November 13, 2020

First regional COVID-19 program launched in EECA region

The Alliance for Public Health has launched the first regional COVID-19 program funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria. The budget is $500,000. The implementation of activities is designed for 8 months: from November 1, 2020 to June 30, 2021.

The COVID-19 program will be coordinated by the #SoS_project team in 14 countries of Eastern Europe and Central Asia at the regional level with a national focus on countries not  receiving grants from the Global Fund – Bosnia and Herzegovina, as well as Russia.

“It was obvious to us that the countries of the EECA region urgently need additional support. Primarily to help them maintain the advancements of HIV/TB programs that are at risk because of COVID-19. The effective provision of HIV prevention, diagnosis, treatment, care and support services across the region must continue,” said Tatiana Vinichenko, Portfolio Manager at the Global Fund. – Therefore, the decision to initiate special funding in connection with COVID-19 for operational activities in the countries was extremely necessary. And the regional program will allow us to provide support for regional initiatives and national initiatives in several countries at once”.

Note that the volume of government funding for HIV services among key populations and people living with HIV was extremely insufficient in the EECA region at the beginning of 2020. With the COVID-19 outbreak, which rocked the entire world, all countries began to revise their budgets, prioritizing measures against COVID-19. This has jeopardized many years of work to build the sustainability of HIV services across the region.

“The support of the Global Fund has played a critical role in the immediate response to the COVID-19 problem,” says Sergey Filippovych, director of the #SoS_project at the Alliance for Public Health. “At the same time, there are countries in the EECA region that do not receive financial support from the Global Fund. They do not have national grants, and they are even more vulnerable, which negatively affects the response to epidemics. Therefore, our team decided to support these countries and ensure the allocation of funding for critical events through the Global Background regional grant mechanism. ”

Based on the analysis of the epidemiological situation, the latest technical guidelines and assessments available, as well as the existing funding structure, problem areas were identified in programs to ensure the sustainability of programs and HIV in EECA countries related to the COVID-19 problem. These are the areas that have been selected as the focus of the regional COVID-19 program:

  • The continuity of HIV services in the cities of the Russian Federation and Bosnia and Herzegovina; simplification and increasing availability of services
  • Respect for human rights, gender equality for representatives of key groups in response to COVID-19
  • Contingency planning for sustainable service delivery in EECA countries during and after COVID-19.

In the Russian Federation, the project is supposed to provide services related to HIV and prevention of COVID-19 to at least 2,500 PLHIV and key populations. Masks, gloves, hygiene kits will be purchased for them. It is also planned to install syringe machines and condoms in order to minimize personal contact and reduce the risk of COVID-19 infection.

In Bosnia and Herzegovina, work will focus on establishing and operating a telemedicine systemfor patients who live in remote areas and cannot reach clinics in nearby towns or villages.

At the same time, planning and national approval of COVID-19 related changes in HIV services will be undertaken in all project countries.

A separate focus of the COVID-19 program will be human, community and gender rights, in the context of adaptability and delivery of HIV services, and ensuring sustainable access to services. The geography of monitoring human rights violations using the REAct tool, as well as the work of the partner of the Eurasian Harm Reduction Association, will be expanded and systematized in several more countries of the region. Thus, the closure of borders also led to the interruption of the supply of drugs for substitution therapy to Moldova. This risk exists in other countries as well. In addition, government agencies responsible for OST and harm reduction programs in several countries have not announced a tender for the purchase of drugs or announced the acceptance of bids from civil society organizations providing harm reduction services. This is already a critical situation in Montenegro and Bulgaria.

Note that #SoS_project quite naturally became the main platform for the implementation of measures on COVID-19 as part of the new support program for the region by the Global Fund. Existing partnerships with national partners, knowledge of the region and problems, understanding of financial gaps and opportunities, as well as work on budget advocacy at the national and municipal levels, the #SoS_project team will help strengthen the program and ensure its immediate launch and rapid implementation within 8 months. It is assumed that the services and terms of their provision will continue in the future.

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November 04, 2020

Irina Kutsenko: I was a deputy who closed the sites of OST and LGBT organizations

Irina Kutsenko, a deputy of the Odessa City Council dealing with social issues in the city, received an international award #InYourPower. She became the first and so far the only government official nominated by civil society.

