AccScience Publishing / GHES / Online First / DOI: 10.36922/ghes.2536
Submit to GHES
Cite this article
7
Download
196
Views
Journal Browser
Volume | Year
Issue
Search
Forthcoming Issue
Current Issue
View All
News and Announcements
View All
REVIEW

Trajectory and progress of opioid agonist therapy programs in the Kyrgyz Republic 

Amanda R. Liberman1* ,  Ainura Kurmanalieva2 ,  Damira I. Biibosunova3 ,  Natalya Shumskaya2 ,  Roman Ivasiy1 ,  Daniel J. Bromberg4,5,6 ,  Lynn M. Madden1,7 ,  Frederick L. Altice1,4,7
Show Less
1 Section of Infectious Diseases, School of Medicine, Yale University, New Haven, Connecticut, United States of America
2 AIDS Foundation East-West in the Kyrgyz Republic, Bishkek, Kyrgyzstan Republic
3 Division of Global HIV and TB, CDC, Bishkek, Kyrgyzstan Republic
4 Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, United States of America
5 Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
6 Department of Psychiatry and Psychotherapy (Campus Charité Mitte), Charité—Universitätsmedizin Berlin, Berlin, Germany
7 APT Foundation, New Haven, Connecticut, United States of America
GHES, 2536 https://doi.org/10.36922/ghes.2536
Submitted: 23 December 2023 | Accepted: 10 May 2024 | Published: 26 September 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Download PDF
Cite
XML
Abstract

The incidence and mortality of human immunodeficiency viruses (HIVs) are rising in Eastern Europe and Central Asia (EECA), particularly among people who inject drugs. Opioid agonist therapies (OATs), such as methadone or buprenorphine, are the most effective treatments for opioid use disorder and serve as a key HIV-prevention strategy in EECA. OAT uptake across the region, however, has been limited. The Kyrgyz Republic was the first Central Asian country to initiate OAT and remains a pioneer in the region. To understand the progression of OAT scale-up, all legislations related to drug policies or methadone in the Kyrgyz Republic were analyzed from the country’s founding to March 2023 and compared with policies in neighboring countries, particularly Kazakhstan and Tajikistan. Concurrently, local news coverage and policy reports were also assessed. OAT has been available in the Kyrgyz Republic since 2001, initially as a pilot project funded by international donors, and then with gradually increasing state support. Since its inception, the methadone program has evolved and influenced neighboring countries in Central Asia, despite numerous political challenges. The Kyrgyz Republic has expanded access to methadone, revised clinical protocols, and increased the number of distribution sites in communities and the carceral system to ensure broader access, aiming for program sustainability. While methadone policies and implementation in the Kyrgyz Republic have advanced earlier and more expansively than in neighboring countries, some challenges persist. Based on the findings, the suggestions provided may support the sustainable scale-up of methadone programs, enabling continued growth and improvement.

Keywords
Kyrgyz Republic
Methadone policy
Opioid use disorder
Opioid agonist therapy
Funding
Funding for this research was provided through the National Institute of Drug Abuse (R01DA054851) and Fogarty International Center (D43TW010540, D43TW012492).
Conflict of interest
The authors declare that they have no competing interests.
References
  1. About Narcotic Drugs, Psychotropic Substances and Precursors, Pub. L. No. 66. (1998). Available from: https://cbd.minjust. gov.kg/act/view/ru-ru/74?cl=ru-ru [Last accessed on 2023 Jun 01].

 

  1. Aizberg, O. (2008). Opioid Substitution Therapy in Selected Countries of Eastern Europe and Central Asia. Available from: https://rcn.kg/uploads/files/19jan-final-ost overview_ rus_Jan 92_2_.pdf [Last accessed on 2023 Aug 01].

 

  1. Alieva, G., Saiakova, M., & Yusupova, A. (2013). Michels, I.I., Iskakova, C., & Zelichenko, A. (eds.). Women and Addiction in the Kyrgyz Republic. Available from: https://library.fes. de/pdf-files/bueros/bischkek/10178.pdf [Last accessed on 2023 Aug 01].

