May 31, 2019

Chisinau joins Paris Declaration to end the AIDS

On May 31, 2019, acting mayor of Chisinau Ruslan Codreanu and UNAIDS Regional Director for Eastern Europe and Central Asia Vinay P. Saldanha, signed the Paris Declaration on accelerating action in Large Cities to end the HIV/AIDS epidemic.

Chisinau became the first city in Moldova and the first among the cities of the regional project #SoS_project, which signed the declaration, thereby declaring its active leadership position in the global movement to combat the HIV/AIDS epidemic in major cities around the world. It should be noted that in Moldova annually register about 900 new cases of HIV infection, about 20 percent of which occur in the capital.

In his speech, Ruslan Codreanu noted that this is a historical moment and it will be difficult to achieve the necessary indicators of the strategy 90-90-90, but it is never too late to start making the necessary changes to improve the lives and health of people. “The program’s budget will amount to 1.7 million lei. This money will be spent on information campaigns, prevention, which is important, treatment, care and support. It’s not quite clear where this money will be allocated, but we are counting on social partnership,” – said prime.md acting mayor of Chisinau Ruslan Codreanu.

The city authorities of the capital of Moldova have committed themselves to a significant increase in the coverage of Chisinau residents in the prevention, testing and treatment of HIV infection, with the goal of eliminating the AIDS epidemic and focusing on programs for key groups.

“Chisinau was the first to sign the Paris Declaration in the new regional project “Sustainability of HIV services for key groups in the EECA region” (aka # SoS_project), which covers 14 countries and 24 cities in the Eastern Europe and Central Asia region. The capital of Moldova sets an example to other cities, how to take the initiative in their own hands, applying the best international experience, developing an effective urban strategy, allocating the necessary funding and supporting effective HIV/AIDS activities to improve the health of citizens. This is not the final point, but only the beginning of an effective municipal response to the HIV/AIDS epidemic, where the non-governmental sector, which is very well developed in Moldova, should play a crucial role. Our organization has experience with the association Positive Initiative, which has great expertise in this area. And we are convinced that NGOs must become strategic partners at the municipal level in order to successfully achieve common goals. The Alliance team is ready to provide technical and expert support to the city, ” – said Andriy Klepikov, executive director of the Alliance for Public Health .

The Paris Declaration assumes that the city undertakes to do everything to achieve the indicators 90-90-90 by 2020. This means that 90% of all residents should be tested for HIV, 90% of those infected should receive treatment and 90% of them should have zero viral load (the virus must be completely suppressed). According to the World Health Organization, by 2030 the world will be able to stop the HIV epidemic.

“It is extremely important for us that the Paris Declaration does not become just another declarative statement. It is for this reason that we are working with partners to ensure that in the next 2-3 months the Municipal Program will be approved, in which there will be specific and measurable goals, distributed roles, and, accordingly, budgets. This will be the first confirmation that partners at the municipal level really want and are ready to mobilize in order to achieve the goals of strategy 90-90-90 and save lives ”, – said Ruslan Povega, CEO of the Initiative Positive association. – “Today we have witnessed a manifest political will, which is expressed in the fact that when people want, in a short time they do something that seemed to someone very difficult and impossible. I thank the mayor of the city for a sustainable partnership, for hearing us, understanding the importance of the subject matter and assuring that he will do everything possible so that at the municipal level the situation began to change for the better. I sincerely believe that the Paris Declaration in Chisinau will be successfully implemented. ”

In turn, Vinay P. Saldanha congratulated Chisinau on joining the international initiative and noted that the participants in the declaration “stop the spread of HIV once and for all.”

According to Mr. Saldana, the city needs to act at an accelerated pace not only to reach 90-90-90, but it is also extremely important to eliminate discrimination against people living with HIV and key groups, which is a significant barrier. And in this struggle the city is not alone, Chisinau is supported by a team of leaders at the regional and national level who are ready to share their expertise.

The signing of the Paris Declaration was the main and final action of the national campaign “Chase the virus, not the people” in Moldova! (region campaign).

It should be noted that the signing of the Paris Declaration was one of the results of the project “Sustainability of HIV services for key groups in the Eastern Europe and Central Asia region”, which is being implemented in Moldova by the public association Initiative Positive.

