 Can you tell us what investments and impact the Global Fund made in terms of fighting injecting drug users in terms of fighting HIV-AIDS among injecting drug users in the region? Well, the Global Fund hasn't done anything on its own. It's actually by investing in the countries and the people in the countries. And it's really their leadership and their work and it begins with the affected communities but also government response. So in some countries Belarus, Moldova, Romania, to some extent Kazakhstan, we have seen significant progress and there have been investments by the Global Fund that has supported some of that. But it's really been because of the Georgia also here, Ukraine. So there are countries that are making progress and the Global Fund has supported some of that but it really is just support. It's the in-country work by the civil society groups, by the government, by UN agencies that are here, UN AIDS for example, that that progress is made. Why the Global Fund supporting harm reduction? Because it works. So harm reduction is proven as the effective tool in people who inject drugs and it not only works on HIV, it actually works through a societal mechanism. So what's called substitution therapy actually gives people their lives back. Many people unfortunately think the use of and drink as drugs is a societal choice in some ways. It actually is an addiction like other addictions and there's a medical treatment for an addiction as there's a medical treatment for many other addictions just like there's a medical treatment for depression. There is medical treatment that gives people their lives back and what we've learned is that that substitution therapy not only reduces HIV, one of the ways it reduces HIV is by people become employed. They have their family again. They don't have to steal in order to obtain intravenous drugs and they actually don't need intravenous sharing of drugs that can lead to HIV infection. And so countries for example like China that were totally opposed to harm reduction programs for security reasons when their security forces understood the impact not just on HIV but on actually society changed completely and now provide harm reduction. So harm reduction works, the evidence is overwhelming but it works not just as an HIV tool, it actually works because it treats an addiction and gives people back their lives. A lot of middle income countries global fund projects ended or being ending now. Why did the global fund decide to end projects in these countries? Well we actually have a transition and it's not middle income countries we don't actually end projects until you get to upper income or your disease burden is very low. So it's a combination of how much disease you have how much HIV and tuberculosis particular in this region and also your income status but it's not it's not middle income it's actually upper income so our high income. But as countries have more money themselves as their economies grow the external financing does go down as it should because countries have to take on more responsibility but if you look at this current three-year period through 2017 and the previous three-year period the amount in the amount of money in the region is exactly the same except for a few countries because their disease burden is very low and because their incomes have grown so much the money the amounts are the same or higher in the majority of the countries in the region. For the period beyond that we'll have to see what the disease burden is what the income status is also how much money we're able to raise and and then for the three years beyond that I think the challenges will become more difficult because the incomes will be growing and the disease burden we hope will be declining. We were filming in some countries for example Serbia and Bulgaria where global fund projects ended and that's in dangers the existence of harm reduction programs which were dependent on international donors so how can you make sure that you can avoid the same bad examples in the future how can you work with with governments to ensure that these transitions will be smoother in the future. So we actually are working with governments and doing transition plans but it's not just us I mean it's a collective effort including with the government civil society but importantly other agencies UN agencies are here. Bulgaria is a somewhat unique circumstance it's in the European Union so countries that are in the European Union have mechanisms through the European Union and European Commission and the European Commission and the Europe actually is our one of our largest donors so it makes no sense to them to give money to us to give money to their member states so there are other mechanisms within the European Union. Now governments and countries have to access those mechanisms so we're working with the parts of the European Union that have those financing mechanisms on the country to make sure the countries are aware of them and can access them but for countries in the European Union it's a very different situation similar to a state in the United States we wouldn't finance them either. What about countries which are outside of the EU for example Serbia, Montenegro or even Mexico, Thailand which are facing the same future in terms of harm reduction programs? Well Mexico transitioned from the global fund a while ago and actually have tried to keep up their harm reduction programs but you know they're upper middle income countries and so we don't finance large programs in upper middle income countries because it's the responsibility of the governments to fund large-scale programs. Thailand is in the process of transition and they actually have a bill before their parliament to finance in fact their goals for people who inject drugs are doubling as we transition from Thailand so they're actually projecting a significant increase in services to people who inject drugs in Thailand. Now we have to work with them and it's not always through the same mechanism and not often as a challenge and you know some groups are upset that when they don't get funded to do something but if the people get services that's what we're after so each country is unique and each country is different. Montenegro and and Serbia have relatively low levels of infection and high incomes and that you know we also have to fund other countries so there are countries in Africa that are hundreds of millions of dollars a year underfunded to provide services to their people and so our total budget for the world is less than four billion dollars a year the total need for these three diseases in low and middle income countries is in the neighborhood of 50 billion dollars a year so you know there just isn't the resource and so if a country has a low disease burden and a high income external financing is very difficult. So does it mean that in those countries like Russia Ukraine where there is a high disease burden because there is a very rapid HIV epidemic among one of the most vulnerable population you are committed to continue funding these programs? Well Ukraine is very heavily funded by the global fund by far the highest amount of any country in this region they also have higher income. Russia is a high income country and we don't fund high income countries we don't fund programs in any high income countries and so Russia has is in its last phase of a grant from the global fund because they're high income so Ukraine is different it's a middle income country and we do finance resources but they're they're getting to an upper middle income country and so over time they need to assume more responsibility they are they actually are increasing their own financing but there have been difficulties recently that have made that complex that we continue to work with them so but the Ukraine the amount Ukraine has dedicated to it for this three years is approximately the same as it had over the last three years but there will be a decline over time because they they have resource. But even if Russia is a high income country but there is lack of political will to support some very important programs for example substitution programs bands and that is no funding for needle exchange programs so how flexible are your criteria like are you considering also like political the lack of political will in some countries. No because our financing comes from a development agency and once a country's high income they're responsible for their people so I come from a city Washington DC that has a higher HIV rate than any country in this region that has a higher HIV rate and the same infection rate in the gay community and the same infection rate in some places as the drug and drug use population we don't have programs in the United States either so once your high income you're responsible for your people. So what do you suggest for those society organizations that are based in those countries where there will the global fund projects will end so how to ensure that there will be a transition to domestic funds. So we're working on that collectively but it can't just be the civil society in the traditional sense of the populations affected by the disease because that's politics is politics and budgets and there's a lot of need no matter where you go so we are working to engage a broader coalition for example medical professionals the faith community as well as key affected populations so we need to engage a broader segment of society so that they're educated about the issues know about the issues and become part of a coalition that advocates for resource because alone traditional civil society key affected populations will probably not be sufficient we need to have a broader coalition of people who are supportive and that's what we're working to build but that's not just the global fund it's actually all of us collectively doing that. Okay thank you very much.