 

  1. Alistar, S.S., Owens, D.K., & Brandeau, M.L. (2011). Effectiveness and cost effectiveness of expanding harm reduction and antiretroviral therapy in a mixed HIV epidemic: A modeling analysis for Ukraine. PLoS Medicine, 8(3):e1000423. https://doi.org/10.1371/journal.pmed.1000423

 

  1. Azbel, L., & Altice, F.L. (2022). How methadone becomes an intoxicant: The making of methadone within prisons in the Kyrgyz Republic. In: Routledge Handbook of Intoxicants and Intoxication. Milton Park: Taylor and Francis, p.203-220. https://doi.org/10.4324/9780429058141-17

 

  1. Azbel, L., Bromberg, D.J., Dvoryak, S., & Altice, F.L. (2022). Addiction treatment as prison governance: A critical discourse analysis of methadone delivery in Kyrgyz prisons. Contemporary Drug Problems, 49(1):106-120. https://doi.org/10.1177/00914509211060723

 

  1. Azbel, L., Wegman, M.P., Polonsky, M., Bachireddy, C., Meyer, J.P., Shumskaya, N., et al. (2018). Drug injection within prison in Kyrgyzstan: Elevated HIV risk and implications for scaling up opioid agonist treatments. International Journal of Prisoner Health, 14(3):175-187. https://doi.org/10.1108/IJPH-03-2017-0016

 

  1. Bachireddy, C., Shrestha, R., Bromberg, D.J., Azbel, L., Kurmanalieva, A., Wegman, M., et al. (2022). Methadone within prison and linkage to and retention in treatment upon community release for people with opioid use disorder in Kyrgyzstan: Evaluation of a national program. International Journal of Drug Policy, 101:103558. https://doi.org/10.1016/j.drugpo.2021.103558

 

  1. Bojko, M.J., Dvoriak, S., & Altice, F.L. (2013). At the crossroads: HIV prevention and treatment for people who inject drugs in Ukraine. Addiction, 108:1697-1699. https://doi.org/10.1111/add.12243

 

  1. Bojko, M.J., Mazhnaya, A., Makarenko, I., Marcus, R., Dvoriak, S., Islam, Z., et al. (2015). “Bureaucracy and Beliefs”: Assessing the barriers to accessing opioid substitution therapy by people who inject drugs in Ukraine. Drugs: Education, Prevention and Policy, 22(3):255-262. https://doi.org/10.3109/09687637.2015.1016397

 

  1. Degenhardt, L., Grebely, J., Stone, J., Hickman, M., Vickerman, P., Marshall, B.D.L., et al. (2019a). Global patterns of opioid use and dependence: Harms to populations, interventions, and future action. The Lancet, 394(10208):1560-1579. https://doi.org/10.1016/S0140-6736(19)32229-9

 

  1. Degenhardt, L., Grebely, J., Stone, J., Hickman, M., Vickerman, P., Marshall, B.D.L., et al. (2019b). Global patterns of opioid use and dependence: Harms to populations, interventions, and future action. The Lancet, 394(10208):1560-1579. https://doi.org/10.1016/S0140-6736(19)32229-9

 

  1. Eurasian Harm Reduction Association. (2019). Analytic Note on the Proportionality of Imposed Fines for Narcotic Drug Possession in the Kyrgyz Republic. Lithuania: Eurasian Harm Reduction Association.

 

  1. Farnum, S.O., Makarenko, I., Madden, L., Mazhnaya, A., Marcus, R., Prokhorova, T., et al. (2021). The real-world impact of dosing of methadone and buprenorphine in retention on opioid agonist therapies in Ukraine. Addiction, 116(1):83-93. https://doi.org/10.1111/add.15115

 

  1. Instructions on implementation of methadone maintenance therapy and needle and syringe programs in institutions of the State Penitentiary Service under the Government of the Kyrgyz Republic. (2015).

