary decision which cannot ensure continuity of the services and turns the social work into a business service which brings substantial risks for its quality.
During the first day of operation, 35 people obtained a safe injection equipment from the service.
Association “Health without Borders” was established in 2004. It is specialized in counseling and testing services for HIV, hepatitis and sexually transmitted infections in key populations. It maintains a low-threshold medical center CheckPoint Sofia – Center for Sexual Health.
Initiative for Health Foundation was established in 1997. It is specialized in the provision of services for reduction of the harms of injecting drug use.
I Foundation was established in 2004. It is specialized in the provision of counseling and support services for people living with HIV.