In an exclusive interview, she shared her story: about why she stayed on the sidelines for a long time and closed the OST sites and LGBT organizations; how she came to understand the importance of supporting the city’s HIV/TB program and the work of harm reduction programs, why it significantly helps to improve the health of citizens; about the experience of cooperation with non-governmental organizations, about building a dialogue with medical and security agencies; about conversations on inconvenient topics with deputies, as well as how to prioritize these issues on the municipal agenda and launch an information campaign that the city media will talk about.

So, now Irina Kutsenko is an active defender of community rights at the level of city authorities, a person with tremendous energy and extraordinary willpower. She continues to initiate changes in the city in relation to the most vulnerable groups of the population. She does everything to bring medical and social services in Odessa closer to the most advanced global approaches to harm reduction and combating HIV/TB . But it was not always like that.

“I was the deputy who closed the site of substitution therapy in my district, I collected signatures from people against gay culture and its spread in our city, that is, I was a deputy who conducted completely different activities,” says Irina. But after completing the course of the International Harm Reduction Academy, she began to actively dig into the problem: “I started reading in the Internet, listening to interviews of people, listening to life stories, and I understood that I was wrong!”.

Having changed her personal understanding of the problem and the ways to solve it, Irina gradually begins to cooperate with public organizations to make Odessa a safer city and people more socially protected.

“When representatives of a public organization came to me with a harm reduction project in the city, I already understood what they were talking about. At that moment, I realized that the NGO today knows more than any of the officials. At first I was just listening,” the deputy recalls.

The first task of Irina Kutsenko and members of the public was to find a common language, when everyone is doing their own thing. “We needed everyone – doctors, authorities, and public organizations – to unite into one common work,” she recalls. “Before, everyone was separate.”

The main step towards changing the situation in the city was the fact that disparate society representatives began to communicate. The dialogues took place with the participation of deputies, in the mayor’s office, with the necessary arguments and eloquent statistics, which were often hidden or uninformative for the authorities. As a result of this work, the mayor of the city supported the initiative, and today in Odessa steps are purposefully implemented within the framework of the already signed Paris Declaration. Odessa is also the first city in Ukraine to take on commitments under the Zero TB Cities initiative and is systematically moving towards overcoming the tuberculosis and HIV epidemics. In 2 years, this results from joint efforts and a radical increase in the effectiveness of tuberculosis treatment through the provision of treatment “at primary care” – from 52% to 71%.

However, as the mayor of Odessa Gennady Trukhanov said, it was not easy for the city itself. The deputies debated heatedly during two sessions. The city authorities, in addition to local everyday problems, also need to tackle global challenges, in particular – to help medical workers in the fight against epidemics. After all, everyone is interested in this. “Mayors are assessed by the state of the city: roads, roofs, warmth, comfortable public space. This is all true. And we can achieve cleanliness in the cities, but with the spread of all dangerous infections in the world, God forbid, the time may come when there will be no one to walk along these roads,” the Odessa mayor emphasized.

Also, within the framework of the program, outpatient treatment of tuberculosis was introduced instead of in-patient model, and medical practitioners began to actively test visitors for HIV at polyclinics, educational institutions, and purchased a large number of tests. Thus, the city was able to increase the HIV detection rate and provided an opportunity to make treatment available for people.

“Of course, there are still many problems, but, step by step, we are changing the situation in the city,” says Irina Kutsenko. “We understand that the projects are coming to an end, but those declarative things that were signed by the mayor, and we, as deputies, will have to implement both in this convocation and in the next one, because this is a matter of the life of our citizens”.

Interview timecode:

00:01 – a short content of the interview, consisting of vivid statements of the charismatic deputy

00:58 – how it all began

02:13 – dialogue with the people who need help

04:05 – meeting of the fraction:

“Well, guys, I’m going to tell you something completely different now … We must legalize sex work and open substitution therapy sites. They thought I was crazy. ”

05:23 – dialogue with public organizations, the mayor and the Paris Declaration: Odessa approach

08:45 – HIV and TB, stigma and treatment initiation under a motivation program for health workers

11:28 – projects “go away”, but the issue of people’s lives remains on the agenda

11:45 – harm reduction services in municipal pharmacies in Odessa

12:40 – how the city HIV / TB program was developed for 65 million hryvnia

15:02 – life hacks and shame: how NGOs helped convince MPs to support the city’s HIV/TB programs