 

  1. Ivasiy, R., Madden, L.M., Farnum, S.O., Shumskaya, N., De Leon, S.J.G., Bromberg, D.J., et al. (2022). Implementation opportunities for scaling up methadone maintenance treatment in Kyrgyzstan: Methadone dosage and retention on treatment over two years. Drug and Alcohol Dependence Reports, 4:100075. https://doi.org/10.1016/j.dadr.2022.100075

 

  1. Joint UN Programme on HIV/AIDS. (2023). UNAIDS Data 2023. Available from: https://www.unaids.org/en/resources/ documents/2023/2023_unaids_data [Last accessed on 2024 Feb 28].

 

  1. Katkalova, O. (2021). In: Kranzhelich N, editor. Analysis of Changes in Harm Reduction Service Packages and their Cost Per Client in the Transition from International to Public Funding in Kyrgyzstan. Available from: https:// harmreductioneurasia.org/wp-content/uploads/2022/03/ unit-costs-kyrgyzstan-2021-ru.pdf [Last accessed on 2024 Aug 01].

 

  1. Kazakhstan Union for PLHIV, ITPCru, Central Asian Association of PLHIV, & Public Foundation AGEP’C. (n.d.). Information Pereboi. Available from: https://pereboi.kz/information [Last accessed on 2023 Jan 17].

 

  1. Khachatrian, A. (2009). Uzbekistan: Government discontinues pilot opiate substitution therapy program. HIV/AIDS Policy and Law Review/Canadian HIV/AIDS Legal Network, 14(2):26-27.

 

  1. Kluczewska, K., & Korneev, O. (2021). Policy translation in global health governance: Localising harm reduction in Tajikistan. Global Social Policy, 21(1):75-95. https://doi.org/10.1177/1468018120961851

 

  1. Kyrgyz Republic Funding Request Form. (2022). Available from: https://data.theglobalfund.org/location/KGZ/documents [Last accessed on 2024 Aug 02].

 

  1. Labor Codex of the Kyrgyz Republic. (2004). Available from: https://cbd.minjust.gov.kg/act/view/ru-ru/1505 [Last accessed on 2024 Aug 02].

 

  1. Latypov, A., Bidordinova, A., & Khachatrian, A. (2012). Opioid Substitution Therapy in Eurasia: How to Increase the Access and Improve the Quality. SSRN Electronic Journal, 1-20. https://doi.org/10.2139/ssrn.2184370

 

  1. Liberman, A.R., Bromberg, D.J., Azbel, L., Rozanova, J., Madden, L.M., Meyer, J.P., et al. (2021). Decisional considerations for methadone uptake in Kyrgyz prisons: The importance of understanding context and providing accurate information. International Journal of Drug Policy, 94:103209. https://doi.org/10.1016/j.drugpo.2021.103209

 

  1. Liberman, A.R., Bromberg, D.J., Litz, T., Kurmanalieva, A., Galvez, S., Rozanova, J., et al. (2022). Interest without uptake: A mixed-methods analysis of methadone utilization in Kyrgyz prisons. PLoS One, 17:e0276723. https://doi.org/10.1371/journal.pone.0276723

 

  1. MacArthur, G.J., Minozzi, S., Martin, N., Vickerman, P., Deren, S., Bruneau, J., et al. (2012). Opiate substitution treatment and HIV transmission in people who inject drugs: Systematic review and meta-analysis. BMJ, 345(7879):e5945. https://doi.org/10.1136/BMJ.E5945

 

  1. Makarenko, I., Mazhnaya, A., Polonsky, M., Marcus, R., Bojko, M.J., Filippovych, S., et al. (2016). Determinants of willingness to enroll in opioid agonist treatment among opioid dependent people who inject drugs in Ukraine. Drug and Alcohol Dependence, 165:213-220. https://doi.org/10.1016/j.drugalcdep.2016.06.011

 

  1. Matieva, V.S., Chokmorova, U.Z., Ismailova, A.D., Asybalieva, N.A., Yanbukhtina, L. F., Sarybaeva, M.E., et al. (2015). Country Report on Progress in Implementation of the 2014 Global Response to HIV: Republic of Kyrgyzstan. Available from: https://www.unaids.org/sites/default/files/country/ documents/KGZ_narrative_report_2015.pdf [Last accessed on 2023 Aug 23].