At the regional level, a three-year project under a grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria is implemented by a consortium: Alliance for Public Health, 100% Life (All-Ukrainian Network of PLWH), The Central Asian Association of People Living with HIV and The Eurasian Health Network of Key People groups, with the participation of national governmental and non-governmental organizations, regional key populations networks , international agencies and organizations, as well as technical partners.

#SoS_project will focus on ensuring the sustainability of services for key populations in 14 countries of Eastern Europe and Central Asia. As a result of the project, by 2021, national funding for HIV/AIDS programs will be increased by $10 million from national, regional and municipal budgets in the countries of the EECA region. It is also planned to ensure $73.4 million savings in the countries budgets through optimised ARV procurement.

Text: Inna Gavrylova

Photos, video: Initiative Positive

Semnarea Declarației de la Paris privind stoparea epidemiei cu HIV

Semnarea Declarației de la Paris privind stoparea epidemiei cu HIV

Опубліковано Initiativa Pozitiva Пʼятниця, 31 травня 2019 р.

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May 07, 2019

Behind the scenes of medicine: why Kyrgyzstan is in the focus of regional #SoS_project? (video)

Andriy Klepikov, executive director Alliance for Public Health, became the guest of Aibar Sultangaziyev’s unique author’s program “Behind the Scenes of Medicine” on Next TV in Kyrgyzstan.

The theme of the new broadcast was a discussion of “Barriers and opportunities to end the HIV epidemic”.

The program guests talked a lot about the current HIV/AIDS epidemic in the country, how to improve it and what is being done for this, as well as global trends and international partners that provide significant support to Kyrgyzstan in the fight against HIV/AIDS and TB.

So, Andriy Klepikov talked about why the focus of the new regional project “Sustainability of Services for Key Groups in the EECA Region”, which received the laconic name #SoS_project, is aimed at Kyrgyzstan. He spoke about global best practices for ensuring the sustainability of HIV services, which became the basis for #SoS_project; about why the Global Fund’s withdrawal is inevitable and about the importance of ensuring a sustainable transition to state-financed national programs in the next 2-3 years.

Note that the author and host of the TV program is Aybar Sultangaziev, a prominent public figure and director of the Partnership Network Association.

(Text: Inna Gavrylova)

Watch the TV show >>>

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May 04, 2019

Ukraine best practices was discussed at the international conference #HR19 in Porto

#HR19: People before politics!

This was the main message of the 26th International Conference on Harm Reduction (#HR19), which was held from April 28 to May 1 in Porto city (Portugal). The conference is one of the key global platforms in the field of health care, at which top-level harm reduction issues are raised.

This year at #HR19, a number of countries presented their successful experience in implementing harm reduction programs that had a direct impact on improving the public health situation in a particular region and improving the quality of life of people who use drugs, their families and communities.

Participants #HR19 started talking about Ukraine at the opening ceremony of the conference. Ukrainian Andriy Yarovyi, who was illegally detained and convicted in the temporarily uncontrolled territory of the Luhansk region, the so-called “LPR”, was presented with the prestigious international award “Carol and Travis Jenkins Award” (watch video). Note that it is awarded on annually since 2005.

In 2019, Ukraine’s advanced experience was presented in a series of discussions at the 26th International Conference on Harm Reduction.

Andriy Klepikov, Executive Director of the Alliance for Public Health, called on donor governments to allocate funds for the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria. He stressed that these funds play a critical role in stopping the HIV/TB epidemics in the EECA region.

Mr. Klepikov spoke about a working harm reduction program in Ukraine, which had a significant impact on reducing the dynamics of the HIV/AIDS epidemic. The program itself in the country of harm reduction in the country has existed for over 15 years. Initially, it was limited mainly to the exchange of syringes, the distribution of condoms and the holding of groups. Since 2008, with the support of the Global Fund in Ukraine, a substitution therapy program has been introduced. Today, as a successful practice, it is exemplified at expert sites at various levels.

“On the example of Ukraine, we see the effectiveness of preventive programs that are gradually moving from donor to state funding this year. In the process of transition, it is important to keep these programs working, high-quality and efficient, so that they continue to contain the epidemic”, – said Andriy Klepikov.

Techniques to improve the HIV cascade were presented at separate sessions.

Testing innovations and experience in organizing assisted self-testing for HIV in Ukraine were presented by Tatyana Salyuk, director of the METIDA project of the Alliance for Public Health.