17:15 – “It’s all right with the Duke “: mural, media resonance and HIV testing

18:56 – creation of the second center of integrated social services for harm reduction in Ukraine (the first is in Sumy)

19:17 – new format of cooperation with law enforcement agencies

19:43 – “we are on the sidelines until they explain to us”

22:45 – “speak a simple language”

23:00 – how to calculate the budget of the city program

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August 25, 2020

Conference for and about teens “Through virtual to real”

We are happy to invite you to the Conference for and about teens “Through virtual to real” that will take place on 15-17 of September 2020 online. The website of the Conference is http://conf2020.afew.org.ua/

to follow the Conference in FB please, visit  https://www.facebook.com/events/703708923796603/

🔴 What for?
We are holding this conference to ensure that teenagers have access to friendly, systematic and high quality services. We believe that the prevention of HIV/tuberculosis/hepatitis/sexually transmitted infections must be effective, correspond to international standards and be easy to get for every teenager.

🔴 For whom?
For adolescents and professionals working for and with adolescents

🔴 Who are the organizers?
ICF “AIDS Foundation East-West (AFEW-Ukraine) and ICF “Alliance for Public Health”.

🔴 Why online?
In times of global epidemic, access to information and learning should be safe. In addition, holding the Conference online will give a unique opportunity to participate for everyone!

🔴 In what language?
The official language of the Conference is Ukrainian. But we will also provide a translation of some of the sessions into English and Russian.

🔴 How will it all happen?
On the Conference website, which we will show you very soon, you will be able to learn about the program, speakers and schedule of sessions, to choose the most interesting ones and, after the registration, join all of the events. We will additionally inform you about the beginning of registration.

🔴 Why to register?
• Some of the events will be broadcast on our social networks, but only registered participants of the Conference will have access to all sessions and materials of the Conference.
• Registered participants of the Conference will be able to receive a certificate of participation.
• If you register, you will be able to participate in all discussions during the online sessions and continently communicate with other participants.
• There will be a raffle of prizes with promotional materials of the Conference as an additional bonus for everyone registered.

🔴 What is the hashtag of the conference?
#віртуальнопрореальне

In order to apply please fill in the form at the http://conf2020.afew.org.ua/reyestracziya/

Session categories:

  • Building skills and competencies of adolescents
  • Mental health
  • Sexual and reproductive health and rights
  • Adolescents in conflict with the law
  • Digital Security and Media Literacy
  • Human Rights and legislation
  • Adherence to treatment
  • Access to services
  • Prevention of negative consequences of risky behavior: proactive tools
  • Violence and bullying
  • Safe leisure activities
  • Other

The program of the Conference includes mixed demonstration of recorded and live sessions.

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August 17, 2020

The sixth regional digest overview has been released by #SoS_project team

Overview of the regional and national activities of the #SoS_project team in April-July 2020
Stay safe, stay strong and wear a mask / #WearAMask Challenge

IN THE NEW RELEASE 
The #SoS_project regional partners team continues to advocate for the sustainability of HIV services at the regional and national level in Belarus, Bosnia and Herzegovina, Georgia, Kazakhstan, Kyrgyzstan, North Macedonia, Moldova, Montenegro, Romania, Russia, Serbia, Tajikistan, Ukraine and Uzbekistan.
We are introducing our sixth regional digest overview.

The main topic of the second quarter of 2020 was clearly COVID-19, human rights issues, the sustainability of public health programs in the countries of the region, and in the context of the response nongovernmental organizations appropriately accepted the challenges of the first wave of COVID-19.
A descriptive regional Community Initiatives Map was created with over 50 stories of NGOs confronting the challenges of the coronavirus crisis from March to the present day.
With the involvement of international experts, Practical Recommendations were developed for health systems in EECA countries on transforming a sustainable response to HIV/TB/HCV in the context of COVID-19.
A number of recommendations, reports, documents and publications were developed and published in the countries, which were relevant with a view to the challenges of the current time.
NGOs from EECA countries took up the challenge not only of HIV, but also of the first wave of COVID-19. But this is not enough.
“We cannot say that COVID-19 has become a quiet time for the workers of nongovernmental organizations that provide HIV services. On the contrary, the coronavirus has thrown the light on health issues in society, and the current period should definitely be a time to take actions. Enhanced actions in response to HIV. We must work faster, better, and, obviously, for less money, –  says Tetiana Deshko, Director of the International Programs Department of the ICF “Alliance for Public Health”. – I’m sure it is high time to mobilize in order to achieve the key global community goals on AIDS”.

