Building on the country’s new laws and guidelines to achieve everyone’s right to essential medicines – and at a fair price.
The number of people living with HIV in Kyrgyzstan is estimated to be 7,600. This equates to a prevalence rate of 0.2% which jumps to 6.3% for gay men and other men who have sex with men, 11.3% for prisoners, and 12.4% for people who inject drugs. Since 2011, the total number of officially registered cases of HIV in the country has almost doubled
4,503 people have been assigned HIV treatment, but only 3,237, less than half of all people estimated to need treatment, are receiving drugs.
The reason for the increase in new HIV infections and the gap in treatment is three-fold: Firstly, stigma and discrimination, including a distinct lack of services in prisons, which prevents people from accessing life-saving treatment; secondly the over-pricing of medicines; plus a lack of drug registration in the country for certain essential medicines.
Kyrgyzstan’s government is committed to providing free treatment to all people living with HIV. Since 2018, 40% of HIV treatment regimens have been purchased from the state budget, (60% purchased through Global Fund support) and the country also has ‘anti-monopoly’ regulations. However barriers to procurement, and therefore access, remain.
These issues also apply to Hepatitis C and TB. With regards to TB, almost no second-line TB drugs are registered in the country. The number of people living Hep C is estimated at 8,937, and 7,695 people are recorded to be living with TB.
Co-infection of HIV and TB, and/or HIV and Hep C is a pressing concern. A holistic response that tackles stigma and treatment barriers needs to be urgently addressed in order prevent avoidable deaths.
Our focus
Our campaign partner in Kyrgyzstan, the Partnership Association, is focused on lowering the price of essential medicines and increasing access to optimal treatment for HIV, Hep C and TB.
The Partnership Association played a leading role in developing a roadmap for the transition of the HIV programme to national funding. As a result, tackling barriers to treatment has been included in the roadmap, and the HIV and Hep C treatment guidelines were updated. New HIV drugs, including dolutegravir, darunavir, atazanavir, have been included in the list of essential medicines.
Kyrgyzstan’s laws have also been amended, critically, to promote the full use of TRIPS flexibilities, including compulsory licensing, in order to access fairly priced medicines.
The Partnership Association’s priorities include:
- Advocating for the full implementation of the new HIV and Hep C guidelines, including lowering the price and increasing access to the drugs that have now been included on Kyrgyzstan’s essential medicines list.
- This includes continuing to push for treatment regimens to be optimized and developing strategies to ensure these newer treatment regimens are fairly priced and therefore cost-effective. The organization will be monitoring purchases and prices of generic drugs and, where relevant, engaging with generic manufacturers on the issue of price, or to enable the entry of new generic manufacturers to increase competition.
- Continue the dialogue with the Ministry of Health: Providing advice and expertise on strengthening the patent examination process and providing evidence to support the issuing of compulsory licenses on drugs where required.
- In parallel, while the patent process is improved, the Partnership Association will identify unmerited patent applications and file patent oppositions as necessary.
- Due to the efforts of the Partnership Association, Hep C treatment is now provided free of charge for people living with HIV. The official cost of a 12-week course of sofosbuvir-based Hep C treatment in Kyrgyzstan is one of the lowest in the world ($300 to $600 USD). So far, Hep C treatment has been procured for 184 co-infected patients within the national HIV treatment programme. The aim for 2019/20 is to reach all people in need with treatment.
- Review clinical protocols for TB treatment, to support the government’s procurement of optimal and affordable treatment for first- and second-line medicines.
Relevant documents:
Analysis of ARV Procurement in Kyrgyzstan, 2017 (in Russian).
Last updated February 2019.