The AIDS2024 Conference

Ahead of the 25th International AIDS Conference, which will be held in Munich in late July, the regional information campaign “Walls are not the answer! #PutPeopleFirstEECA” is launched. Сampaign is coordinated by the VirusOFF media platform and the Alliance for Public Health, with the support of UNAIDS EECA. The campaign and activities are carried out with the participation of regional networks and organizations.

The campaign aims to amplify the voices of the Eastern Europe and Central Asia (EECA) region and give communities, activists, public and international organizations, and human rights defenders working to end the AIDS epidemic a platform to speak out about what hinders the region from stopping the epidemic and why it is important to put people first.

“The #PutPeopleFirstEECA campaign is an important cooperation of regional organizations and community networks of EECA region in the information field ahead of the International #AIDS2024 Conference. #SoS_project 2.0 always supports such initiatives of the region. We believe that only through the joint efforts of all stakeholders and sustained international support we can overcome barriers such as restrictive laws, criminalization and stigmatization, and, make a significant progress in access to treatment and sustainability of HIV services. I encourage experts from the region to share their views and experiences on best approaches, support the campaign,” said Inna Gavrilova, Alliance for Public Health.

The EECA region faces significant barriers such as restrictive laws, criminalization, and stigmatization, which hinder the fight against HIV. To combat these challenges and prevent the building of new “walls” in the region, the concerted efforts of all stakeholders and sustained international support are needed.

According to UNAIDS, the HIV epidemic in Eastern Europe and Central Asia is the fastest-growing in the world. Since 2010, the number of new cases in the region has increased by 49%, and the number of deaths has risen by 46% over the same period. Additionally, only half of the patients with HIV-positive status are receiving therapy.

Ineffective laws, criminalization, gender inequality, and the consequences of the war in Ukraine are just a few of the reasons why countries in Eastern Europe and Central Asia may not meet the goal of ending the epidemic by 2030.

What needs to be done to stop the spread of the infection? How can governments be convinced to fully fund prevention and support programs? And why should people be put first in the fight against HIV? These questions will be discussed at the AIDS 2024 International Conference, where the Eastern Europe and Central Asia region will be one of the priority topics. The information campaign is part of the #PutPeopleFirst initiative launched by the organizers of the 25th International AIDS Conference.

If you want to join, record your short video message answering the question “Why should people be put first in the fight against the HIV epidemic?” and post it on social media with the hashtag: #PutPeopleFirstEECA and #PutPeopleFirst. Your opinion could lead the way!

The #PutPeopleFirstEECA campaign is coordinated by the VirusOFF media platform and the Alliance for Public Health, with the support of UNAIDS EECA. The campaign and activities are carried out with the participation of regional networks and organizations: ECOM, ITPC EECA, EHRA, Teenergizer, EWNA, ENPUD, REG, EKPC, AFEW, HAC, 100% Life, Alliance Consultancy, Life4me+, Eurasian Movement for the Rights to Health in Prisons, SoS_project 2.0, #BaltHUB and others.

Follow the pages of the VirusOFF media platform and its partners on social media to not miss updates within the campaign and the launch of the special EECA page for AIDS 2024.

Learn more about Eastern Europe and Central Asia at AIDS 2024 by visiting aids2024.virusoff.info, a special web page dedicated to EECA and AIDS 2024 on the online regional platform Virus OFF. 

Instagram – Virus off

Facebook – Virus Off

X Social Network – UNAIDS EECA 

Linkedin – Alliance for Public Health 

Kyiv, Ukraine – 19/06/2024 

ICF “Alliance for Public Health” in partnership with the Alliance Consultancy is pleased to announce the opening of the Help24 TeleHealth telemedicine platform and online clinic. This unique platform, based on the Help24 website, provides free online medical services to vulnerable populations in Ukraine. In particular:

• Virtual consultations with doctors.
• Remote referral for laboratory tests.
• Online prescription and treatment monitoring.
• Access to HIV and other sexually transmitted infections prevention.
• Mental health counseling.
• Testing and counseling for infectious diseases.