Read full Digest #6 on your browser.

Thank you for your attention and enjoy the reading.

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July 29, 2020

Lyubov Vorontsova: Ensuring sustainability of HIV and COVID-19 services in prisons is possible

1,152 people with HIV, or 4.5%* of all people living with HIV in Kazakhstan stay in the penitentiary institutions of the Republic of Kazakhstan as of June 31, 2020. More than 1,000 people living with HIV in prisons receive antiretroviral therapy, which is 3.2 times more than in 2012.

Lyubov Vorontsova, Director of the #SoS_project in Kazakhstan, shared the experience of the Central Asian Association of PLHIV in the context of HIV and COVID-19 prevention and treatment in penitentiary institutions, as part of the online conference “Prisons in the context of COVID-19”.

“Preventive work in the context of health in the penitentiary system can be more effective only where close interaction and mutual understanding is established among all stakeholders: government agencies, penitentiary institutions and non-governmental organizations”, Lyubov Vorontsova says, “We work to ensure that people in custody have the opportunity to exercise their right to the highest attainable standard of physical and psychological health guaranteed by the state”.

She noted that the Central Asian Association of People Living with HIV (CAA PLHIV) has set a number of key tasks for HIV/TB prevention and support for PLHIV who are in prisons with the support of #SoS_project. The partners of CAA PLHIV in the penitentiary component in Kazakhstan are the Office of the Ombudsman in the Republic of Kazakhstan, the National Preventive Mechanism (NPM), the ICF “Alliance for Public Health” and the Network (“100% Life”).

Key activities in the 2019-2021:

  • Improve the efficiency and accessibility of HIV services delivery (continuity from testing to care) in prisons.
  • Promote access to and respect for human rights in prisons.
  • Develop a Concept for achieving the 90-90-90 goals in the penitentiary system of Kazakhstan.
  • Apply the results obtained in Kazakhstan in other EECA countries.

According to Ms. Vorontsova, a number of strategically important activities were implemented during the first year of work.

Thus, she noted that in September 2019, #SoS_project partners from the Network “100% Life” and representatives of the Secretariat of the Ombudsman of the Verkhovna Rada of Ukraine visited the country. They visited Kazakhstan to discuss the implementation of changes in the monitoring system for the observance of the right to health, as well as access to HIV treatment and prevention services. The main areas of cooperation and work were recorded at a joint meeting of CAA PLHIV, UNAIDS, CCM with the Ombudsman in Kazakhstan, and are being consistently implemented.

In the same 2019, a training workshop “Monitoring the observance of the right to health of persons in custody and convicts” was organized for members of the NPM of Kazakhstan. During the event, the participants developed a national algorithm for ensuring control over the observance of the right to health of people held in custody and convicted in the prisons of Kazakhstan.

 

In 2020, the pandemic slightly shifted the schedule of activities, but on June 11, a meeting of the Country Coordinating Committee was held, at which the NPM presented a report on the situation of persons with socially dangerous diseases in prisons. It is important to note that this was a joint initiative of the ALE Central Asian Association of People Living with HIV and the Office of the Ombudsman in Kazakhstan. The presentation itself was drafted by members of the NPM of Kazakhstan.

Key findings of the report:

– Convicts do not have access to all medical and social services available to other citizens;

– There are not enough clinicians in the penitentiary system to provide such access to health care

To date, CAA PLHIV, with the support of #SoS_project, the 100% l Life Network, have developed a worksheet for studying health care in prisons – as a monitoring tool for NPM members. Importantly, the worksheet has been expanded with a COVID-19 prevention access monitoring component. This document has been sent for approval to the NPM Coordination Council for further use as a permanent tool during monitoring visits to prisons.

Lyubov Vorontsova said, “We are preparing the module “Public participation in monitoring the right to health and access to HIV-related services in prisons” as a component of the online training on human rights and HIV in Kazakhstan. This module will include a component on monitoring access to prevention and treatment of COVID-19″.

She also noted that the project team has further plans:

– Development of recommendations for NPM in Kazakhstan to achieve the goals of the 90-90-90 strategy in the penitentiary system of the Republic of Kazakhstan.

