US embassy cable - 05ZAGREB36

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 
------------------- 
 
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 
--------------------------------------------- --------------- 
 
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 
--------------------------------------------- ------- 
 
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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