Chapter 28 eu report 2015

______________________________________________________________________________________________________________________________________________АС - Центар за оснаживање младих особа које живе са ХИВ-ом и АИДС-ом
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Мејл: office@aids-support.org, Сајт: http://aids-support.org/ Мајке Јевросиме 21, Стари Град, 11000 Београд
Contribution to report of Chapter 28 - Serbia 2015
A. General Information
1. Name of the organization: AS - Center for the Empowerment Youth of people who are living with HIV and AIDS
2. Title: Contribution to report of Chapter 28 - Serbia 2015
3. Town/Country: Belgrade, Serbia
4. Duration of the Report: (2014-2015)
5. Improved quality of life and social status of people living with HIV
The contribution of the Progress Report for 2015 from Serbia and recommendations are made on the basis of
inclusion guidelines for civil society organizations in the process of making regulations: Official Gazette of Republic of
Serbia (conclusion 05 number 011-8872/ 2014), adopted by the Government of Republic of Serbia in Belgrade, on
26. August 2014. LAIC advisory process was conducted with the aim to engage and build a partnership public
administration bodies and civil society organizations for active participation in the preparation, decision-making and
monitoring with recommendations of the European Union in order to ensure their effective and efficient
implementation to Improving the implementation of the National Strategy on HIV infection and AIDS in Serbia.
Serbia belongs to the category of countries with low prevalence of HIV infection and the epidemic is under control
thanks to donation of 40 milion dollars1 from Global fond for establishing decentralised sustainable service and
prevention of HIV, support, care and treatment for persons who live with, are affected by, or vulnerable from
HIV/AIDS, HCV/HBV, TB and PPI, with participation and empowerment of their families in the social process.
Upon completion of funding from the Global Fund from Geneva, the entire civil society sector has a challenge
without elementary conditions for daily functioning and further work in the fight against HIV. Therefore, the
continuation in supporting individuals who are living with HIV is threatened, which includes psychosocial support,
professional and peer to peer counseling, empowerment, legal aid and home care for the most vulnerable people.
The current program for support people who are living with HIV has helped to reinforce and get together around
common needs, but associations are not managed to ensure sustainability minimum package services and space to
with the customers and carry out daily activities. To create model of co-operation of health care institutions and CSO
of People who are living with HIV/AIDS should be able to enable sustainable development national program for HIV
and co-infections including the prevention, diagnosis and universal access to health institutions, joint possibility for
obtaining medicines, in co-operation with other countries2, using tools developed during implementation of the
program HP 2008-2013, Equity action3 and Action for health4.
Institute for Public Health Batut and the National Office for HIV/AIDS in the beginning of the year of 2014. started
the process of creating an action plan for the period to year of 2015. on the basis of recommendations in
accordance with GAP analysis5 and goals of Strategy for HIV and AIDS 2011-20156 respiratory infection and National
M & E plan7 for HIV (2011-2015).
1 http://portfolio.theglobalfund.org/en/Country/Index/SRB
2. The initiative for the joint procurement (Luxembourg, May 2014), 6.3.2. ARV therapeutically administered to HIV/AIDS:
http://ec.europa.eu/health/preparedness_response/docs/jpa_explanatory_en.pdf
3. EQUITY Action – guidance for structural funds, http://fundsforhealth.eu/
4. Action for health - Strategic regional plans, www.action-for-health.eu
5 http://ccm.gov.rs/download/doc/documents/srp/GapAnaliza2012.pdf
6
http://www.hivpodrska.org.rs/uploads/docs/HivStrategija2012.pdf
7 http://www.batut.org.rs/download/publikacije/Plan za monitoring.pdf

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Main outcomes of held Consensus conference echoed with people living with HIV community needs and have key
interventions/services in order to enable further success and a comprehensive response to HIV in Serbia. Defined
measures include:
Voluntary and confidential consulting and testing for HIV in the fieldwork conditions;
The program of reduceing damage among drug users;
Field work and mobile medical units to work with populations under increased risk of HIV;
Centers for support (drop-in centers) for populations under increased risk of HIV;
The program of care and support for people living with HIV through model "positive prevention" aims to
increase self-confidence, a sense of competence for people living with HIV and the ability to protect their
health and avoid the transfer of infection to another8 with people living with HIV 9 involvement and
participation in the creation of health and social policy, decision-making processes and implementation
procedures that are related to HIV prevention, treatment and empowerment in order to enable smooth and
continuous implementation of programs care and support for persons living with HIV.