Konstantin Dumchev, scientific director of the Ukrainian Institute of Public Health Policy, spoke about adherence to ART and reducing the viral load among HIV patients in Ukraine who use drugs.

A separate leitmotif emphasized the role of cities in improving people’s health. At the session on the role of cities in local drug policy, there were examples from Ukraine to strengthen funding for harm reduction programs in cities, drug testing, and work with city police.

They also told in Porto about the first Ukrainian harm reduction office in the EECA region, which opened in December 2018 on the basis of the regional narcological dispensary in Sumy (Ukraine).

The effectiveness of such cabinets has been scientifically proven for a long time, and this is the first space of this kind in the countries of Eastern Europe and Central Asia, which exists through local funding. The additional funds provided by the Public Health Alliance and the International Renaissance Foundation were needed only to launch the project, including repairs and equipment for the premises. For official work of the cabinet a special package of documents was prepared. The organization and opening of the cabinet was coordinated by the harm reduction activist, the head of the Freezone organization, Alexey Zagrebelny.

Tatiana Deshko, Head of the International Programs Department of the Alliance for Public Health, told about the success of urban initiatives on HIV / TB in EECA cities and, in particular, the program in Odessa.

Tetiana Deshko at the Harm Reduction International Conference 2019 in Porto, Portugal. ©Jared Krauss/HRI

Two years ago, within the framework of the regional public health alliance project “Accelerated response to the HIV/TB epidemic among key populations in Eastern Europe and Central Asia”, the Odessa Municipality joined the global initiative of the Track Track Cities, aimed at overcoming the HIV/AIDS epidemic by 2030.

The joint work of the Alliance, the Odessa Municipality, NGOs partner and representatives of key groups led to an increase of 50% in the number of patients receiving ARV therapy. For comparison, in Kyiv, which is also the city of the initiative of Fast Track Cities, over the same period, progress was 43%, and even less all over Ukraine – only 37%.

27,378 representatives of key groups were covered with HIV prevention services, of whom 17,430 were people who inject drugs (84% of the estimated number). Mortality due to HIV in Odessa decreased by 19% from 117 people in 2017 to 95 people in 2018.

“It is extremely important that the funds allocated in 2018 work in harm reduction programs in Odessa. The distribution of syringes for the program’s funds through pharmacies has already begun. We are waiting for the most important decisions on social contracting, which will allow the program funds to be directed to the low-threshold services of the city’s NGOs”, – Tatiana Deshko noted.

They spoke at the 26th International Conference Porto and about the Ukrainian project on harm reduction for young people who are experimenting, Drugstore. Representatives of the Elton John AIDS Foundation spoke about the project, talked about it at a press conference, and participants in HR19 discussed Drugstore on the sidelines.

Video broadcasts of the conference sessions can be viewed here.

Text: Inna Gavrylova

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May 03, 2019

Preparatory process for the UN General Assembly high-level meeting on Universal Health Coverage

This week on 29th of April Alliance for Public Health has attended and presented comments on the interactive multi-stakeholders hearing on Universal Health Coverage at the United Nations Headquarters in New York, United States. This meeting was the preparatory process for the UN general assembly high-level meeting on universal health coverage on 23 September 2019 in New York, with the overall theme: Universal Health Coverage: Moving Together to Build a Healthier World. The President of the General Assembly, with the support of the World Health Organization and UHC2030, has convened the interactive multi-stakeholder hearing as part of the preparatory process for UN HLM. Permanent representative of Japan is the friend of UHC and Thailand and Georgia was the co-facilitators of the event.

The hearing took place from 10:00 to 18:00, in the General Assembly Hall at the UN Headquarters in New York. The discussion was focus on core themes around UHC, noting that UHC is a catalyst for social-economic development and a key contributor to equity, social justice and inclusive economic growth. Nearly 600 stakeholder’s representation from all over the world participated the hearing. In consultation with global CSO’s UHC2030 have submitted following key asks during the hearing and can be found here. Zahedul Islam, Director of Treatment, Procurement and Supply Management of APH has taken part in the interactive discussion and provided comments on

  • How to bring about actionable commitments from the member states during the HLM and ensure its implementation
  • Should CCM mandates be expanded to include UHC in the country level where all multi-stakeholder partners are involved
  • Should UHC integrate traditional medicine and other non-traditional medical practices while creating a UHC basic service package
  • How to leverage parliamentary platform to progress UHC agenda with policy makers in the country level

The outcome of the hearing will be published within the next few weeks and inform the preparation of the zero-draft political declaration on UHC that will be negotiated by Member States. APH is proud to be part of this multi-stakeholder hearing and UN high-level meeting process.