 

  1. Mazhnaya, A., Bojko, M.J., Marcus, R., Filippovych, S., Islam, Z., Dvoriak, S., et al. (2016). In their own voices: Breaking the vicious cycle of addiction, treatment and criminal justice among people who inject drugs in Ukraine. Drugs: Education, Prevention and Policy, 23(2):163-175. https://doi.org/10.3109/09687637.2015.1127327

 

  1. Meyer, J.P., Culbert, G.J., Azbel, L., Bachireddy, C., Kurmanalieva, A., Rhodes, T., & Altice, F.L. (2020). A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction. Harm Reduction Journal, 17(1):1-9. https://doi.org/10.1186/s12954-020-00435-7

 

  1. Ministry of Health of the Kyrgyz Republic, & Republican Centre for Psychiatry and Narcology. (2022). Treatment of People with Opioid Addiction Based on Opioid Agonist Substitution Therapy: Clinical Guidelines.

 

  1. Ministry of Health of the Kyrgyz Republic, & Republican Narcology Center. (2015). Treatment of Opioid Dependence Using Methadone Maintenance Therapy: Clinical Protocol. Available from: https://rcn.kg/uploads/files/КП_ ОЗТнаПРИКАЗ_29.05.2015.pdf [Last accessed on 2023 Jun 11].

 

  1. Ministry of Health of the Kyrgyz Republic, & Republican Narcology Center. (2017). Mental and Behavioral Disorders Due to the Use of New Psychoactive Substances in Children and Adolescents. Diagnostics, Treatment and Prevention. (Clinical Protocol).

 

  1. Ministry of Justice of the Kyrgyz Republic. (n.d.). Centralized Databank of Legal Information of the Kyrgyz Republic. Available from: https://cbd.minjust.gov.kg [Last accessed on 2023 Jun 04].

 

  1. Moeller, L., Moeller, L., Karymbaeva, S., Subata, E., Kiaer, T., & Europe Worrld Health Organization. (2009). Evaluation of Patients in Opioid Substitution Therapy in the Kyrgyz Republic. Available from: https://www.euro.who.int/ pubrequest [Last accessed on 2023 Aug 01].

 

  1. Nachega, J.B., Musoke, P., Kilmarx, P.H., Gandhi, M., Grinsztejn, B., Pozniak, A., et al. (2023). Global HIV control: Is the glass half empty or half full? The Lancet HIV, 10(9):e617-e622. https://doi.org/10.1016/S2352-3018(23)00150-9

 

  1. On Additional Measures for Counteraction of Illicit Trafficking of Narcotic Drugs, Psychotropic Substances and Precursors, Pub. L. No. 654. (2011). https://cbd.minjust.gov.kg/act/ view/ru-ru/95293 [Last accessed on 2023 Jun 11].

 

  1. On Amendments to Order No. 71 of 2001 March 13 on the Conditions and Procedure for Substitution Therapy for Persons with Drug Dependence in the Kyrgyz Republic, Pub. L. No. 17. (2002). Available from: https://cbd.minjust. gov.kg/act/view/ru-ru/30207 [Last accessed on 2023 Jun 04].

 

  1. On Amendments to the Regulations “On the Conditions and Procedure for Conducting Methadone Maintenance Therapy for Persons Who Inject Drugs in the Kyrgyz Republic”. (2017).