Challenges:
The availability of treatment and drug therapy has improved in 2014 by placing four new second-generation drug
on the positive list (Prezistra, Isentres, Viread and Celsentry), or enabled only for 6% of patients who are resistant to
existing therapies. However, new drugs have long been obsolete for Europe and the world where it uses third, fourth
and even fifth generation of generic drugs, which are also the cheaper. It took ten years to put new drugs on the
positive list. The registration process is necessary to accelerate and facilitate the launch of talks between the former
republics of the creation of a single market for procurement of ARV therapy, it lowered the price of drugs or import
generic drugs.
UNAIDS database10 states that Serbia after Bosnia and Herzegovina other country in Eastern Europe and Central Asia
at drastically high price of drugs for HIV compared to other countries. On the other hand globally Serbia is among
the first of the two countries, which at least means, only 250 euros invested in the treatment of patients.
Tests, reagents and apparatus for diagnosing and monitoring the progression of HIV infection and immune status
are often unavailable and patients do not have the ability to do the necessary analysis that are very important
because they help infectologists in determining the best combination of drugs and monitoring of the same infection
and disease. Although the World Health Organization recommended that the analyzes should be done three times a
year, in Serbia testing is conducted once a year or never. Inability to do the test resistance and lack of PCR and CD4
tests endangers the health, life of patients and increases the cost of treatment. Therefore it is necessary to examine
the accountability and responsibilities of employees to determine why there is a delay in procurement.
Equality and tolerance towards people with HIV is necessary because of the low level of social awareness about HIV
and people who have HIV, which in reality creates an increase in prejudice. Because of the fear of stigma and
discrimination, people with HIV are often isolated from social processes leading to extreme social vulnerability. For
more successful treatment, rehabilitation and assistance to vulnerable groups with inclusive operation, it is
necessary that civil society organizations continue to work hard and develop new services for its customers while
providing quality information, psychosocial services and protection of human rights with the promotion of positive
prevention, tolerance and healthy lifestyles.
8. Internacional HIV/AIDS Alliance, 2007
9
. HIV/AIDS and pozitive prevention
10 http://www.aidsactioneurope.org/system/files/9._basics_generics_-_raminta_stuikyte.pdf

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For this reason our common priority is to find the best way to cover the financing gap for HIV/AIDS programs. The
concept of sustainability is closely linked with the growing sense of social responsibility, building stronger networks,
cost control and optimization of existing resources. Bearing in mind the difficult financial situation due to the
devastating floods that hit Serbia in 2014, it is clear that the development of financial sustainability will be a
challenging task, but will also enable us to improve our health care system of the country. It is expected that the plan
for sustainability to be part of the review of the national strategy. To enable the successful implementation of these
concepts, in agreement with the Serbian government and other stakeholders, proposes the following:
1. To update National Health Accounts with disease specific sub-accounts amend the regulation of health
care, which would allow us to better understand how HIV and AIDS, as well as financial flows.
2. To investigate the possibility of reducing the cost of ART in negotiations with pharmaceutical companies
and suppliers. It would be useful to investigate the costs of ART neighboring countries.
3. To organize detailed and clear evaluation of HIV/AIDS programs, which are implemented by national,
international experts and stakeholders to identify priorities and ways to save.
4. To create a work plan and provide funding Ibbs's. Recent results show an increase in HIV infections among
MSM population in Serbia.
The prerequisite for success is to create, submit and adopt a new Strategy for HIV infection and AIDS;
accompanying Action Plan, the National M&E Plan for HIV and Model cooperation association of persons who
have HIV with health institutions, with the implementation of support programs in the health, social and legal
protection that includes specific outcomes:
Proposal Context for support CSO People living with HIV:
The main motive of our participation is to contribute in improving the quality of life and social status of persons with
HIV, their families and friends, through their dedicated and responsible, active participation in the systematic
process of creating, adopting, planning measures, implementation of activities, evaluation of the results and
implementation of new programs and policies in all segments of the community and all levels of management.