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May 01, 2019

Andrii Yarovyi was awarded the prestigious award at the conference #HR19

Famous social activist Andrii Yarovyi, who was illegally detained and convicted in the temporarily uncontrolled territory of the Luhansk region, the so-called “LNR”, was presented with a prestigious international award.
On April 28 at the opening ceremony of the #HR19: 26 International Conference on Harm Reduction in Porto (Portugal) was announced the award of the authoritative international award “Carol and Travis Jenkins Award” to Andrii Yarovyi as a victim of daring human rights violations related to illegal imprisonment for the storage of legally obtained medical drug replacement therapy.

Andrii Yarovyi could not personally receive the award, he handed the appeal, which was read during the presentation of the award.
In the letter, Andrii thanked for acknowledging his contribution to the protection of the rights of people who use drugs and the development of harm reduction programs. In his letter, he noted that he was convinced of the achievement of goals. “The most important thing is to believe. To believe and not to stop, ”wrote Yarovaya.
The “Carol and Travis Jenkins Award” has been awarded at the International Conference on Drug Related Harm Reduction since 2005. The purpose of the event is to recognize the contribution of communities or individuals in the field of harm reduction from drug use, health care and human rights.
Learn more about Andrii Yarovyi.

Text: Inna Gavrylova

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April 05, 2019

#SoS_project strategy presented at The Global Fund EECA Constituency meeting in Tajikistan

On April 3, a working meeting of the Global Fund to Fight AIDS, Tuberculosis and Malaria countries of the Eastern Europe and Central Asia region (EECA Constituency) was held in Dushanbe (Tajikistan) with representatives of the Ministries of Health and the National Coordination Councils of the five Central Asian countries: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan.

Professor Natalia Nizova, Deputy Member of the Board of the Global Fund from the EECA electoral group, said that the focus of the meeting was on enhancing the participation of representatives of the public sector of Central Asian countries in the electoral group.

“The EECA Constituency is one of the seven Governors of the electoral groups in the Global Fund, whose leading members are representatives of state structures delegated by countries. It was important for us to hold a meeting on the territory of one of the countries of Central Asia a region that is currently characterized by a rapid increase in new cases of HIV and tuberculosis, said Professor Nataliya Nizova. – The objectives of the meeting were to provide additional information on the opportunities that, through participation in the Constituency, are opened up for the countries of Central Asia as well as in discussions with representatives of the regional offices of UNAIDS and WHO on the consolidation of available resources in the region for the successful preparation of countries for the transition period. The Constituency meeting was been prepared for more than a year with the assistance and support of the Ministry of Health of Tajikistan, which allowed the participation of both members of the delegation of the Global Fund electoral group and invited participants”.

During the meeting, Pulod Jamolov, Executive Director of SPIN Plus (Tajikistan) and a member of the regional team #SoS_project presented a three-year project strategy with the support of the Global Fund “Sustainability of Services for Key Groups in the EECA Region” (#SoS_project).

“The multi-country #SoS_project has a complementary structure design and clearly defined goals. In the whole EECA region, we plan to attract more than $10 million in prevention programs for key groups. And this is extremely important in the context of the transition to state financing. WHO representatives who attended the meeting expressed interest in the project strategy. I think, we will continue the new dialogue with WHO on the project implementation at other regional and country sites,” Pulod Jamolov said.

“A regional project is another resource for Central Asian countries that cannot be implemented without the active involvement of Ministries of Health, CCM teams and an understanding of the prospects that are opened up for each country and region as a whole, noted Professor Nataliya Nizova.

From the speech of Natalia Nizova at the launch #SoS_project meeting (Kiev, Ukraine, March 26, 2019)

#SoS_project will focus on ensuring the sustainability of services for key populations in 14 countries of Eastern Europe and Central Asia. As a result of the project, by 2021, national funding for HIV/AIDS programs will be increased by $10 million from national, regional and municipal budgets in the countries of the EECA region. It is also planned to ensure $73.4 million savings in the countries budgets through optimised ARV procurement.