“Help24 TeleHealth is not just a new platform. This is a strategic direction of the Alliance’s work and another step towards the introduction of modern IT solutions in Ukrainian medicine, which means a significant leap forward in ensuring the availability and quality of medical care for key and vulnerable populations, especially in wartime and the destruction of the healthcare system. In 2023, 13,267 medical consultations were provided through the platform. The Help24 TeleHealth platform is an innovation that saves lives!“ – emphasizes Andriy Klepikov, Executive Director, ICF “Alliance for Public Health”.   

Help24 TeleHealth is:

• • A unique Ukrainian platform that offers online clinic and telemedicine services specially created for people living with HIV and other vulnerable groups.
  • A comprehensive solution that allows you to:
    • Receive preventive and treatment services for HIV, mental disorders, and viral hepatitis even in the context of military operations and the destruction of the healthcare system.

• Access diagnostic tools and PrEP remotely.

• Take advantage of psychological assistance.
• Read information and educational materials.
• A team of more than 15 experienced medical professionals who guarantee openness, expertise, and confidentiality of consultations, regardless of your location.
• Absolute data security and confidentiality, as information protection is one of the platform’s top priorities.

“Help24 TeleHealth is a new stage in providing affordable and high-quality online medical services,” – says Vlasta Brodska, Director, Alliance Consultancy. “With this platform, we are breaking down barriers and ensuring equal access to healthcare for all groups of people. Our goal is to provide the necessary support to those who are most vulnerable to HIV and other infections, so all Help24 TeleHealth services are free of charge. We believe this innovative platform will become a key tool for improving the health and well-being of our citizens.”

The initiative is supported by the Public Health Center of the Ministry of Health of Ukraine, as well as Frontline AIDS and Gilead. 

Andriy Bilets, an infectious disease specialist at the Department of HIV Management and Control, Public Health Center of the Ministry of Health of Ukraine, emphasizes the importance of telemedicine and Help24 TeleHealth in the fight against HIV in the context of active hostilities in Ukraine: “Given the current situation in Ukraine, telemedicine is becoming extremely important as it helps to ensure timely diagnosis, treatment and prevention of HIV infection, especially in conditions of limited human resources and lack of access to healthcare facilities due to damage or destruction of infrastructure. This not only saves time and money for patients, but also allows them to receive prompt, qualified assistance regardless of their location, which is especially important during military aggression and active hostilities.”

“We support this initiative because it provides patients with access to HIV diagnosis, treatment and prevention, helping to overcome existing barriers and provide quality and comprehensive medical care even in the most difficult times. Through the implementation of such interventions, we not only ensure the implementation of the State Strategy for the Development of Telemedicine in Ukraine, but also strengthen the implementation of the necessary response to HIV for different populations, including vulnerable groups, and hope that such projects will form the basis of a modern, effective medical system in our country.“ – says Andriy Bilets.

In 2023, the Cabinet of Ministers of Ukraine approved the Telemedicine Development Strategy, identifying this area as a priority tool for developing eHealth and digital transformation. Help24 TeleHealth was created to implement this strategy and ensure equal access to quality healthcare services for key populations, including HIV, mental health, and related areas. 

“Telemedicine is an effective form of access to basic healthcare services and an integral component of a comprehensive healthcare system. Telemedicine services must be a necessary and effective tool to overcome barriers to access to basic standard medical services, which is especially important given the challenges to the healthcare system caused by the war. Thus, telemedicine is not an additional but a basic need for key populations, including people living with HIV, internally displaced persons, and those who are forcibly staying abroad. That is why the purpose of creating telemedicine offices and the telemedicine module of the Help24 Telehealth platform is to standardize the telemedicine method itself, to develop and implement standard operating procedures and algorithms to meet the needs of key populations, including people living with HIV,” adds Sergii Antoniak, infectious disease Doctor, Project coordinator, Help24 TeleHealth. “In general, telemedicine should be considered one of the priority elements of comprehensive eHealth in Ukraine, which provides access to quality health care, promotes health restoration, rehabilitation of Ukrainians and prevention of HIV and other socially significant diseases.” 

Help24 TeleHealth offers comprehensive healthcare solutions right on your screen, wherever you are!