Political reforms set in the center of the current transition, reinforced the prospect of Euro-Atlantic integration and
the accession of the Serbia in the EU, provides political momentum for influence, lobbying and advocacy for the
development and implementation of relevant laws and procedures on the rights of persons with HIV. This context
creates a real opportunity and the chance to stand up for change disturbing the position, taking into account the real
needs of People who are living with HIV in Serbia and the region for social policy reforms and decentralization of
social services:
Initiating the creation of a common institutional framework for inter-agency co-operation and participation in the
process of establishing and maintaining institutional cross-sectoral dialogue11 between the public, private and
CSO12 sector,
The establishment of modern Internet technologies in business, improve communication and better cooperation
among people with HIV, civil society organizations and the community at large;
Organizing various activities such as panel discussions, roundtables, workshops, debates, conferences, seminars,
festivals, exhibitions, concerts, Summit, tours, theme nights, study visits and exchanges, in order to affirm the civil
society, inter-sectoral cooperation and participation people living with HIV in society;
Media promotion of inter-sectoral cooperation and transparent implementation of other activities that
contribute to achieving the objectives of GIPA Principle13
;
Lobbying and advocacy rights of people with HIV and initiating the establishment of a national day dedicated to
people living with HIV infection and AIDS, which contributes to increasing the visibility of people with HIV.
11 National Forum of PLWHA of Serbia in line with the objectives of prolonged Action Plan of EU and neighboring countries
12
Civil Society Organisations
13 http://www.data.unaids.org/pub/BriefingNote/2007/jc1299_policy_brief_gipa.pdf

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Above mentioned activities should result in:
 Real time improvement of the approach to the prevention, treatment, care and support for persons with HIV
which will lead to the elevation of life standard of persons with HIV.
 Up to date and evidence based plicy making with clear priorities, followed with quality and deliverable
strategies and action plans with allocated budgets and in scope of EU best practices and policies.
 Strong networking with EU think tenk organisations in field of HIV/AIDS, inatitutions;
 And finally developed and sustainable one stop shop services for persons with HIV.
1. Institutionalization of associations of persons with HIV, in Serbia contributes to reducing the number of new cases
of infection, improves quality of life and reduces stigma and discrimination against people who have HIV infection or
AIDS with create and implementation:
1.1. Model friendly cooperation association of persons who have HIV infection or AIDS with health institutions
1.2. Guidelines for the provision of social services to associations of persons with HIV;
1.3. The procedures for the establishment of five coordinators, people who have HIV in local government;
1.4. The quality system of the associations of persons with HIV;
1.5. Service standards for persons with HIV in the national response to HIV;
1.6. CSO Forum for HIV / AIDS in the Republic of Serbia as a liaison with the European Union and the world;
1.7. The procedures of forming a multi-disciplinary body for monitoring programs intended for people with HIV;
1.8. The plan for monitoring and evaluation of support programs for persons with HIV
1.9. Reporting procedures, auditing and publication of the results of programs for people who have HIV.
CSO in Serbia has a range of skills and competencies for representation and work on better information, defining
priorities and models for support of PERSONS WITH HIV. Associations of PERSONS WITH HIV launched a dialog with
the aim of creating joint system sustainability, and service support for the period 2015-2020, with the tendency to
further professional development, which demands the following measures:
 Establishing the forum OCD for HIV/AIDS (CSF) Serbia, as well as representative bodies of the largest
networks and civil society organizations, with aim to make it easier for persons who live with, or are affected by
the edges on HIV/AIDS, their parents and friends, to participate in development processes in national and
European policy and implementation of European projects, the exchange of information, recommendations,
and policy experiences with creators, European institutions, EU members of civil society forum for HIV/AIDS
(CSF), Members of the board of EU HIV/AIDS Think Tank forum comprising representatives of the member
states and EU countries in the region, with participation of EU presidency group therapy for AIDS (EATG) and
AAE EU AIDS network.

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Forum of civil society organizations for HIV/AIDS (CSF) Serbia would have task to work on establishment of co-
operation, capacity building of institutions and organizations and supporting the Ministry of Health, the Ministry of
Labor and Social Policy, Trustee for the protection of equality, Protector of Citizens, The Ministry youth and sports
and other interested parties in the implementation, monitoring and evaluation of national response to HIV, so that
their activities would be directed at the following activities:
To initiate the adoption of regulations which would have contributed to that counselling and testing are
much more available to citizens who are more vulnerable to HIV, in order to be advised that a greater
number should be tested, and thus learned about their HIV status. Early knowing of HIV status has great
importance to the individual, and the collective level. It helps us to live more responsibly, more productive
and fulfilled, and positive results in the case allows us to start the therapy in time which will prevent the
emergence of AIDS.