The implementation of the three-year project will be coordinated by the Alliance for Public Health, in a consortium with the 100% Life (All-Ukrainian Network of PLWH), the Central Asian HIV’ Association and the Eurasian Key Populations Health Network, with the participation of national governmental and non-governmental organizations, regional key populations networks , international agencies and organizations, as well as technical partners.

Text: Inna Gavrylova

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April 01, 2019

Andriy Klepikov: The #SoS_project aims to ensure the sustainability of HIV services by 2021

14 countries of EECA and Balkan regions will be able to save more than $ 73.4 million thanks to optimized procurement of antiretroviral drugs and optimization of treatment regimens.

These funds will allow reallocation of funding and expansion of treatment programs and services for key populations in countries. This was announced by Andriy Klepikov, Executive Director of the Alliance for Public Health during the presentation of the regional project “Sustainability of Services for Key Groups in the EECA Region”, which was shortly named #SoS_project.

“The enormous savings at the regional level are very well and in details calculated,” – emphasized Andriy Klepikov. – “This is not a figure from the ceiling. Behind it, there are strategic calculations, analytics, which is confirmed at the level of each country as well as on regional level. There are some specific calculations that have already been transformed into a commitment format in some countries, because in all countries these applications were approved by the CCM – the national coordination mechanisms for HIV/AIDS”.

To achieve the expected savings, the project will develop strategies for optimizing the cost of ART regimens, which will lead to a decrease in the average cost of first-line ART. Advocacy activities will also be carried out aimed at reducing prices for ARVs and using savings to finance the needs of prevention and care services for the Key Groups and PLHIV. In addition, work to optimize clinical guidelines for ART, a list of drugs in accordance with WHO guidelines is planned, as well as advocacy to include countries in voluntary licensing and registration of generic manufacturers.

The regional project “Sustainability of Services for Key Groups in the EECA Region” is the largest and most comprehensive regional project of the Global Fund to Fight AIDS, Tuberculosis and Malaria in Eastern Europe and Central Asia. It brings together 14 countries of the EECA region and southeastern Europe and the 23 cities with the highest burden of prevalence of HIV/AIDS.

“Unfortunately, we cannot work at the same time everywhere,” says the executive director of the Alliance for Public Health. “Therefore, we have chosen 23 cities with the largest number of HIV-cases. This is a reasoned choice when, effectively working in cities, you can influence the effective response of the HIV/AIDS epidemic and at the state level”.

The main goals of the project are to increase the financial sustainability and effectiveness of HIV programs, remove the most significant barriers to accessing prevention and care services for PLHIV, and increase the effectiveness and accessibility of HIV services delivery models for key populations.

To achieve these goals, the Global Fund provided financial support in the amount of $ 13 million. Andriy Klepikov said that almost half of these funds ($ 5.6 million) will go to the advocacy of the reduction of prices for ARV drugs and optimization of procurement mechanisms.  Another quarter of the project budget ($ 3.2 million) is planned for budget advocacy. $ 1.6 million is provided for the removal of legal barriers, the same amount for project management. Another $ 1 million will go to operational research.

The #SoS_project team will actively cooperate with all those who can provide, and/or affect the necessary changes, both from civil society and government agencies. It is also planned to interact with recipients of country GF grants to achieve common goals and successful experience in introducing innovations in some countries of the region will be extended to other states. All actions to introduce innovations will be accompanied by operational research, which will become the evidence-based research for launching new initiatives.

“The idea is not only to throw in some initiatives, but simultaneously with such interventions to launch operational research, which will help identify and prove their effectiveness,” explained Andriy Klepikov. – “It worked, in particular, in Ukraine. But we would not want other countries to take it on faith. In each country for advocacy, before the Ministry of Health will start funding, it is important to get a serious evidence base, which is collected through operational research”.

According to the plans, budget advocacy within the project will consist of the following elements: development/updating of the functional mechanisms of public procurement of prevention and care services and support services from NGOs; increasing the capacity of NGOs and government representatives on budget advocacy, reallocation of financial resources, relations with government structures; support for the development of national social contracting guidelines; advocacy for the adoption of municipal programs and funding related activities.

Moreover, as part of the project, it is planned to attract $ 10.250 million in prevention programs for key groups from savings made through the project.