 

  1. On Amendments to the Resolution Government of the Kyrgyz Republic “On Narcotic Drugs, Psychotropic Substances and Precursors Subject to Control in the Kyrgyz Republic” Dated 9 November 2007 No. 543, Pub. L. No. 535. (2018). Available from: https://cbd.minjust.gov.kg/act/view/ru-ru/12731 [Last accessed on 2023 Jun 01].

 

  1. On Approval of Mechanisms for Decentralization of Medical Services for People Living with Human Immunodeficiency Virus in the Kyrgyz Republic. (2019). Available from: https:// aidscenter.kg/wp-content/uploads/2021/02/Prikaz_-542_ ot_22_04_2019_detsentralizatsiya_uslug_dlya_LZHV.pdf [Last accessed on 2023 Aug 01].

 

  1. On Approval of the Anti-Drug Program, Pub. L. No. 54. (2014). Available from: https://cbd.minjust.gov.kg/96031/ edition/1144804/ru. [Last accessed on 2024 Sep 23].

 

  1. On Approval of the Fifth National Report of the Kyrgyz Republic on the Implementation of the International Covenant on Economic, Social and Cultural Rights from 2012 to 2019 Years, Pub. L. No. 91-r. (2021). Available from: https://cbd. minjust.gov.kg/act/view/ky-kg/218554 [Last accessed on 2023 Jun 04].

 

  1. On Expanding the Program of Substitution Maintenance Therapy with Methadone for Opioid Dependence in the Territory of Bishkek and Chui Region, Pub. L. No. 15, 56. (2011). Available from: https://continent-online.com/ Document/?doc_id=30336270#pos=0;0 [Last accessed on 2023 Jan 13].

 

  1. On HIV/AIDS in the Kyrgyz Republic, Pub. L. No. 149. (2005). Available from: https://cbd.minjust.gov.kg/act/view/ ru-ru/1747 [Last accessed on 2023 Jun 04].

 

  1. On Measures to Prevent Coronavirus Infections (COVID-19). (2020).

 

  1. On Measures to Reform the System of Law Enforcement Agencies of the Kyrgyz Republic, Pub. L. No. 161. (2016). Available from: https://cbd.minjust.gov.kg/act/view/ru-ru/69165 [Last accessed on 2023 Jun 11].

 

  1. On Psychiatric Care and Guarantees of Citizens’ Rights in the Provision of Psychiatric Care, Pub. L. No. 60. (1999). Available from: https://cbd.minjust.gov.kg/act/view/ ru-ru/225 [Last accessed on 2023 Jun 01].

 

  1. On the Conditions and Procedure for Conducting Methadone Maintenance Therapy for People Who Use Injection Drugs in the Kyrgyz Republic, Pub. L. No. 625. (2017).

 

  1. On the Creation of a Working Group for the Revision of the Clinical Protocol “Treatment of Opioid Dependence Based on Maintenance Therapy with Methadone”. (2015).

 

  1. On the Expansion of the Methadone Substitution Treatment Program in the Branches of the Organizations of the Ministry of Health of the Kyrgyz Republic. (2007).

 

  1. On the Extension of the State Program for Prevention of HIV/ AIDS Epidemic and Its Socio-Economic Consequences in the Kyrgyz Republic for 2006-2010 until 2012, Pub. L. No. 680. (2011). Available from: https://cbd.minjust.gov.kg/ act/view/ru-ru/95319?cl=ru-ru [Last accessed on 2023 Jun 04].

 

  1. On the Implementation of Orders of the Ministry of Health of the Kyrgyz Republic No. 625 Dated July 17, 2017 and No. 1082 Dated November 28, 2017, Pub. L. No. 131. (2017).

 

  1. On the Implementation of the Project GLO J71/OFID-UNODC, Pub. L. No. 494. (2010). Available from: https://www.rcn. kg/uploads/files; https://www.стандарт/детокс/реаб/ налоксон.pdf [Last accessed on 2023 Jun 04].