To sign up for a consultation, please follow the link: 

https://h24.org.ua/  

https://help24.org.ua/uk/doctor-consultation-info 

Kyiv, Ukraine, June 12, 2024 – Alliance for Public Health in partnership with the MAINline International, within the framework of the SoS 2.0 project, has adapted and launched a training course “Interventions for the Mental Health of People Who Use Amphetamine Stimulants (ATS)”. This course is designed to help service providers better understand the link between mental health and ATS use, as well as to provide them with the knowledge and skills to work effectively with this category of people.

“Community-based interventions are crucial in areas where access to healthcare is affected by stigma and availability. Today we took the first step in offering important interventions to people who use methamphetamine, by gaining insight into what mental wellbeing is. What a fun session!” said Simon Williams, Learning lead & Project lead Asia, MAINline International 

The course has an adaptive structure that allows participants to study topics independently and consolidate their knowledge through online sessions with a moderator. It consists of 10 theoretical topics and 4 online modules.

The course modules include the following topics: 

-Recognizing mental health problems among people who use ATS

-Screening for mental health problems among people who use ATS

-Basic community mental health interventions for people who use ATS

-Establishment of mental health-based referral networks for people who use ATS

“We were pleasantly surprised by the high level of interest in the new training course,” shares her impressions Nadia Yanhol, Project Manager, Alliance for Public Health. “In three days after the announcement of its launch, 120 participants from all over Ukraine registered. The first online session, which took place today, gave us the opportunity to meet an incredible group of participants who have mastered the topic of mental health of people who use methamphetamine.”

Advantages of the course:

Flexibility: Participants can take the course at their own pace and time.

Interactivity: Online sessions with a moderator provide an opportunity to ask questions and get clarification.

Accessibility: The course is available in Ukrainian and English.

“As part of the further development of the project, we plan to translate the course into Russian and distribute it in the countries of the Eastern European and Central Asian region,” emphasized Nadia Yanhol, Project Manager, Alliance for Public Health. “We are convinced that this course will be a valuable tool for professionals working with people who use amphetamine-type stimulants (ATS) and will help improve the quality and effectiveness of their primary care.”

Get access to the course

Over the past 7 years, one of the country’s largest projects, HealthLink, was being implemented, providing Ukrainians with the opportunity to get tested for HIV and start treatment free of charge, quickly and safely.

Overcoming numerous challenges, such as the Covid-19 pandemic and the beginning of the full-scale invasion, the Alliance for Public Health and CO “100% of Life”, in partnership with 29 non-governmental organizations and more than 700 health care facilities, worked tirelessly to ensure that as many Ukrainians as possible would have access to HIV prevention, testing and treatment. Before the war, the project was being implemented in 12 regions with the highest HIV prevalence (Dnipropetrovs’k, Kirovohrad, Zaporizhzhia, Donetsk, Odesa, Chernihiv, Poltava, Cherkasy, Kherson, Mykolaiv and Kyiv oblasts (regions) and the city of Kyiv). After the outbreak of the war, activities in Kherson region were suspended, and Zhytomyr, Zakarpattia, Lviv, and Ivano-Frankivsk regions were added to the project. The results of the project are really impressive, as we have managed to:

• test over one million people;
• detect around 26,000 new HIV+ cases;
• 90% of newly detected patients started taking ART.

“Despite the very ambitious goals of the project, we were constantly trying to introduce something new. We used a lot of non-standard approaches and innovations that yielded tremendous results, making HIV testing commonplace for all people,” – says Maryna Varban, HealthLink project manager, the Alliance.

“Safe Boxes” Innovation. During Covid and the war, online services became extremely popular. Given that people in the modern world are increasingly striving to maintain their privacy, we have developed the website oraltest.org.ua, which is popular among members of the LGBT community. Here you can order a safe box that contains a rapid HIV test, contraceptives, lubricants, informational materials and stylish souvenirs. This initiative has helped to reach people living in small towns and villages, the most isolated group of men over 35, and the broader MSM community. A total of 15,000 safe boxes have been distributed during the project’s implementation.

“Prevention videos at health care facilities” Innovation. People waiting to see a doctor in the corridor of a health care facility are mostly sitting around doing nothing, so we decided to use this time to good effect. We distributed 180 plasma TV sets among partner medical institutions and created a series of videos on health, hygiene, debunking myths about HIV, pregnancy, etc. Each video ended with a call to get tested, and people who saw this information could immediately ask their doctor about an HIV test. After watching the videos, about 6,000 people sought testing.