The implementation of the three-year The Global Fund project will be coordinated by the Alliance for Public Health, in a consortium with the 100% Life (All-Ukrainian Network of PLWH), the Central Asian HIV’ Association and the Eurasian Key Populations Health Network, with the participation of national governmental and non-governmental organizations, regional key populations networks , international agencies and organizations, as well as technical partners.

Text: Inna Gavrylova

Foto: Julia Nikolenko

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March 22, 2019

Saving $73,4 million on ARVs for 3 years: The EECA strategy on sustainability of HIV services will be presented in Kyiv

On 26-27 of March, partners’ meeting dedicated to the launch of a three-year multi-country project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia” funded by The Global Fund, will be held in Kyiv. The meeting will bring together participants from 24 countries.

As a result of the project, by 2021, national funding for HIV/AIDS programs will be increased by $10 million from national, regional and municipal budgets in the countries of the EECA region. It is also planned to ensure $73.4 million savings in the countries budgets through optimised ARV procurement.

The implementation of the three-year project will be coordinated by the Alliance for Public Health, in a consortium with the 100% Life (All-Ukrainian Network of PLWH), the Central Asian HIV’ Association and the Eurasian Key Populations Health Network, with the participation of national governmental and non-governmental organizations, regional key populations networks , international agencies and organizations, as well as technical partners.
Andriy Klepikov, Executive Director Alliance for Public Health:

“Eastern Europe and Central Asia is the only region in the world where HIV epidemic continues to grow. Our new project has an ambitious goal – to break this trend. It will become possible thanks to a variety of innovative and effective interventions, and most importantly – ensuring the sustainability of services for the most vulnerable to HIV groups, thanks to increased funding from national budgets. In addition to the work on the national level, we focus on the 23 cities with the highest burden of HIV. The success of the strategy that we have chosen has already been demonstrated in Fast-Track CITIes project, implemented by the Alliance in EECA region. The next three years will require tremendous efforts from the whole team, as there has not yet been a project of such an unprecedented scale, goals and level of partnership in the EECA region. And we gladly accept this challenge! ”

 

 

The regional project will focus on ensuring the sustainability of services for key populations in 14 countries of Eastern Europe and Central Asia: Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, the Russian Federation, Tajikistan, Uzbekistan, Ukraine, and also Bosnia and Herzegovina, Montenegro, North Macedonia, Romania and Serbia.

 


Dmitry Sherembey, Chairman of the Coordination Council of CO “Network 100% of Life

“We are confident that our expertise in working with key populations, building viable health care systems, expanding access to treatment will be useful for the entire regional project. The experience “100% of Life” has gained in previous years is invaluable and will significantly improve the situation in the region. Working with key populations, we acquired the skills necessary to build active and effective communities that are ready to represent and defend their own interests, even after international donors will have left the region”.

 


Dumitru Laticevschi, Regional Manager of Eastern Europe and Central Asia Team, The Global Fund to Fight AIDS, Tuberculosis and Malaria:

 «We view the Regional Grant as a significant catalytic addition to the programmes supported by the Global Fund in the countries of Eastern Europe and Central Asia. Its powerful design is the outcome of a robust collaborative development process and we count on measurable improvements in both areas of sustainability – a) reducing burden of HIV and b) more domestic funding for more efficient interventions to  maintain the gains in the fight against HIV in the future”.

 

 


Vinay P. Saldanha, Director, Regional Support Team, Eastern Europe and Central Asia, UNAIDS:

“Ensuring access to HIV services for key populations is the most important task, by solving which, we can confidently move towards our main goal – to end the AIDS epidemic by 2030. In this regard, the Global Fund project is of utmost importance. We are pleased to join the project Steering Committee and work together with a consortium of organizations led by such experienced and strong partners as the Alliance for Public Health and the 100% of Life Network (All-Ukrainian Network of People Living with HIV). UNAIDS is ready to provide full support to the project, primarily in the field of advocacy at the highest national and international level”.The three-year project “Sustainability of Services for Key Populations in Eastern Europe and Central Asia” aims to improve the financial sustainability and effectiveness of HIV programs, reduce existing legal barriers and protect the most important human rights for access to HIV prevention and care, improve the efficiency and accessibility of HIV services delivery models (HIV care cascade) for key populations.

