The European Union and its Member States (MSs) have made substantial progress towards reaching the United Nations’ Sustainable Development Goal 3 ‘To ensure healthy lives and promote well-being for all at all ages’, and its specific target of ending HIV/AIDS, TB and other communicable diseases. However, significant differences and inequalities that prevent further progress towards these targets still exist within the EU, namely between MSs, and between and within the affected communities. Project CORE – “Community Response to End Inequalities” aims to reduce these inequalities by promoting, strengthening and integrating the community responses that have proven key in reaching those “hard to reach” by mainstream prevention and healthcare services, especially in MSs where these responses are still lacking. To strengthen community responses, CORE will use capacity building, networking, and the exchange of good practice and innovative approaches, including for data monitoring and reporting. To ensure ownership and stakeholders’ interest in implementing and sustaining these interventions, it will proactively reach out and engage relevant stakeholders. To promote integration of these approaches into disease prevention and health promotion strategies and systems, it will address legal, policy, and structural issues. It will build on and intensify collaboration of regional networks and national and local organisations of people living with HIV, key populations, and service provider organisations. It will use, adapt, and disseminate existing national, regional, and global good practice approaches and tools from across key populations and disease areas, and provide platforms for exchange. CORE will focus on expanding, strengthening, and sustaining community initiatives so they are able to work with communities left behind in national responses. It will integrate and harmonise community initiatives to respond, in particular to the needs of people with multiple vulnerabilities.

Under this action grant proposal, CORE pursues the following strategic goals:

1. Focusing on EU Member States in central and south-eastern Europe, strengthening the capacity of community-led and community-based services to provide prevention, testing, counselling, linkage to and retention in care with respect to HIV/AIDS, TB, viral hepatitis and STI. To build the capacity of community-led and community-based services to respond to the needs of individuals who experience multiple vulnerabilities and/or belong to more than one key population (intersectionality).
2. Consolidate and increase the scope and effectiveness of community-based linkage to care in an integrated testing approach for the early diagnosis of HIV, TB, viral hepatitis, and STI. Ensure effective referral to mainstream healthcare services through a peer approach.
3. Support exchange and dialogue between community-led and community-based service providers, community networks, representatives of key affected communities, and other stakeholders for the development and implementation of national and local programmes in response to HIV/AIDS, TB, viral hepatitis and STI. Ensure that groups currently lacking adequate access to services are reached and involved in the project. Generate interest and gain the support of key actors to promote the sustainability, transferability and scale up of project output.
4. Address policy, legal and structural barriers to create an operating environment supportive and appreciative of community-led and community-based initiatives in response to HIV/AIDS, TB, viral hepatitis and STI

Afrikaherz works within the Working Package (WP) 5 of the CORE project.

Specific objectives (WP 5):

- Expand the use of harmonised data collection and reporting tools among community-based voluntary counselling and testing services provided by implementing partners.

- Expand the use of peer-facilitated referral systems to promote linkage to and retention in care

The main aim of WP5 is to consolidate and increase the scope and effectiveness of community-based service provision in an integrated prevention, testing, linkage to care and treatment adherence approach. It will focus on early diagnosis of HIV, viral hepatitis, other STI, and Tuberculosis using a data collection tool based on needs identified by the community. WP5 will harmonise testing and linkage to care data collected by community-based services, generating Europe-wide standardised indicators to be used at local, national and regional levels. To achieve this, the COBATEST network tools, developed as part of the HIV-COBATEST project, will be used and adapted as necessary, following the consensus recommendations for collection and integration of CBVCT testing and linkage to care data into national surveillance systems for HIV, viral hepatitis and STIs, generated by the INTEGRATE project.

WP5 will also develop a peer programme manual to contribute to effective peer support strategies. WP5 will deliver a systematic assessment of potential strategies for scale-up and transfer of innovative health pathways, and create the necessary knowledge base to overcome barriers to scaling-up access to treatment that will be identified in the context of different healthcare settings across the participating community-based organisations (CBO).

The interventions envisaged with the CBO invest in promoting safer behaviour and risk reduction (both sexual and associated with drug use), increasing health literacy, and disseminating targeted and adapted information. Furthermore, the multidisciplinary community that will be established by CORE will champion good practice in the implementation of health service delivery.

WP5 activities will be implemented in 14 CBO based in 12 European countries (Bulgaria, Cyprus, Greece, France, Germany, Hungary, Poland, Portugal, Romania, Slovakia, Slovenia, and Sweden). They will focus on the groups most affected by these HIV, TB, viral hepatitis and STI: people who use drugs, sex workers, men who have sex with men, migrants, and ethnic minorities, using the following strategies:

1. Map and develop activity plans to be implemented through the project by community-based service organisations (CBO) by identifying the current approaches, resources, needs, and barriers for community-based integrated testing and linkage to care to the most vulnerable groups.
2. Review and harmonise data collection tools, quality assurance, data analysis, and dissemination.
3. Pilot and implement new modules to add to the COBATEST data collection tools according to the identified needs.
4. Pilot multilevel strategies according to need, and follow the activity plans developed for community-based services organisations to improve the implementation and integration of interventions at the service delivery level.
5. To effectively reach the communities most at risk for HIV, TB, viral hepatitis, and STI, and to improve linkage and adherence to care through the implementation of a peer programme

Project duration: 01.01.2023-31.12.2025

Funding: European Union (European Health and Digital Executive Agency | EU4H Project Grants)

Lead Organisation/Coordinator: Deutsche Aids-Hilfe (DAH) e.V.

Partner organisations:

• European Aids Treatment Group Ev - EATG
• Fondazione Lega Italiana Per La Lotta Contro L'aids - Lila Milano Onlus - Fondazione Lila Milano Onlus
• Gat - Grupo Portugues De Activistassobre Tratamentos De Vih/Sida - Pedro Santos
• Prins Leopold Instituut Voor Tropische Geneeskunde - ITM
• Institut De Investigacio En Ciencies De La Salut Germans Trias I Pujol - IGTP-CERCA
• Stichting International Committee On Rights For Sexworkers In Europe
• Stichting Africa Advocacy Foundation
• Ceska Spolecnost Aids Pomoc Zs
• Foundation For Social Education - Fundacja Edukacji Społecznej
• Praksis Association - Programs Of Development Social Support And Medicalcooperation
• Noaks Ark Mosaik
• Drustvo Kulturno Informacijsko In Svetovalno Sredisce Legebitra
• Zdrave Bez Granitsi Sdruzhenie - Health Without Borders Association
• Hatter Tarsasag - Hatter Society
• Federation Parapluie Rouge
• Asociatia Carusel - Carusel Association
• Asociatia Romana Anti Sida - ARAS
• Obcianske Zdruzenie Odyseus - Odyseus
• Verband für Interkulturelle Arbeit (VIA) Regionalverband Berlin/Brandenburg e.V.
  
• Kinisi Symparastasis Gia To Aids - Aids Solidarity Movement
• Jogriporter Alapitvany - Right Reporter Foundation
• Positive Voice - Hellenic Organization Of People Living With Hiv Positive Voice
• Stichting De Regenboog Groep - De Regenboog Groep