“Video Doctor” Innovation program aimed to improve the index testing rate. Doctors were provided with tablets on which they showed videos with information about HIV to the patients during counseling and explained further steps in case of HIV detection. A series of videos with instructions on how to involve partners in testing was also developed. During the intervention, more than 2,000 patients watched the videos and 1,400 of them then referred their partners for testing. About 500 of them were found to be HIV+.

“The Testomats (Test Vending Machines)” Innovation has made free HIV testing even more accessible by allowing people to get an oral HIV test-kit and self-test kits in a place convenient to them. To do this, one needed to visit the respective website, answer the questions, generate 2 QR codes, bring them to the scanner, and receive their HIV test-kit and a box of condoms at the Testomat. In total, 3,700 tests were distributed through these Test Vending Machines.

“Supervisor Support” Innovation. Throughout the project, it provided the professional support and motivation of the staff: health care workers and NGO representatives. The number of face-to-face supervisions was significantly reduced due to the war, but despite the difficulties, supervisors managed to conduct more than 500 supervision visits to NGOs and health care facilities for 5,000 participants. The need in individual supervision led to the creation of the website supervision.org.ua, which provided more than 7,000 supervisions online.

“Online Support Groups” Innovation – combined 2 approaches: peer-to-peer mentoring and an online platform for communication, thereby creating a safe place where people with the same experience could gather. Professional psychologists-moderators of support groups held thematic meetings on living with HIV, provided psychological support and stress management and motivational counseling services to build adherence to ART, and other services. This approach made it possible to support PLHIV at risk of dropping out of treatment and help them to adjust to their new status. In total, the project organized more than 100 support groups for PLHIV, MSM and social workers.

Here is the story of HIV detection efforts from the NGO “Alternative”, Chornomorsk.

“I received a call from a client who is now defending Ukraine in the Armed Forces and who asked me to send him ARV drugs to the front. His wife was supposed to pick up the medication. While talking to her, I found out that she did not know anything and did not want to know about her husband’s HIV status. But I couldn’t just give her the medication and let her go, so I told her about all the risks and why it was important for her to know her HIV status as well and, if necessary, start treatment. I was very much afraid that when she left the office, I would never see her again, so I decided not to wait, but to take an HIV test right away. I had oral test-kits, which came in handy because the result was positive. I wouldn’t say I was surprised, but the main task now was to get the woman to the clinic for further examination and make sure she started her ARV therapy.

The woman refused to see a doctor. She asked to take a few days to think about it and, after receiving therapy for her husband, went home. A few days later, she called me and told me that she had been thinking about the test results and what we had discussed during the meeting. She said she agreed to additional examinations and treatment. Now she is taking ART, and we keep in touch. After a while, I talked to her husband, who was very grateful for the work that was done for his wife”.

We were able to achieve such outstanding results thanks to fruitful and well-coordinated teamwork and support of each other in these difficult times. We would like to express our sincere gratitude to all our partners who have been standing side by side and working purposefully on the result.

The project was implemented with the financial support from the CO “100% of LIFE” and the ICF “Alliance for Public Health” as part of the HealthLink project: “Accelerating Ukraine’s Efforts to End HIV” project implemented with the support from the United States Agency for International Development (USAID).

A program to introduce an innovative method of pre-exposure prophylaxis for HIV infection has been launched in Ukraine – long-acting injectable cabotegravir, which, if used in accordance with medical recommendations, protects against HIV infection through sexual contact by 99%. 

The supply of long-acting cabotegravir was made possible through a partnership between the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and ViiV Healthcare. Implementation of the project in Ukraine was organized by the Public Health Center of the Ministry of Health of Ukraine in partnership with the PEPFAR Coordination Office, CDC, USAID, WHO, ICF “Alliance for Public Health”, and NGO “ALLIANCE.GLOBAL”. 

After a systematic review of the evidence and results of the studies WHO recommends the use of CAB-LA for PrEP.   The availability of the medication in Ukraine will allow expanding the access and coverage of pre-exposure prophylaxis services, as well as HIV prevention in general, which is especially important in a time of war. The offer of injectable cabotegravir along with tablet forms of PrEP (TDF/FTC) provides a possibility of choice: regular oral medication or an injectable, extended-release version. 

