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Central Asia Projects
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ZdravPlus Central Asia Health Reform Project
The 5-year USAID ZdravPlus Project provides resources to help the governments of Central
Asia to improve the financial sustainability, efficiency, and quality of their health care while preserving
equitable access. Implemented by US-based consulting firm Abt Associates and partners, the ZdravPlus
Quality Public Health and Primary Health Care in Central Asia Project operates in Kazakhstan, Kyrgyzstan,
Tajikistan, Turkmenistan and Uzbekistan. Partners include John Snow Inc. (JSI), Boston University School
of Public Health Center for International Health and Development led by Brenda Waning, Scientific Technology
and Language Institute (STLI), CitiHope International, Morehouse School of Medicine, Institute for Sustainable
Communities, and Socium Consult (Kyrgyzstan). The role of Boston University, as a sub-contractor to Abt
Associates, is to set the technical agenda, provide technical assistance, build local capacity, conduct
research, monitor and evaluate interventions, engage in policy dialogue and promote collaboration among
local and international counterparts on pharmaceutical issues as they relate to evolving health reforms.
The primary emphasis of the group is on drafting, revising, implementing, and evaluating pharmaceutical
policies to support the health reforms. The emphasis in Kyrgyzstan and Kazakhstan is focused around the
establishment, maintenance and expansion of health insurance systems for medicines. Other regional and
country level work has addressed medicine quality, decentralization of medicine procurement, medicine prices,
human resource shortages, and evidence-based medicine, including selection and standard treatment guidelines
and rational use of medicines. The Boston CCPP, in conjunction with WHO Euro and WHO Geneva co-facilitated
a National Drug Policy launch and implementation meeting in Dushanbe, Tajikistan.
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CAPACITY Central Asia HIV/AIDS Project
The Central Asian Program on AIDS Control in Vulnerable Populations (CAPACITY) Project is a 5-year
HIV-prevention project funded by the US Agency for International Development (USAID) and implemented in the
five Central Asian countries of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan. The purpose
of the CAPACITY Project is to provide technical support and assistance to the countries of Central Asia in
their efforts to launch large-scale and urgent responses to HIV/AIDS epidemics among vulnerable populations.
The CAPACITY Project is managed by JSI Research and Training Institute, Inc. in partnership with Abt
Associates Inc, Brenda Waning of Boston University, Howard University, the International HIV/AIDS Alliance,
and Population Services International.
The role of Boston University is to set the technical agenda, provide technical assistance, build
local capacity, conduct research, monitor and evaluate interventions, engage in policy dialogue and promote
collaboration among local and international counterparts on pharmaceutical issues as they relate to provision
of anti-retroviral therapy (ART) services, including anti-retroviral (ARV) adherence and integration of AIDS
services.
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USAID Project to Increase Access to Medicines in Rural Kyrgyzstan
Under the USAID/Central Asian Program on
AIDS Control in Vulnerable Populations (CAPACITY) Project,
qualitative research conducted by Brenda Waning, Paul Bolton
and Judy Bass examined barriers to antiretroviral therapy
(ART) uptake and adherence in Temirtau, Kazakhstan where the
regional HIV/AIDS epidemic is concentrated and most prevalent
among intravenous drug users (IVDU) and substitution therapy
for IVDU is illegal. Free list and key informant
interviews suggested barriers to uptake and adherence to ART
include: widespread discrimination and stigma with
regards to both HIV/AIDS and IVDU; adherence information as
provided by health professionals instills fear such that
patients feel they are better off to never begin ART than to
begin ART and miss a few doses and fear that side effects will
be more uncomfortable than disease progression; no community
experience of successful outcomes with ART and a resultant
disbelief in ART efficacy; feelings of being guinea pigs for
US research; distrust in free generic medicines; single and
centralized/vertical delivery system with limited hours of
operation; difficulty in keeping track of IVDU patients as
they travel through detoxification, rehabilitation, and prison
systems. Follow-on work includes the design,
implementation and evaluation of interventions to address some
of these barriers.
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LATEST UPDATES
WHOCCPP
awarded funding for Interdisciplinary
Research and Training for Improving
Access to and Use of Medicines in China by Harvard
China Fund
Upcoming Courses
MedIC
Initiative Courses in Accra, Ghana, November 16-25, 2008
and Beijing, China in the Spring of 2009
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