To ensure the availability and new generic medications, because since 1998, or since the introduction of
highly active combined antiretroviral therapy in treatment of HIV infection in the Republic of Serbia, are
registred twice as less infected and triple less of those who died from AIDS. All the World researches cited in
this area shows that antiretroviral therapy (HAART) is not only to improve the quality of life of people living
with HIV, but also reduces probability of transmission of viruses for 96 %.
To ensure a comprehensive resocialization, which includes medical, legal, psychological support, as well as
professional empowerment and participation of people living with HIV,
Setting co-ordinators from existing persons with HIV organizations in five municipal centers (Novi Sad,
Nis, Pancevo, Belgrade and Subotica), who has duty of defineing standards of work and competencies in
order to responsible, professional and timely performed advocacy, lobbying and advocacy at the local level in
consultation, training and the provision of services, using internet technology, as well as a unique concept
during which develop mechanisms delegation and define functions and responsibilities that are related to
the development, implementation and monitoring of national and local strategies, action plans and
development projects and programs.
To increase visibility and impact of persons with HIV on decision-makeing in Serbia and the EU, involve
persons with HIV in the decision-making process in the local community, and that they are capable, they
have strong information, methodological and qualified resources for representing the interests and
protection of their civil rights and freedoms, to directly and continuously monitor the implementation
activities in co-operation with its partner organizations and networks; that through innovative forms of
entrepreneurship education gain knowledge and skills that allow them to start or improve their own
business, the positive impact on improving socio-economic situation in the local and regional community.
To establish a national day dedicated to persons who have HIV to increase visibility. The initiative has
received support from protector of gender equality for Republic of Serbia and has been published in the
regular annual report for 2013. That was presented to National Assembly of the Republic of Serbia. The
initiative is in line with good practice example in the United States of America and the goals of signed
Memorandum of Co-operation that is supported by 15 civil society organizations from Serbia.
Support to political commitment to fight against HIV and review implementation of Dablin declaration and
Implementation of Resolution 1997 adopted in may 2014. by the Parliamentary Assembly of the Council of
Europe: 'The migrants and refugees in the fight against AIDS', which provides for programs to ensure an
appropriate services for migrants with HIV, and in particular: 9.1 - regarding legal measures,9.2.- access to
testing, treatment and preventive measures,9.3. - in connection with the policy measures.

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Preconditions:
1. Alternative Report14 coalition of civil society organizations from Serbia presented 28 and 29.04.2015. at the 54
session in Geneva before the UN Committee CAT - Convention against Torture and Other Cruel Inhuman or
Degrading Treatment or Punishment.
2. More than 5515 institutions, associations, civil society organizations and informal groups from Serbia gave their
support16 and joined the initiative of the European Commission17, together with civil society organizations,
networks and alliances in the European Union and Asia, a letter18 which was sent to the Minister of Health of
the EU and country the environment, the European Commission Directorate General (DG)19 for Public Health
and Consumers of the European Union (SANCO20), relevant stakeholders and interested parties in the EU and
globally.
3. Joint action on HIV and HARM reducing21 the impact with the invitation of Minister of Health and directors of
pharmaceutical companies22 (Abbvie, BMS, Gilead, Janssen, Merck/MSD) on universal access to treatment, and
treatment of hepatitis C;
4. Call the Ministry of Health23 officials to express support renewal of political commitment to the fight against
HIV/AIDS and to continue the implementation of the Dublin Declaration;
5. Call: "Hepatitis C: Better protection and treatment by 2015 for all in Europe"24 with a request to the first
generation of PI (Boceprevir and Telaprevir) replacement for safer and more effective drugs for treatment of
hepatitis C (HCV),
6. Manifesto on HIV prevention: We urgently need PreP!25 of European, national institutions and pharmaceutical
companies;
7. Appeals to the Commissioner for Health and Food Safety EU, to plan a coordinated response26 to tuberculosis in
Europe;
8. Appeal to all interested parties in Europe and pharmaceutical companies to continue financing DAD study27.
We respect the Mandate, EU Guidelines and conditions for support to implement of:
The Report EC 2013 and 2014 for Serbia and Third EU Health Programme 2014-2020, with the Work Plan for
2014 are instruments of the EC for implementation of the EU Health Strategy Together for Health, which
supports the overall EU 2020 strategy.