“Pre-exposure prophylaxis is one of the evidence-based methods of controlling the HIV epidemic in the world. Over the past 3 years, the number of people receiving pre-exposure prophylaxis in Ukraine has tripled. Ukraine has been selected as one of 5 countries among the PEPFAR partner countries prioritized for expanding access to the injectable form of pre-exposure prophylaxis – long-acting cabotegravir. This is a modern innovative drug that will be available in medical institutions of the two cities after the registration is completed,” said Ihor Kuzin, Deputy Minister, Chief State Sanitary Doctor of Ukraine, during a joint press conference in Kyiv. 

According to Mykhailo Rosada, Director General of the Public Health Center of MOH Ukraine, the introduction of the newest pre-exposure prophylaxis medication in Ukraine was made possible by the strong cooperation of the Public Health Center, the PEPFAR team, the ICF Alliance for Public Health, the NGO ALLIANCE.GLOBAL, and WHO. 

The PHC, together with partners, created a Working Group on the organization of the introduction of injectable drugs for HIV prevention, selected specialists for implementation teams, and developed operational manuals and clinical pathways. PEPFAR has centrally procured CAB-LA in the amount of 1,350 vials, which corresponds to almost 200 annual courses, and transferred them to the PHC as the project implementer.

“Until recently, HIV was called the ‘plague of the 21st century’. Today, we can –  not only to control the disease, but also prevent it by 99%. This is the efficacy rate of Cabotegravir, an innovative sustained-release drug for pre-exposure prophylaxis of HIV. I am grateful to our international partners for their strong support and cooperation, which helps to save and preserve the lives of Ukrainians,” said Mykhailo Rosada, Director General of Public Health Center of MOH.

Ukraine became one of the few PEPFAR partner countries to be the first to implement the CAB-LA program. A roadmap for the introduction of long-acting cabotegravir as pre-exposure prophylaxis for HIV in Ukraine was developed and approved, and negotiations were held with representatives of health care institutions in Lviv and Kyiv to implement CAB-LA. 

“We are very pleased that Ukraine has applied to participate in the first wave of CAB-LA rollout. Given the risks associated with the war and the constant displacement of the population, we are confident that this highly effective and innovative drug will be a convenient alternative in Ukraine. Thanks to the commitment and professionalism of our government and civil society partners in Ukraine, I am confident that together we can end the HIV epidemic,” said Brendan T. Garvin, Director of Management and Budget at U.S. PEPFAR.

CAB-LA implementation is planned to start in Kyiv (Kyiv City Clinical Hospital #5) and Lviv (Lviv Regional Phthisiopulmonary Clinical Treatment and Diagnostic Center of the Lviv Regional Council) for the MSM group (men who have sex with men). 

Andriy Klepikov, Executive Director of the Alliance for Public Health, shared his experience of advocating for this opportunity for Ukraine:

“This is a truly remarkable day: Ukraine was the first country in the Eastern Europe and Central Asia region to receive the most modern drug for pre-exposure prophylaxis of HIV infection. For 3 years, we had been negotiating and arguing the need for CAB-LA, but often heard that it was not the right time. However, we did not lose our motivation and kept moving forward. Ukraine won this right through successful negotiations and the trust of its partners. This program is being launched thanks to the support of the US Government under the PEPFAR program. Despite the challenges of war, Ukraine is a leader in the implementation of innovative technologies in HIV prevention.”

Andrii Bogoslavets, Head of the Pre-Exposure Prophylaxis and Information Campaigns Project at ALLIANCE.GLOBAL, said: “The organization has been working with the support of international donors and the ICF Alliance for Public Health to distribute PrEP among the community since 2018, and we  understand how important PrEP is in overcoming the HIV epidemic. PrEP tablets are an effective solution to protect against HIV infection. When taken daily, it protects against HIV by up to 99% and has become a know-how in overcoming the HIV epidemic.  Today, we presented an injectable form of PrEP, which will be a great solution for those members of the community who may miss taking pills on a daily basis. And the fact that cabotegravir needs to be injected every two months is a great solution for the community, which will protect 99%. Knowing the feedback from, the community is looking forward to when this drug will be available and hopes that after this pilot project there will be an expansion when this medication will be available in all cities of Ukraine”. 