– Creation of a working group to implement recommendations for NPM in Kazakhstan on achieving the 90-90-90 goals in the country’s penitentiary system, as well as the development of a Concept Note for the implementation of these recommendations.

– Implementation of the practical application of the monitoring tool (worksheet for studying health care in prisons) and the inclusion of the collected information in the report of the Ombudsman in Kazakhstan for 2021.

*Note that in total, according to estimates of early 2020, the number of people living with HIV in Kazakhstan was 31,378, and according to officially registered data, only 25,753 people know about their status.

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July 28, 2020

Alliance Model of HCV Treatment Featured in WHO Compendium of Good Practices in the Health Sector Response to Viral Hepatitis in the WHO European Region

July 28 is proclaimed by WHO as World Hepatitis Day. On World Hepatitis Day 2020 WHO Regional Office for Europe  published Compendium of good practices in the health sector response to viral hepatitis in the WHO European Region (https://apps.who.int/iris/bitstream/handle/10665/333494/9789289055161-eng.pdf?sequence=1&isAllowed=y).

We are proud that Alliance input in global and national hepatitis elimination process, its yearlong experience in HCV community based treatment, is demonstrated in Compendium amongst European region good practices in viral hepatitis response.

Alliance HCV treatment program “Scaling up Access to HCV Community Based Treatment for Key Populations” was launched in 2015. For 5 years   5000 patients were granted HCV diagnostic, treatment and social support for free. Presently with the support of the Global Fund 1800 HIV/HCV coinfected patients are getting HCV treatment, 90% out of them are PWID and their partners, 10% prison population. Till the end of 2020 additional 1500 HIV/HCV coinfected patients form KPs will get HCV basic diagnostic, treatment and social support services for free within Alliance program.

Following WHO recommendations, Alliance practices public health approach by using pan-genotyping DAA drugs, produced by leading international generic manufactures, and simplified HCV diagnostic. Every participant of Alliance HCV treatment program is granted social support. Education on HCV transmission ways and on safe behavior practices as well as three sessions on HCV reinfection prevention are integral to treatment process. Owing to case managers good practices and patients’ commitment, retention on treatment among program participants, who completed therapy this year, reached unprecedented 99,5%.

Alliance takes pride of setting trends in innovative HCV treatment with DAAs in Ukraine and making it accessible for the most in need populations; of implementing modern HCV diagnostic with GeneExpert machines directly on treatment sites; of getting the lowest for Ukraine price for DAA drugs; of  98% of treatment success. This year we started to implement cascade of HCV services by referring HIV prevention and harm reduction programs clients with positive results of HCV rapid tests to HCV treatment program.

WHO Compendium of good practices in the health sector response to viral hepatitis in the WHO European Region witnesses Alliance success in HCV control and encourages us for finding new approaches to equity in access to HCV diagnostic and treatment, bringing services closer to the patients on the way to hepatitis elimination and universal health coverage.

On occasion of World Hepatitis Day  Alliance avails of this opportunity to present our deepest respect and gratitude to physicians and medical workers, to case managers and patients for taking responsibility and following healthy lifestyles!  

Everybody can get HCV infection 

HCV testing is the only way to get

HCV confirmative diagnostic and treatment 

Viral Hepatitis C is curable 

National Hotline on Viral Hepatitis: 0-800-50-33-10

 

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July 28, 2020

5,000 patients received free up-to-date treatment of hepatitis C within the innovative program run by Alliance for Public Health!

In 2015, after many years of preparatory activities, Alliance for Public Health  initiated a free program to treat hepatitis C virus (HCV). A year after, patients representing high-risk populaitons were the first in Ukraine to receive HCV treatment with current direct-acting antivirals (before HCV treatment was based on interferons, with multiple side effects, treatment interruptions and cure rates not exceeding 50%). In 2017, for the first time in our country Alliance initiated HCV screening, testing and treatment services to be provided to the first several dozens of inmates in penal institutions.

HCV treatment success rate in Alliance programs was up to 98%!

In 2019, with support of the Global Fund to Fight AIDS, Tuberculosis and Malaria Alliance procured 3,740 new HCV treatment courses. According to the WHO recommendations, we use generic direct-acting antivirals (DAAs), pangenotypic (universal) treatment regimens and simplified diagnostics approach. Only this year, over one thousand patients successfully completed their treatment, with the adherence to treatment reaching the record level of 99.5%!