Prolonged Action Plan EU and neighboring countries and general Communication objectives defined of EC;
Agenda for the representation of PERSONS WITH HIV, was a revolutionary document launched 2012th by the
Global Network of people living with HIV and CSO, with a Call to action and Operational Programme “Positive
health, Dignity and Prevention”.
Call for global dialogue process and guidelines for Engaging sent 12 June 2014, representatives of institutions,
CSO, representatives of key populations and key members of the CCM from the GFATM, Geneva.
The third program of Health 2014-2020, Health for Growth and HORIZON 2020 program of financial assistance
EU.
14 http://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/SRB/INT_CAT_CSS_SRB_20088_E.pdf
15 https://onedrive.live.com/view.aspx?cid=666B992080FB07B8&resid=666B992080FB07B8%2118807&app=WordPdf
16 http://www.slideshare.net/centaras/report-for-eucsfhivaids
17 http://ec.europa.eu/about/index_en.htm
18 https://onedrive.live.com/redir?resid=666B992080FB07B8%2118584
19 http://ec.europa.eu/about/ds_en.htm
20 http://ec.europa.eu/dgs/health_consumer/index_en.htm
24 https://onedrive.live.com/view.aspx?resid=666B992080FB07B8!19391&app=WordPdf
25 http://www.eatg.org/gallery/171805/The%20HIV%20Prevention%20Manifesto%20FINAL.pdf
26
http://www.tbcoalition.eu/wp-content/uploads/2015/03/CSO-letter-to-Commissioner-Andriukatis-26022015.pdf
27 http://www.treatmentactiongroup.org/hiv/dad-signon

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National Law and Strategy
Strategy HIV/AIDS; M&E Plan, GAP analysis; Policies for youth participation, Platform of cooperation CSOs within
the NPM; Strategy against discrimination; Poverty; Youth Health28; for Young29; Public health30; development of
mental health care31; Palliative care32; Drug Enforcement33; Quantities of safe blood34; Improvement gender
equality of women35; Quality of patient care36 Public health laws37; The Criminal Code38; Palliative care, Gender
Equality39; Prevention of Discrimination Persons Disabilities40; Protection infectious diseases of health care 41;
health insurance42; Protection of personal data43.
Additional reference:
a) Regulation of the European Parliament and of the Council on establishing a Health for Growth Programme, the
third multiannual programme of EU action in the field of health for the period 20142020.
http://ec.europa.eu/health/programme/docs/prop_prog2014_en.pdf
b) Regulation (EU) No 282/2014 of the European Parliament and of the Council of 11 March 2014 on the
establishment of a third Programme for the Union's action in the field of health (20142020) and repealing
Decision No 1350/2007/EC (with EEA relevance)
http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32014R0282&from=EN
c) Commission Staff working document Action Plan on HIV/AIDS in the EU and neighbouring countries:
20142016 http://ec.europa.eu/health/sti_prevention/docs/ec_hiv_actionplan_2014_en.pdf
d) Commission implementing Decision of 26.5.2014 concerning the work programme for 2014 in the framework of
the third Programme of the Union's action in the field of health (20142020) and the EU financial contribution to
the WHO Framework Convention on Tobacco Control, serving as a financing decision.
http://ec.europa.eu/health/programme/docs/wp2014_en.pdf
e) Public Health Programme - Work Programme for 2014, Annexes I to VI:
http://ec.europa.eu/chafea/documents/health/wp2014_annex_en.pdf
f) Communication from the Commission to the European Parliament, the Council, the European Economic and
Social Committee and the Committee of the Regions. Combating HIV/AIDS in the European Union and
neighbouring countries, 2009 -2013
http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52009DC0569&from=EN
g) White Paper: Together for Health: A Strategic Approach for the EU 2008-2013
http://ec.europa.eu/health-eu/doc/whitepaper_en.pdf
28 Official Gazette no.104/06
29 Official Gazette no. 55/08
38 Official Gazette no. 85/05, 88/05, 107/05, 72/09 and 111/09
42
Official Gazette no.107/05, 109/05 and 106/06
43 Official Gazette no.97/08 and 104/09 - etc. Low
The report compiled Djurica Stankov,
executive director of AS Center
06. May 2015.

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