 


On March 26, a video of the Meeting opening and the project presentation will be published on the Facebook page of the Alliance for Public Health. Join us online!

Text: Inna Gavrylova

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March 22, 2019

Alliance Engaged in the Activities to Mark the World TB Day

On March 21, 2019, on the eve of the World TB Day, public campaign “It’s time” was organized in front of the Ukrainian Parliament building with support of Alliance for Public Health. Within the campaign, a four-meter installation of a clock was set up at the Constitution Square near the Parliament, with the key messages of TB response in Ukraine put on the clock dial instead of the numbers, together with the slogan “It’s TIME to end TB.” This event was held within international awareness-raising campaign “Its time” initiated this year by the Stop TB Partnership to draw the attention of general public and government officials to the problem of TB.

At the press briefing, campaign organizers said that every year approximately 3,700 people die of TB in Ukraine, which is about 10 people every day. This situation leads to the annual indirect losses of more than $12 million. Although in the recent years there has been certain improvement of the situation, Ukraine remains one of the countries with the highest burden of multi-drug resistant tuberculosis – the most severe form of TB, which incurs longer-term, more expensive and less effective treatment. Besides, according to the WHO about 23% of TB cases in Ukraine are missed.

To improve the situation, the Cabinet of Ministers developed a middle-term strategic document – National TB Program – which is currently reviewed by the Parliamentary committees.

“The National TB Program that we are discussing today is not only the document setting the direction and creating the grounds of TB response in the country, but should also be part of the accountability system to monitor compliance with the commitments, which Ukraine undertook at the UN General Assembly High-Level Meeting on TB in September 2018. It’s time to start implementing those commitments on detecting, treating TB and overcoming stigma against people with this disease. I think that to achieve this goal it is crucial to establish cooperation of the responsible governmental authorities with the civil society and with MPs. Our joint efforts can become the driving force, which will allow the country to turn the tide in TB epidemic,” pointed out Serhii Kiral, MP, Chair of the Parliament Platform to Fight TB.

During the national round table in the Parliament, which was held before the press briefing, MPs, heads of the government bodies, international experts, and representatives of civil society and patient organizations discussed the situation with tuberculosis in Ukraine and pointed out that for the third year the country has been functioning without a valid National TB Program approved by the Parliament, which has an extremely negative impact on the efficiency of TB response. For our country, resolving this problem is a matter of national security, which requires comprehensive and interdepartmental approach at all levels.

Ending TB by 2030 is a joint intention of the humankind. Currently, Ukraine demonstrates a persistent trend towards reduction of the incidence of new and repeated TB cases. Last year, this number was 800 less than in 2017. Today Ukraine fully funds the procurement of TB drugs, and by procuring those drugs through international organizations, we were able to increase the quantity of the drugs purchased almost 40-fold. For instance, last year Linezolid was procured by international organizations for $0.27, while in 2014 the Ministry of Health procured it for $2.85,” told Dr Ulana Suprun, Acting Minister of Health of Ukraine.

With support of the Global Fund and other donors, Ukraine made a big progress in fighting tuberculosis. In the context of transition from donor to domestic funding of TB response, it is crucial not to lose our achievements. Draft law No. 9467 stipulates implementation of a patient-centered approach to TB care, compliance with the rights of patients and their family members, involvement of communities to end the epidemic of TB in line with international strategies and recommendations,” outlined Zahedul Islam, Director: Treatment, Procurement and Supply at Alliance for Public Health, which is the focal point of civil society organizations in Ukraine in working with the international movement of parliamentarians, the Global TB Caucus, and provides technical support to the Parliament Platform to Fight TB.

Besides, the participants discussed the issues, which people with TB currently face. Olga Klymenko, Chair of TB People Ukraine, who defeated TB and now helps other people in fighting the disease, told about her own experience of TB and the challenges that other patients are exposed to: “It is crucial to make sure that people who receive treatment can rely on all the required human and professional support to successfully complete their therapy. In 25 years of the epidemic, we never had a stronger support at the national level than we have today. Just a couple of years ago, the main treatment rule was “total isolation.” In the last two years, we have seen effective positive changes in the system, which stayed rigid for many years. Outpatient treatment, procurement of social support services with local budget funds, access to new drugs. However, to make such changes systematic, we need a National Program, which would recognize them at the legislative level. Thousands of patients are awaiting such changes. I hope that all those who have the power to make decisions will remember that they are responsible for thousands of human lives.”