Today, our program provides access to HCV treatment to the key population members with HIV/HCV co-infection from all over Ukraine, including temporarily uncontrolled areas as well as inmates in 13 institutions of the State Criminal-Executive Service of Ukraine. Only in 2020, we expanded treatment coverage to include Zakarpattia, Luhansk, Donetsk, Ternopil, Volyn and Chernivtsi regions.

Even with strict restrictions because of the COVID-19 pandemic, project case managers support every client, successfully ensuring uninterrupted therapy and high treatment adherence. The unique experience of preventing reinfections in the time of lockdown and creative approaches to knowledge sharing helped us to develop an awareness-raising brochure, containing answers to the most popular questions, which patients ask when talking to social workers.

In five years of Alliance HCV treatment program implementation:

  • 5,000 patients have received or are currently receiving treatment
  • There was an evolution of treatment from interferon-based to current pangenotypic/universal regimens
  • Treatment and main diagnostics are provided to patients free of charge
  • The procurement cost of direct-acting antivirals (provided to patients free of charge) has been reduced from USD 900 to the lowest price for Ukraine – USD 75 per standard 12-week treatment course
  • A simplified approach to HCV diagnostics has been introduced
  • For the first time, HCV diagnostics is done using GeneXpert systems directly in the treatment facilities of Ukraine
  • For the first time, regional laboratory centers of the Ministry of Health are involved in HCV diagnostics
  • A model has been introduced to educate patients from the key populations on the routes of HCV transmission, safe behavior, prevention of reinfections and its efficiency has been proven
  • A cascade of services is provided by referring prevention program clients with positive results of HCV rapid tests to the treatment program
  • Cascade of services is provided to the patients in the penitentiary system
  • 100% monitoring of treatment quality is implemented
  • For the first time, a study on the rates of HCV reinfection among successfully cured key population members has been carried out
  • Sustainability of the program has been ensured with multiple sources of funding

Today, on the World Hepatitis Day, we would like to sincerely thank doctors, case managers and patients for their commitment and participation in the Alliance treatment program and for their invaluable contribution to elimination of viral hepatitis in Ukraine.

Hepatitis treatment program implemented by Alliance has been included in the Compendium of good practices in the health sector response to viral hepatitis in the WHO European Region.


For reference:

The WHO data show that Ukraine is the only country in the European region, which has been included into the list of 28 countries with the highest hepatitis burden in the world.  It is estimated that up to 5% of people in Ukraine are infected with hepatitis C, which totals one to two million Ukrainian citizens who require treatment. 

The surveillance system existing in Ukraine as well as the limited access to diagnostics and treatment services do not allow getting accurate cumulative data on the burden of this disease. Meanwhile, there number of people who know about their HCV status is dozens times lower: according to the Public Health Center of the Ministry of Health of Ukraine, in January 2020 the estimated number of people with HCV in Ukraine was 1,342,418 people. Only 87,269 people receive medical follow-up services (6.5% of the estimated number).

As the disease is often asymptomatic (“silent infection”) and left without treatment, chronic hepatitis C is the main driver of hepatic cirrhosis and primary liver cancer. Peculiarities of the clinical HCV progression lead to its late diagnosis, often at the terminal stages of hepatic disease.

In November 2019, Ukraine joined the Global Health Sector Strategy on Viral Hepatitis by approving the National Strategy on HIV/AIDS, Tuberculosis and Hepatitis until 2030. Goals of implementing the National Strategy until 2030:

  • 90% of new viral hepatitis cases will be prevented;
  • 90% of people with viral hepatitis will be diagnosed and will know about their status;
  • up to 90% of patients will receive treatment, which will be effective and will lead to full recovery (for HCV) or effective control of the disease (for HBV). 

 


Compendium of good practices in the health sector response to viral hepatitis in the WHO European Region


Testing is the only possible way to diagnose viral hepatitis. 

National Viral Hepatitis Hotline: 0-800-50-33-10

Alliance for Public Health

http://aph.org.ua/       https://www.facebook.com/AlliancePublicHealth

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July 23, 2020

NGOs from EECA countries have stood up to the challenge not only of HIV, but also of the first wave of COVID-19. But that’s not enough

According to the new UNAIDS Global Report on the Global AIDS Epidemic, the world is making significant but dramatically uneven progress, especially in expanding access to antiretroviral therapy. At the same time, the COVID-19 pandemic also had a significant negative impact on the achievements of the countries of Eastern Europe and Central Asia in the fight against HIV/AIDS over the 30 years of the epidemic.