 

  1. On the Liquidation of the State Drug Control Service under the Government of the Kyrgyz Republic, Pub. L. No. 637. (2016). Available from: https://cbd.minjust.gov.kg/act/view/ ru-ru/99557 [Last accessed on 2023 Jun 11].

 

  1. On the Prevention of Offences in the Kyrgyz Republic, Pub. L. No. 82. (2005). Available from: https://cbd.minjust.gov.kg/ act/view/ru-ru/1679 [Last accessed on 2023 Jun 04].

 

  1. On the Protection of Citizens’ Health in the Kyrgyz Republic, Pub. L. No. 6. (2005). Available from: https://cbd.minjust. gov.kg/act/view/ru-ru/1602 [Last accessed on 2023 Jun 04].

 

  1. Ponticiello, M., Azbel, L., Tate, M.M., Bromberg, D.J., Pykalo, I., Kiriazova, T., et al. (n.d.). Introducing methadone maintenance therapy into Ukrainian prisons: A qualitative study of criminal subculture, Russia’s full-scale invasion, and contested methadone objects. Frontiers in Psychiatry, 14:1227216. https://doi.org/10.3389/FPSYT.2023.1227216

 

  1. Program “Methadone Substitution Therapy in Bishkek”, Pub. L. No. 41. (2001). Available from: https://cbd.minjust.gov.kg/ act/view/ru-ru/31844 [Last accessed on 2023 Jun 01].

 

  1. Regulations on the Rules and Procedure for Identifying, Registering and Recording in Public Health Institutions of the Kyrgyz Republic Persons Who Allow Non-Medical Consumption of Psychoactive Substances. (2001). Available from: https:// cbd.minjust.gov.kg/act/view/ru-ru/31551/20?mode=tekst [Last accessed on 2023 Aug 02].

 

  1. Republic of Kazakhstan. (n.d.). “Adilet” Legal Information System. Available from: https://adilet.zan.kz/eng [Last accessed on 2023 Jun 03].

 

  1. Republic of Tajikistan. (n.d.). National Center of Legislation under the President of the Republic of Tajikistan. Available from: https://ncl.tj [Last accessed on 2023 Jun 03].

 

  1. Republican AIDS Center of the Ministry of Health of the Kyrgyz Republic. (n.d.). [Data]. Available from: https://aidscenter. kg/dannye/?lang=ru [Last accessed on 2024 Apr 07].

 

  1. Republican Narcology Center of the Ministry of Health of the Kyrgyz Republic. (2016). Clinical Aspects of Methadone Maintenance Therapy for Nursing Staff of Methadone Dispensing Rooms: A Training Manual. Available from: https://www.rcn.kg/uploads/files; https://www.модуль для медсестер по ПТ.pdf [Last accessed on 2023 Aug 11].

 

  1. Republican Narcology Center of the Ministry of Health of the Kyrgyz Republic. (2017). Mental and Behavioral Disorders Due to the use of New Psychoactive Substances in Children and Adolescents: Diagnostics, Treatment and Prevention. Avaialble from: https://rcn.kg/uploads/ f i les/28353_%D0%9A%D0%BB%D0%B8%D0% B D % D 0 % B 8 % D 1 % 8 7 % D 0 % B 5 % D 1 % 8 1 % D 0 % B A % D 0 % B 8 % D 0 % B 9 % 2 0 % D 0 % B F % D 1 % 8 0 % D 0 % B E % D 1 % 8 2 % D 0 % B E % D 0 % B A % D 0 % B E % D 0 % B B % 2 0 % D 0 % B F % D 0 % B E % 2 0 % D 0 % 9 D % D 0 % 9 F % D 0 % 9 0 % D 0 % 9 2 . % 2 0 % D 0 % 9 E % D 0 % B A % D 0 % B E % D 0 % B D % D 1 %87%D0%B0%D1%82%2010. 07.17%D0%B3.pdf [Last accessed on 2023 Jun 04].

