About the Regional Knowledge Hub for the Care and Treatment of HIV/AIDS in Eurasia

The Regional Knowledge Hub for the Care and Treatment of HIV/AIDS in Eurasia was established in 2004 by the American International Health Alliance (AIHA) to assist countries in Eastern Europe and Central Asia to provide comprehensive, high quality HIV/AIDS prevention, treatment, and support services. AIHA’s regional offices in Moscow currently oversee and administer the Knowledge Hub’s programs and activities, which are helping to build human resource capacity critical to the effective design and delivery of healthcare and related support services to people living with HIV or AIDS.

The Knowledge Hub is supported by the World Health Organization (WHO); the German BACKUP Initiative implemented by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ); the Global Fund to Fight AIDS, Tuberculosis and Malaria and Global Fund national principal recipients; and other international donor organizations.

Capacity Building through Collaboration Working with key national, regional, and international stakeholders, the Knowledge Hub and its affiliated clinical centers are actively strengthening the ability of countries in Eastern Europe and Central Asia to provide comprehensive, high quality care and treatment to people living with HIV/AIDS by:

  • Developing expertise among health and allied professionals through training opportunities;
  • Providing direct technical assistance as needed;
  • Linking people and institutions involved in the provision of HIV/AIDS prevention, care, treatment, and support; and
  • Adapting, developing, and disseminating the latest evidence-based guidance for HIV/AIDS care specialists based on national and international standards.

The Knowledge Hub’s first priority has been to respond to the urgent need for countries in the region to rapidly develop the capacity of their healthcare providers to initiate antiretroviral therapy using medications provided through the Global Fund and other donors while at the same time scaling up related care and treatment programs in high incidence communities.

Working closely with policymakers in target countries, Knowledge Hub experts design and execute training programs in keeping with national strategies and international best practices that are supportable by both national and international funds. Since 2004, the Knowledge Hub has directly trained more than 5,000 care providers from 10 countries spanning Eastern Europe and Central Asia. These practitioners are currently responsible for providing ART to in excess of 50,000 individuals who are living with HIV/AIDS, as well as providing medical and psycho-social care and support to countless others who are infected with or affected by HIV.

With this key priority in mind, the Knowledge Hub has supported the development of affiliated clinical training sites — centers of excellence at sub-regional and national levels that now serve as sustainable sources of training and continuing education for a wide range of current and future care providers. These sites include centers of clinical excellence in Ukraine (Kyiv and Odessa) and Russia (St. Petersburg).

In addition, the Knowledge Hub has helped to train several hundred faculty members associated with national postgraduate programs in Azerbaijan, Belarus, Kazakhstan, Moldova, Russia, Ukraine, and Uzbekistan. With support from the Central Asia AIDS Control Project and funding from the World Bank, the Knowledge Hub is currently assisting the Ministry of Health of Uzbekistan and National AIDS Centers throughout Central Asia to develop a regional clinical training center in Tashkent, Uzbekistan, along with facilitating related strengthening of national faculty in each of the countries in the region.

A key component of the Knowledge Hub’s capacity strengthening role is the provision of technical assistance utilizing both regional and international clinical experts who possess a deep understanding of the HIV epidemic in Eastern Europe and Central Asia coupled with extensive experience in the provision and organization of appropriate care and treatment. The Knowledge Hub also supports related regional adaptation of clinical practice guidelines and care protocols, maintaining an extensive, comprehensive Web-based clearinghouse in both English and Russian languages to further support the use of current evidence-based materials and promote continuing education and quality improvement.

Currently, the Knowledge Hub offers more than 40 courses on a broad range of HIV-related care and treatment topics through its growing regional network of affiliated centers of clinical excellence and postgraduate education.

In Ukraine, courses have been conducted at various affiliated clinical sites through an agreement with the Ministry of Health, the National Medical Academy of Postgraduate Education, and the Ukrainian National AIDS Center since the Knowledge Hub was established in 2004. These clinical centers of excellence include:

Knowledge Hub courses are provided in the Russian Federation through an affiliation with the Baltic AIDS Training and Education Center (Baltic ATEC) in St. Petersburg. Established in 2008 by St. Petersburg City AIDS Center, Pavlov State Medical University, the Republican Infectious Disease Hospital at Ust-Izhora, and AIHA to assist Russia’s national and regional efforts to scale up HIV/AIDS services, the Baltic ATEC builds upon the work of a similar training center established in St. Petersburg in 2006. The Baltic ATEC’s capacity strengthening programs — which include curricula and faculty development — is supported through funding from the United States Agency for International Development (USAID), the World Health Organization (WHO), and other international donors and strategic partners. Participating clinical centers of excellence include:

  • St. Petersburg AIDS Control Center (adult care);
  • Botkin Infectious Disease Hospital (adult care); and
  • Republican Infectious Disease Hospital at Ust-Izhora (pediatric care).

Beginning in 2010, an increasing number of Knowledge Hub courses will be provided regionally in Central Asia through affiliation with the Tashkent-based Regional Training Center on Treatment, Care and Support for Persons Living with HIV in Central Asia (RTCCAR). RTC-CAR is being developed at a new clinical center associated with Uzbekistan’s National AIDS Center with funding support from Uzbekistan’s Ministry of Health and the Central Asia AIDS Control Project.

Sustainable Capacity Building to Strengthen Systems, Save Lives

The Knowledge Hub works closely with national authorities and leading centers for postgraduate education to develop curricula and implement training programs, so that physicians who pass a series of courses related to adult or pediatric HIV/AIDS treatment and care may qualify for national continuing education certification. Physicians attending qualifying courses in Kyiv, for example, may receive certification through Ukraine’s National Medical Academy for Postgraduate Education. Those who attend qualifying courses in St. Petersburg may receive certification through Pavlov State Medical University. In the future, similar certification arrangements will be made available for individuals attending courses in Tashkent through the Tashkent Institute for Postgraduate Medical Education. These cooperative arrangements help ensure institutionalization of training capacity well into the future.

The Regional Knowledge Hub has adopted a comprehensive and sustainable approach to training healthcare and allied professionals in HIV/AIDS treatment and support. Curricula are constantly evolving based on the latest recommendations developed by WHO, national experts, and leading international agencies.

Because HIV/AIDS is a complex and relatively new disease, treatment changes rapidly as we learn more about it. With this in mind, courses offered by the Knowledge Hub are continually updated to reflect the latest best practices. They are designed to arm healthcare professionals with critical clinical skills and provide extended opportunities for learning. All training takes place in small groups to better facilitate an open dialogue between instructors and participants.

Knowledge Hub courses emphasize a multidisciplinary “care team” approach. Physicians, nurses, and social workers receive introductory training and mentoring in this collaborative method to build common understanding of HIV and the complementary roles each team member must play to help ensure patients have access to comprehensive, integrated care and treatment. To this end, Knowledge Hub courses also provide training for ob/gyns, psychologists, policymakers, lab technicians, clinic administrators, and clinicians who specialize in tuberculosis, substance abuse, and other fields, as well as case managers, social workers and volunteers working with HIV service organizations.

The Regional Knowledge Hub has also developed a quality control system for each training course. Pre- and post-course surveys and daily assessment tests, combined with onsite mentoring and evaluation of changes in clinical practice, are used to fine-tune curricula and help identify future training needs.