According to the report, Eastern Europe and Central Asia remain one of three regions where the HIV epidemic continues to grow. Therefore, there is an urgent need to scale up HIV services, especially in the Russian Federation.

The report also highlights a large gap between HIV testing and treatment initiation. Only 63%* of people living with HIV who know their HIV-positive status in the region are being treated. And only 41%* of all people living with HIV in the region have suppressed viral load.

The “Seize the Moment” report warns that the HIV response could be slowed down for another 10 years or more if the COVID-19 pandemic seriously disrupts HIV services.

“We cannot say that COVID-19 has become a calm time for the workers of nongovernmental organizations that provide HIV services. On the contrary, the coronavirus has thrown sharper light on health issues in society, and the current period should definitely be a time to take action. Enhanced action in response to HIV. We must work faster, better, and, obviously, for less money, – says Tetiana Deshko, Director of the International Programs Department of the ICF “Alliance for Public Health”, says, – I am sure it is high time to mobilize in order to achieve the key global community goals on AIDS”.

The UNAIDS Global Report emphasizes that it is important for countries to double efforts and act urgently to reach the millions of people still left behind. At the same time, it is worth paying attention to the catalytic regional NGOs that promptly adapted their work in the EECA region in the context of a double challenge to maintain the sustainability of the services provided for people from key populations who badly needed it from the very onset of the coronavirus crisis.

“It is infinitely gratifying that civil society organizations were able not only to continue their work to combat HIV infection, to make the situation safer in order to reduce the risks of COVID-19, but their responses also became responses to the new COVID-19 challenges”, Mrs. Deshko says.

The Alliance for Public Health, UNAIDS and the Asian Association of People Living with HIV have started collecting stories of vibrant, decisive action taken by nongovernmental and government organizations in the EECA region. Today, nearly 60 stories from around the world illustrate this critical work on the interactive online Community Initiatives Map. Any organization or initiative group can send their story, just filling out the form on the website.

Tetiana Deshko also noted that after analyzing the work performed under a double challenge, the Alliance for Public Health team saw that COVID-19 not just complicated the work, but the crisis made them focus on the clearest, most systemic methods of providing HIV care.

 “We found out that there are a number of HIV service recommendations following COVID-19, and we should adhere to them after the peak of the pandemic. In particular, we saw that distribution of substitution therapy drugs for injecting drug users, who account for almost half of new HIV cases in our region, was provided at home for long periods, which could both reduce the cost of providing this service and make it more patient-oriented”, Tatyana said. “We saw that distributing the sufficient number of consumables — including syringes, condoms, and tests, for longer periods also helped people to stock up on consumables and practice safer behavior”.

Online work becomes crucial throughout the world. Online counseling on safe behavior, response to crisis situations, introduction of the practice of using test vending machines, syringe vending machines, dispensing antiretroviral medications for a longer period, sending medicines by mail are crucial. According to Tatyana Deshko, all these steps enabled implementing HIV services and reduce the risk of COVID-19. “We must continue them in the future”, she emphasized.

“We tried to monitor the human rights situation using a special database – an online system for documenting, online monitoring and immediate response to violations of the rights of key groups and HIV-positive people (REAct). We worked in 5 countries: Ukraine, Tajikistan, Georgia, Moldova and Kyrgyzstan, where we observed the situation with the rights of key populations. Unfortunately, we have noted many cases of violation of these rights, while more than a hundred cases of violation of rights were recorded in the first 6 months”.

The situation is different in these countries, but it is still the law enforcement agencies who are responsible for the most cases of the key population rights violations, Ms. Deshko notes. The health officials keep the second place. Key populations, people living with HIV, often face cases of humiliation or violence. This is the analysis that is very clearly outlined in the UNAIDS report, showing that the issue of respect for the human rights of key populations is one of the main obstacles in the response to the HIV and COVID-19 epidemic.

We contacted experts from Kyrgyzstan, Moldova and Ukraine, the leaders of NGOs or projects who have recovered from coronavirus infection and asked what needs to be done so that people could cope with HIV and COVID-19. And that’s what they answered.