Background: 

Long-acting cabotegravir (CAB-LA) is a long-acting injectable drug that belongs to the class of integrase chain transfer inhibitors (a class of antiretroviral drugs). CAB-LA is indicated for pre-exposure prophylaxis of HIV infection for adults weighing at least 35 kg and is used to reduce the risk of sexual transmission of HIV-1. The use of CAB-LA involves the intramuscular injection of 2 doses of the drug with an interval of 4 weeks, then one injection every 8 weeks. In July 2022, the WHO included Cabotegravir in its recommendations for pre-exposure prophylaxis of HIV infection, which was approved by the US Food and Drug Administration (FDA) on December 20, 2021. 

To date, CAB-LA is the only sustained-release injectable that has demonstrated high efficacy in randomized clinical trials (HPTN 083 in cisgender men and transgender women who have sex with men; HPTN 084 in cisgender women in sub-Saharan Africa). 

Expanding HIV prevention choices is an important element of the public health approach to reducing new HIV infections. Offering additional PrEP options has the potential to increase PrEP coverage and effective use, as well as HIV prevention in general, by allowing people to choose the method they prefer.

Recording of the press conference:
https://www.youtube.com/live/OEs_y92A3Rs?si=nSDm7MkHO05Z6Yu9

Alliance for Public Health and CoAct are pleased to be technical partners for the Unitaid-funded Hepatitis C project for the period 2023-2026. This project is part of a consortium led by Frontline AIDS and aims to implement innovative research on community-based hepatitis C treatment models and care and support services in Nigeria.

The UNITAID project, which will be implemented in Gombe State with the participation of the NGO DAPHO, aims to improve the health status and ensure access to quality health services for people who inject drugs. According to the plan, in July 2024, 625 people will receive low-dead-volume syringes for 18 months, and from January 2025, 2800 people will be tested for hepatitis C virus. HCV treatment services with direct-acting antiviral drugs are planned for 250 people, with the goal of completing treatment by October 2025.

The project seems to be very timely, as there is a general concern about the development of the HIV epidemic among PWID in Nigeria, the prevalence of HIV infection among which has increased from 3.4% to 11% over the past 6 years. This is due to the practice of needle sharing (only 36% of respondents reported always or almost always using a clean needle during injections in the past month), as well as low coverage of PWID with key interventions recommended by the World Health Organization, such as substitution maintenance therapy.

Andriy Lemak, 48, and his wife Liuba are from the Carpathian mountains in west Ukraine. Andriy is a Boiko – one of three ethnic groups from this region. A builder by trade, he joined up in February 2022 to fight with the 24th Mechanized Brigade. The couple have three children. This is Andriy’s third rehab.  

INJURY

Andriy: “As soon as I heard what was happening, I went to the army recruitment office. Everyone knew there would be a war. Except those who didn’t want to know, who closed their eyes… I was on Maidan in February 2014, when so many people were killed. They shouted from the stage: Don’t run, because there will be a provocation! And then the boys were carried back as corpses. No one could believe that this would happen… And now we cannot believe that Odesa, Sumy, Kharkiv are being erased from the face of the earth. Dnipro, Zaporizhzhia. We can’t believe it, can we?

I was in Donbas in 2014 and 2015, in Debaltseve. But when Debaltseve was captured, I was at home, we had a rotation. It was Christmas, and our command decided we could go home for Epiphany. So on January 12, I left for home. And Debaltseve began to be surrounded on 18 January. It was taken by February 19. I was very lucky, you could say…

I served for two months in the full-scale war. I was injured in April 2022, in Popasna. I came round in Uman. Аnd Dnipro, Pokrovsk – I don’t remember anything, I was in a coma for 10 days. I think they were pumping me full of something, because I was in the Atlantic Ocean, I was in the Arab Emirates, I was in the trenches…  and on 9 May I started to come to my senses. I started asking: Where am I? What’s the matter with me? Because the last thing I remember was the tank firing, nothing more… There were nurses, doctors – they thought I knew everything, but I don’t remember anything. Maybe they told me ten times. I know that I had this vision… I saw myself from above: My arm was hanging and all black. Because the same arm was torn open. My arm was black and I had no skull, only white brains. And I feel myself – look, my head is there… I couldn’t understand what happened to me, was it just a dream or something. Then I started to ask, and they explained. Then they sent me to hospital in Lviv. And then drip, injections, injections, drips…”

