When a commitment turns into actions: Kazakhstan increases access to opioid substitution treatment

11 October 2012. Astana. The Ministry of Health of Kazakhstan announced the expansion of HIV prevention services for people who use drugs. In an effort to reach a greater number people country-wide, seven new sites providing methadone are scheduled to open on 1 November 2012.  The new sites, more than doubling the current number of service points, will enable people who use drugs in the cities of Aktobe, Zhambyl, Uralsk, Karaganda, Kostanai, Semey and Ekibastuz to access life-saving services in their communities.  

In Eastern Europe and Central Asia HIV prevalence still remains on the rise.  Between 2000 and 2009, the HIV incidence in Kazakhstan has increased by more than 25%, with injecting drug users and their sexual partners at the centre of the epidemic. The Government of Kazakhstan, facing a concentrated epidemic, gradually increased the access of people who inject drugs to tailored HIV services; these include, among others, HIV counselling and testing, HIV treatment, access to condoms and opioid substitution treatment.  

In  2005, noticing with concern the alarming increase in HIV prevalence,  President Nazarbayev urged the Ministry of Health to respond pro-actively to the national HIV epidemic with innovative methods. In this context; the Ministry of Health introduced the first methadone pilot programme in 2008.  The implementation started with the support of the Global Fund and the investment of national resources resulting in two opioid substitution treatment sites, located in Pavlodar and Temirtau opening their doors to clients.   In 2011, following positive results at the pilot sites, the government scaled-up service access by opening a third service point in Ust-Kamenogorsk.

UNODC accompanied the Kazakhstan government and national stakeholders with the scaling-up of HIV services in the country especially within regional project "Effective HIV/AIDS prevention and care among vulnerable populations in countries of Central Asia and the Republic of Azerbaijan".  UNODC supported the implementation of HIV prevention services by providing technical assistance as well as creating opportunities to enhance and develop national capacity.  UNODC offered training courses touching on all aspects of HIV service provision - from legal reform and human rights to clinical management and monitoring and evaluation of effectiveness of programmes. A strong advocate for the expansion of HIV services in the region, UNODC supported the development of the Plan of Action that lead to the scaled up response in Kazakhstan.  With the Ministry of Health at the helm,  UNODC fostered the establishment of an inter-ministerial working group for the expansion of services composed of key national stakeholders and representatives from the Global Fund, UNAIDS Secretariat and other UN agencies.   Also actively involved were international organizations and programmes such as WHO,  PEPFAR and EU -funded organizations.