 

  1. Republican Narcology Center of the Ministry of Health of the Kyrgyz Republic. (2019). Clinical Protocol for Mental and Behavioral Disorders Due to Combined Use of Opioids and Alcohol: Diagnosis and Treatment. Available from: https://rcn.kg/uploads/files/71843_КП; https:// www.Психические/и/поведенческие/расстройства/ вследствие сочетанного употребления опиоидов и алкоголя RU.pdf [Last accessed on 2023 Aug 01].

 

  1. Republican Narcology Center. (2015). Treatment of Opioid Dependence Based on Methadone Maintenance Therapy: Clinical Protocol. Uzbekistan: Republican Narcology Center.

 

  1. Republican Narcology Center. (n.d.). A Brief History of Methadone Maintenance Therapy in the Kyrgyz Republic. Available from: https://rcn.kg/replacement-therapy/history [Last accessed on 2023 Oct 18].

 

  1. Subata, E., Moller, L., & Karymbaeva, S. (2015). Assessment of Opioid Substitution Therapy in the Kyrgyz Republic. Available from: https://www.rcn.kg/uploads/files/OST%20 report_rus_20March2016.pdf [Last accessed on 2023 Oct 19].

 

  1. Tan, J., Altice, F.L., Madden, L.M., & Zelenev, A. (2019). Effect of expanding opioid agonist therapies on the HIV epidemic and mortality in Ukraine: A modelling study. The Lancet HIV, 7(2):e121-e128. https://doi.org/10.1016/S2352-3018(19)30373-X

 

  1. Trends and Events in Harm Reduction in 2005: Countries with Predominantly Injection-driven HIV Epidemics. (2006). Available from: https://www.opensocietyfoundations. org/uploads/3b043e90-d8e7-499c-8ff6-fad8f16fde82/ ihrd2005arrussian_20060911_0.pdf [Last accessed on 2023 Aug 23].

 

  1. Trilling, D. (2012). Kyrgyzstan: Methadone Debate Puts Program at Risk. Eurasianet. Available from: https://eurasianet.org/ kyrgyzstan-methadone-debate-puts-program-at-risk [Last accessed on 2023 Aug 02].

 

  1. (2022a). Full Report-in Danger: UNAIDS Global AIDS Update 2022. UNAIDS. UNAIDS. Available from: https:// www.unaids.org/en/resources/documents/2022/in-danger-global-aids-update [Last accessed on 2023 Nov 01].

 

  1. (2022b). UNAIDS Data Reference 2022. UNAIDS. https://www.unaids.org/sites/default/files/media_asset/ data-book-2022_en.pdf [Last accessed on 2023 Nov 01].

 

  1. Ward, Z., Stone, J., Bishop, C., Ivakin, V., Eritsyan, K., Deryabina, A., et al. (2022). Costs and impact on HIV transmission of a switch from a criminalisation to a public health approach to injecting drug use in eastern Europe and central Asia: A modelling analysis. The Lancet HIV, 9(1):e42-e53. https://doi.org/10.1016/S2352-3018(21)00274-5

 

 

  1. WHO, UNODC, & UNAIDS. (2009). Who, Unodc, Unaids Technical Guide for Countries to Set Targets for Universal Access for HIV Prevention, Treatment, and care for Injecting Drug Users. Available from: https://www.who.int/hiv/pub/ idu/idu_target_setting_guide.pdf%5cnhttp://www.who.int/ hiv/pub/idu/targets_universal_access/en [Last accessed on 2023 Jun 04].

 

  1. Yesenamanova, A., Sultangaziyev, A., & Usenakunova, A. (2014). Recommendations for Universal Access to HIV Prevention, Treatment and Care for People who Inject Drugs in the Kyrgyz Republic. Available at: https://belau.info/hub/wp/ wp-content/uploads/2018/01/Kompleksnyiy-paket-uslug. pdf. [Last accessed on 2024 Sep 23].
Share
Back to top
Global Health Economics and Sustainability, Electronic ISSN: 2972-4570 Published by AccScience Publishing
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here
Accept