Liuba: “An acquaintance told us Andriy was wounded, but they didn’t know where he was. We called the hospitals ourselves and found him. After four days. The military had my number, but they didn’t inform us. Many boys were killed and wounded then… He was in Uman, and then here in Lviv, and I came to Lviv. They gave him an old phone, and I called him. He couldn’t pick up the phone by himself, especially since it was just a normal old one, so someone answered the call for him. I didn’t know at first that he would be blind. Later the doctor told me they had taken out one eye right away. And the other one they said was damaged. I was still hoping that he would be able to see, but it turned out the other eye was completely ruined.”

Andriy: “We went to Germany, to Dresden, and there they said the explosion had damaged my rear retina and it cannot be renewed… So everything died. Now I have two hopes: that technology is advancing and I will have an artificial electronic eye, and that this will not cost half a million or a million euros. If possible, that we can afford it. These are all our hopes.”

REHABILITATION

Liuba: “They found my number through volunteers and called us [about the rehab]. The first time, we immediately agreed, because he hadn’t gone anywhere at all. He liked it because there are guys like him there, and the environment is a bit different from home. They taught us bit each time. Every time they remind him, remind him, and it is already a little better. I keep repeating things to him, but his brain is damaged and he forgets… it’s his short-term memory, he can forget. That’s why he’s like this, a bit nervy. I remind him all the time, and he gets irritated. He has a metal plate; the entire front part of his skull was shattered. Sometimes he can chatter like a small child, when he’s in the mood. His hand doesn’t function well either, the bone was torn out… It’s hard for him to use one hand.

I get a rest here at this rehab. At home – family, routine, work, everything is on me, but here I rest from everything. I relax a little once a year.”

Andriy: “We have to be independent, move independently, understand what we need, learn to live in the world in which fate has put us. We have to survive. The trainers here help us… New people, new experiences, new skills. You don’t want to be alone somewhere, you are looking for new experiences. I didn’t know lots of things. You’re not interested, until you lose your sight. Like orientation — before, I didn’t understand, I was never interested or thought about it. Family problems, how to earn money, where to go…. and then you’re faced with the fact that you can’t see. For me, the first impression was that this is temporary, it will end soon. But it hasn’t ended in two years, and it isn’t going to end. These people show us, tell us things. We need to look for new incentives. New interests. We have to live. God saved my life, I still have children – I have to live.”

BACK INTO SOCIETY

Andriy: “We’ve got two boys and a girl. The oldest is 21. The second is 18, he’s studying at Lviv polytechnic. And our daughter is still at school…. The eldest is at Kharkiv military institute, but now he is in west Ukraine. He went to serve in Chernyakhovsky Defence Institute in Kyiv in September 2021, and in February 2022 our ‘soul brothers’ came. Our ‘liberators’. He was fighting right there in Kyiv. He has unrecognised concussion – one concussion isn’t even recognised as an injury anymore; you need at least two. It was a tragedy for my wife, both her son and her husband at the same time…

We live in a village, in the first mountains of the Carpathians. On the Dniester River. I walk around a little, if there is someone to walk with.”

Liuba: “It’s a bit difficult for him to walk at home, because we have dirt roads. But he can orient himself on earth and grass. And he remembers what is where. He can go to the shop himself, he can visit his friends. There is a little bridge and he can even cross the bridge, from memory. One time we were driving with him somewhere, and I didn’t know the road. He told me from memory where to exit, which building, which turn. Him speaking, and me with my eyes: that’s how we reached the place. He remembers everything that happened a long time ago. It’s what happened now, his short-term memory, that he can lose.

