Ukraine is known for having a severe TB epidemic. It is one of the TOP 5 countries in the world with the highest burden of multidrug-resistant tuberculosis (MDR-TB): MDR-TB is detected in each fourth patient with newly diagnosed TB and in each second patient with TB relapses. Besides, Ukraine has the worst in Europe TB cure rates – only 71% of new TB cases and 39% of MDR-TB cases are cured. Generally, every year over 30,000 people in Ukraine are diagnosed with TB (four new cases every hour), with every eighth patient dying.
On World TB Day, Alliance for Public Health is presenting solutions that are making a major difference in a challenging TB environment, comprehensively addressing TB detection and treatment.
Diagnostics
Alliance is implementing a project aimed at early TB detection among most-at-risk populations. In 2016, over 160,000 clients were reached with screening survey, and 14,000 of those screened positive were examined for TB at healthcare facilities. Finally, 92% of those diagnosed with TB started proper treatment at healthcare facilities. In particular, addressing HIV/TB co-infection is our special focus.
Treatment access
With mobilized resources from the Global Fund and other donors, Alliance dedicated over half of its budget for addressing TB, mainly for procurement of MDR-TB medicines. In 2015-2016 only, we reached USD 34.6 million worth of MDR-TB drugs delivered in all regions of Ukraine.
As of January 1st 2017, altogether 12,551 patients were enrolled to MDR-TB treatment within the program supported by Alliance with the Global Fund funding, and 5,535 of them continued receiving medications and social care from Alliance.
Treatment success
We proved that patient-centred approach with social support is not an additional element which might be added to standard medical MDR-TB treatment. It is a key cornerstone element of the successful MDR-TB treatment.
Within its pilot projects supported by the Global Fund, Alliance proved that combination of medical, social and psychological support allows increasing MDR-TB cure rate twofold. 80% of patients with MDR-TB were cured. This is a really impressive result, considering that the average treatment success rate for such patients in Ukraine is less than 40%.
Despite the growing challenges, Alliance continues its work on the temporarily occupied territories in the east of Ukraine. Alliance successfully delivered humanitarian aid, including MDR-TB treatment, for over 1,400 patients. We also support our 12 partner civil society organizations in Donetsk and Luhansk oblasts working to ensure early TB detection among most-at-risk populations.
Alliance applauds the governmental leadership and growing commitment to stop the TB epidemic. The result is our joint success based on the partnership with the Ministry of Health, State Centre for Public Health, Ukrainian Red Cross Society, Network of PLWH and numerous civil society organisations, community groups and medical facilities. We are greatly thankful to our international partners: The Global Fund, WHO, TB Europe Coalition, Stop TB Partnership, UN Secretary General Special Envoy on HIV/AIDS in Eastern Europe and Central Asia, United Nations Special Envoy on Tuberculosis, UNAIDS, Zero TB Cities, Global TB Caucus, PAS Center, US Government, PATH and other programs we are coordinating our response with.
Ukraine is currently developing a new proposal to the Global Fund for 2018-2020, with significant funding for TB. It is critically needed to scale up patient centred approach to all in need and eligible MDR-TB patients, to focus on missed TB cases and those lost to follow up. Over the new program, Alliance is planning to gradually transfer the civil society components ensuring patient-centred approach to the MDR patients currently funded by the Global Fund to the domestic funding. The newly approved by the Government 2020 Strategy to fight TB and HIV epidemics sets a good framework for this.