HIV/AIDS IN CROATIA -- GLOBAL FUND FILLING A VOID

UNCLAS ZAGREB 000036

SIPDIS


PLEASE PASS ESTH OFFICER
DEPARTMENT FOR S/GAC AND EUR/PGI/BRETT POMAINVILLE
BUDAPEST FOR KARYN POSNER-MULLEN

E.O. 12958: N/A
TAGS: KHIV PHUM PGOV HR
SUBJECT: HIV/AIDS IN CROATIA -- GLOBAL FUND FILLING A VOID
ON EDUCATION AND OUTREACH

REF: ZAGREB 2171

SUMMARY AND COMMENT
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1. With a three-year, $5 million commitment in Croatia, the
Global Fund to Fight AIDS, Malaria, and Tuberculosis has made
possible free and anonymous HIV testing in three urban
centers of Croatia and supported NGO education and outreach
to vulnerable populations. Given Croatia's low prevalence
and low awareness of HIV/AIDS, the Global Fund has played a
crucial role in two areas -- education and targeted
intervention -- whereas the GoC has focused its resources in
treatment and care. Though stigma and lack of understanding
pose significant obstacles to outreach and education efforts,
Global Fund support and superb local partners have already
made significant progress expanding access to testing and
educating vulnerable populations about preventing new HIV
infections.


2. This is the second in a series of three cables looking at
HIV/AIDS in Croatia. Reftel provides a snapshot of the
current situation and Croatia's National Action Plan on AIDS,
while a description of Croatia's drug treatment efforts will
be reported septel. END SUMMARY AND COMMENT.


3. Since 2003, the Global Fund has been essential to GoC
efforts to prevent new HIV/AIDS infections -- it features in
Croatia's updated National Action Plan on HIV/AIDS and the
Ministry of Health has appointed a coordinator for Global
Fund activities. Consistent with the Global Fund's aim of
supplementing rather than replacing local contributions, the
Ministry of Health has channeled Global Fund resources to
areas overlooked by the GoC state budget and national health
insurance system but specifically noted by the National
HIV/AIDS Committee as areas where work is needed -- targeted
inventions into vulnerable populations and education. GoC
expenditures on HIV/AIDS have remained steady at around $2.5
million -- with 90% going to drug treatment, 9% to
prevention, and 1% to research.

GLOBAL FUND OUTSIDE OF ZAGREB -- CASES FROM RIJEKA AND SPLIT
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4. Two Voluntary Counseling and Testing centers (VCTs)
opened in 2004 in Rijeka and Split (Croatia's second and
third largest cities) thanks to Global Fund support funneled
through the Ministry of Health. A third renovated facility
will open in Zagreb in December 2004. In Rijeka, the local
partner NGO Terra works with intravenous drug users,
commercial sex workers, and the sizeable local sailor
population on HIV/AIDS awareness and strategies to reduce
risky behaviors. As a member of RiskNet, Terra works closely
with similar outreach NGOs in BiH, SaM, Bulgaria, and Romania
on methods of reaching vulnerable populations. Terra's
president also sits on the National AIDS Committee to keep
national health leaders informed about targeted invention
progress.


5. The Global Fund provides 70% of the budget of a
Split-based NGO HELP that has worked with Split County's
sizeable intravenous drug user population since 1990.
According to the NGO's president, Global Fund and local
government support are the two most important factors in
HELP's success promoting testing and HIV awareness among drug
users. With Global Fund money, HELP is for the first time
able to provide free drop-in testing and counseling services
for six hours every week in cooperation with the County
Institute for Public Health. (All HELP employees -- even
their financial manager -- receive counseling training.)
Thanks to Global Fund support, HELP has also been able to
expand its geographic reach through a mobile outreach and
awareness-raising program. HELP is also working on building
a regional network of NGOs that work with IV drug users in
Croatia, BiH, and SaM to share techniques and information.

INTEGRATING GLOBAL FUND INTO CROATIA'S HEALTH SYSTEM
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6. Health professionals and NGOs are eager to continue
Global Fund-inspired outreach and education programs after
the project's end in Croatia in 2006. The Ministry of Health
is eager to integrate Croatia's three VCTs into the national
health system. Priorities for 2005 include establishing a
fourth VCT in Croatia's overlooked eastern region and
integrating a peer education program into Croatian high
schools.
FRANK


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