I’d never come across blind people before. And it was so difficult. I even cried, I didn’t know what to do with him. It seemed to me that I explained well how to go somewhere, but for him it was all wrong. And he was so anxious and irritable, and so was I. It took months to get used to how to cope with such a person. Now we’re used to it, we’re already making jokes: What, you’re not going to say where you’re going? He says he’s going to the neighbour’s. He goes along the fence and knows where to turn. I say: What did you say about not being able to see? You can see everything! That’s how we joke.

There is nothing difficult for me, because I can see. But for him… Well, sometimes he thinks it’s difficult for him. But he can do everything. He is so stubborn.

Our village is only small, but many of the men are in the army. They come to us, the ones who are serving. And Andriy reassures them that everything will be fine. That all is well. He always says that everything will be fine. He’s a positive person, he tells jokes. He also says that he was lucky. That there are some guys who are worse off. He says he was lucky.”

March 24th marks World Tuberculosis Day, and for the third year in a row, Ukraine marks it under the shadow of Russia’s brutal war. Despite the devastation – destroyed medical facilities, housing infrastructure, mass population displacement of both civilians and healthcare workers, blackouts, and countless hours spent in bomb shelters – Alliance for Public Health with all its partners continues to provide a strong response to tuberculosis, actively confronting all challenges.

Since the beginning of the war number of missed TB cases grew up. According to WHO nearly every 2nd TB case is missed in Ukraine. Alliance for Public Health focuses its efforts on innovative case finding at the most at-risk groups, providing medical and psychosocial support for both TB and MDR-TB patients, addressing humanitarian and other health needs, strengthening community response, and improving standards and policies.

We know how to end TB. We have the lifesaving tools to prevent, diagnose and treat TB, but we must break down the barriers and inequities that cause millions of people to suffer and die from TB every year.

The global community must act with a focused response that puts people and communities at the center.

Yes! We can end TB! #WorldTBDay

Read the Report:

In the situation of an unprecedented Russian aggression, the Alliance for Public Health is, as always, at the frontlines, fighting for Ukraine and its people. We remain with the people of Ukraine in the struggle for the sovereignty of Ukraine.

March 24/ 2024 World TB Day in War-Torn Ukraine: a Story of Resilience

February 23,  2024/ HIV in Ukraine in the midst of the war

December 31, 2023/ 2024: strong, agile and resilient! Annual statement

December 15, 2023/ Summary report of #HELPNOW HUB for 2022 -2023: 20 months of continuous assistance for 37 thousand Ukrainians around the world

December 1, 2023/  World Aids Day: Resilience Amidst War

October 23, 2023 (stories)/ More than 218,000 Ukrainians received help thanks to new initiatives: people’s life stories and ways to overcome the problems brought on by the war

June 1, 2023/ On International Children’s Day Alliance for Public Health calls to prioritize more children affected by war in Ukraine

March 24, 2023/ UNBREAKABLE AGAINST TB: Situation report on World TB Day

February 23,  2023/ 365 Days of War: Ukrainian HIV/TB Response Stands Strong!

December 31,  2022/ #HelpNow HUB 2022: Support that can’t wait!

December 01,  2022/ War crimes and violations of the rights of key communities against the background of russian military aggression

December 01,  2022/ World AIDS Day: accelerating HIV response during the war

September 01,  2022/ #HelpNow HUB — 6 months being near you to help where you are!

June 20, 2022 situation report/ Humanitarian Convoys of the APH: 111 DAYS ON THE ROAD, 111 DAYS OF AID.
June 10, 2022 situation report/ VIRAL HEPATITIS C.
June 2, 2022 situation report/ 100 days of war. Alliance for Public Health: Response to War Challenges
May 20, 2022 situation report/ POST-OCCUPATION: regions liberated from Russian occupation.
May 6, 2022 situation report/ Prevention
April 28, 2022 situation report/ Internally displaced people and refugees.
April 8, 2022 situation report/ Humanitarian aid.
April 4, 2022 situation report/ Special issue: Situation in the temporarily occupied territories of Kherson and Kherson region
March 31, 2022 situation report/ Special issue: Opioid Agonist Treatment (OAT)
March 26, 2022 situation report
Special Issue/ Situation in Mariupol. Situational Report: response of Alliance to challenges caused by the Russian aggression against Ukraine
March 21, 2022 situation report
March 14, 2022 situation report
March 8, 2022 situation report