Aybar Sultangaziev, Chairman of the Partnership Network Association (Kyrgyzstan): “The catastrophic unpreparedness of healthcare systems, lack of supplies of medicines and medical equipment lead to high mortality and disability of the population due to COVID-19. This is happening against the background of hugely inflated public procurement prices, limited funding and a complete lack of forecasts of the situation development. All this is forcing civil society to take the initiative and, in fact, stand up against the storm of the epidemic. Studying the world experience in treatment and the subsequent promotion of improvement of treatment regimens also apparently concerns only the civil sector, while meeting resistance from conservative specialists”.

Yevgeniy Aleksandrovich Goloshchapov, Director of the Advocacy Department, CSO “Positive Initiative” (Moldova): “We have identified two threats: due to problems with supplies, medicines stocks may run out and people will have no treatment, and due to the economic crisis, it is possible that tomorrow there will be no funds to buy medicines. In this situation, NGOs need to develop broad partnerships to ensure continuous access to treatment, as well as for transparency and efficiency in the use of resources“.

Nataliya Nesvat, Chair of the Board of CO “100% Life” branch in Cherkassy (Ukraine): “In parallel with COVID-19, HIV and TB epidemics continue to grow, and in this situation the role of strong NGOs and communities is more important than ever. After all, it is the people affected by HIV and TB who are trapped in the cut-off from necessary services: diagnostics, hospitalization, timely receiving of HIV medications, other medicines and food. But, along with this, NGO workers, more than anyone else, must understand their full responsibility and adhere to all precautions to minimize the risk of COVID-19 infection. Otherwise, access to vital services and, possibly, to the last hope will be lost”.

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July 13, 2020

All-Ukrainian competition for the media “Drug policy of Ukraine in the age of coronavirus: problems and solutions”

The International Charitable Foundation “Alliance for Public Health” invites the journalists of national and regional mass media to take part in the All-Ukrainian contest on the actual drug policy mainstreaming in Ukraine. The application can be submitted by the authors who have published (or broadcasted) their texts/stories from January 1st to November 13th, 2020.

This event aims to raise public awareness and informedness of modern methods of drug abuse prevention and treatment, in particular to emphasize the expansion of substitution maintenance therapy network, increase access to the state program on HIV/AIDS, hepatitis, tuberculosis for drug addicts.

Besides, the competition should help to reform Ukraine’s repressive drug policy and decriminalize drug addicts. This is important to show by the example of developed countries, where the work of the law enforcement system is focused on combating organized drug trafficking.

The competent jury will determine one winner in the categories of “Television and Radio”, “Printed Press”, “Online Press”, “Blogging”. The authors of the best materials will receive diplomas and financial incentives. The winner in each category will receive a cash prize of UAH 5,000. The competition also provides for individual awards, for example, for a series of materials or the creation of a special project on the theme of the competition.

Requirements for competitive works:

  • Materials can be prepared in any language of national minorities with a translation into Ukrainian or Russian.
  • Publications should focus on Ukrainian realities and world best practices, demonstrate the real state of affairs and offer solutions to the problems of drug addicts.
  • Preference will be given to publications that focus on expanding access to SMT and promoting the decriminalization of drug addicts with a focus on combating the organized drug trafficking by the law enforcement system, raising issues of stigma and discrimination.
  • Also, publications may include the issue of adolescent drug addiction and the rapid change of the drug scene from opioid drugs to synthetic psychotropic substances, the lack of appropriate government rehabilitation programs.
  • Texts provided by the media representatives must be original and free of plagiarism.
  • To participate in the contest, you must enter information about the posted material in the registration form at the link: https://forms.gle/QxAmGd6KSpup8vxZA

The deadline for submission of materials is November 13th, 2020 (6 p.m).

The winners of the competition will be chosen by an independent jury, which will include representatives of the ICF “Alliance for Public Health”, partner organizations, winners of past competitions.

The best materials will be published on the information resources of the ICF “Alliance for Public Health”, so when submitting an application for the competition, the authors automatically allow such publications.

All-Ukrainian competition for the media “Drug policy of Ukraine in the age of coronavirus: problems and solutions” is part of the projects “The Partnership to Inspire, Transform and Connect the HIV response” (PITCH) and “Accelerating progress in reducing the burden of tuberculosis and HIV infection by providing universal access to timely and quality diagnosis and treatment of tuberculosis, expanding evidence-based prevention, diagnosis and treatment of HIV, creating viable and stable health systems” (implemented with the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria).

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