Many developed countries have already given up the practice of long-term hospital stay due to the high risk of cross infection and due to the problems, which patients face if they have to leave their social environment for a long time. Patient-centered approaches currently introduced in Ukraine stipulate, in particular, transition to outpatient treatment if there are no special reservations.

The biggest danger for people around is a patient with undiagnosed TB, while the best TB prevention in this case is detecting the disease as soon as possible and prescribing TB treatment,” emphasized Victor Liashko, First Deputy Director of the Public Health Center of the Ministry of Health of Ukraine.

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March 21, 2019

“TIME to stop TUBERCULOSIS”

Information statement

on the World Tuberculosis Day

On the occasion of the World Tuberculosis Day commemorated annually on March, 24, the Alliance for Public Health report on our achievements in solving the problem of detection and treatment of tuberculosis (TB) in a difficult epidemiologic context.

According to the World Health Organisation (WHO), tuberculosis ranks among the top-10 mortality reasons around the world, and is the main mortality reason in HIV-positive people. In Ukraine, tuberculosis kills over 3700 people a year, which is about 10 persons a day. Despite certain improvement of the situation observed in the recent years, in 2018 alone, 21.3 thousand new cases of tuberculosis were registered in Ukraine. At the same time, about 23% new cases in our country go undetected, and drug-resistant TB insusceptible to conventional medications requires more prolonged and expensive treatment with lower chances of a successful outcome.

The situation is further complicated by the fact that it is now the third year that the Parliament fails to adopt the National TB Program, which reflects the lack of proper political will in the legislature.

Alliance for Public Health (APH) continues implementing comprehensive measures to fight tuberculosis in Ukraine. In 2018, screening surveys under APH’s programs reached almost 308 thousand people of the key populations, and 16.7 thousand people tested TB positive during a screening received diagnostic services at health care facilities. For the first time, 3190 clients from the key populations underwent high-quality diagnostics — molecular genetic testing — at the screening stage. 811 TB cases were identified, with 93% of the TB-positive people starting treatment.

APH introduces new effective approaches to identification of TB cases and further immediate beginning of treatment. Screening of exposed persons strengthened with an innovative result-based funding (RBF) model enabled increasing the number of detected TB cases in exposed persons in 2018 by 3.4 times compared to 2017! And thanks to patient-centered models of care and integration of treatment and social support, treatment success rates of drug-susceptible and drug-resistant TB in 2018 reached as high as 90.9% and 88.7% respectively![i]

In 2018, APH consistently made efforts to restore control of the TB epidemic on the uncontrolled territories in Eastern Ukraine. These efforts have already brought substantial results. Thanks to the work of APH, as of early 2019, as many as 1405 patients were provided with a quality multidrug-resistant tuberculosis (MDR-TB). They comprise 100% of all MDR-TB patients receiving treatment on the uncontrolled territories of Donbass region.

As the coordination center for civil society organisations of Ukraine in the context of collaboration with the Global TB Caucus — an international movement uniting over 2000 MPs, APH provides technical assistance to the interfaction Ukrainian Parliamentary Platform against Tuberculosis. The Platform established in October 2017 includes 47 MPs of Ukraine. In the year and a half, the Parliamentary Platform have held 4 national round tables in the Parliament and, together with their partners, organised several major campaigns commemorating the World TB Day in 2018. Besides, the Parliamentary Platform took an active part in coordination of Ukraine’s participation in the UN General Assembly High-Level Meeting on TB in New York in 2018, and the report “Drug-Resistant TB in Europe” presented by the Chair of the Platform has enabled adoption of the corresponding PACE resolution. The activities of the Parliamentary Platform have been included in the WHO’s Compendium of good practices in the implementation of the Tuberculosis Action Plan for the WHO European Region 2016-2020 as a good example of advancing partnerships to end TB.

We would like to thank all our partners and donors, as well as representatives of civil society, communities, professional and governmental organisations. It is time to stop tuberculosis, and, together, we shall definitely do it!


[i] 90.9% — preliminary data on treatment success rate in patients with drug-susceptible TB who started the treatment in 2017.

88.7% — preliminary data on treatment success rate in patients with drug-resistant TB who started the treatment in Q2 and Q of 2016

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