2018 was marked with innovations, greater scale and remarkable results in fighting HIV, tuberculosis and hepatitis. Next year, Ukraine will be challenged with transition of most of the services from donor to state funding. We celebrate key achievements of the outgoing year, which set a solid ground for successful 2019:
- Nation-wide HIV prevention efforts focusing on Key Populations has brought the epidemic under control. In 2018, 200 000 PWID, 38 000 SWs, 43 000 MSM have accessed HIV prevention services. We run the largest harm reduction program funded by the Global Fund globally. Next year we will pass this successful program to the government for continued funding and management. The Alliance for Public Health (APH) will continue assisting with program oversight, monitoring and technical support to ensure consistently high quality and coverage.
- Effective innovations including PrEP, HIV oral and blood self-testing, tailored programs for transgenders and young people, and new technologies in HIV and TB case finding have strengthened the national response to epidemics. Successful PrEP pilot for 100 MSM in Kyiv with support of CDC became a ground for scaling up PrEP up to 2 800 MSM all over Ukraine next year. The resource selftest.org.ua allowed to confidentially deliver self-tests to rural and remote areas. Optimized Case Finding model, based on active contact tracing and recruitment of the extended risk/social networks of HIV-positive participants, was included into Compendium of good practices in the health sector response to HIV in the WHO European Region. Innovative services and community mobilization efforts among transgender people and experimenting youth (Drugstore project supported by Elton John AIDS Foundation) have also been highlighted as international best practice.
- APH brings new effective approaches in finding missing TB cases and TB treatment. Index screening scaled up through Results-Based Financing (RBF) allowed for a 4 times increase in the number of identified TB patients in 2018 compared to 2017! Ukrainian novel approach was acknowledged by the Global Fund Observer: people-oriented models of care that include social support for patients allowed to double TB treatment success rate from 40% up to 80%! Active engagement in the policy work including support and collaboration with TB Europe Coalition, Stop TB Partnership, WHO, Global TB Caucus, Partnership STOP TB Ukraine, 100% Life, Ministry of Health and Public Health Center brought Ukraine as a strong actor at the UN High Level Meeting on TB in September 2018 and in the post-UN HLM accountability processes on fulfilment of the commitments of the Political Declaration.
- Hepatitis C is no more a neglected disease in Ukraine. APH pioneered Hepatitis C DAA treatment with sofosbuvir and ledipasvir/sofosbuvir making it accessible free of charge for the most marginalized patients. To date 2 162 patients from all over Ukraine have been treated with 95% success rate. These achievements stimulated the Ministry of Health and other international organizations such as MSF to support generic competition and further scale up of Hep C treatment. This year APH in partnership with the Ministry of Justice provided Hepatitis C diagnostic and treatment with DAAs in the penitentiary system to the patients who never received it before – prison population. 50 inmates were treated with 98% treatment success rate!
- In 2018, APH continued pursuing its ambitious goals in sustaining epidemic control in Non-Government controlled areas (NGCA) of Donbas. Continued support of partner organizations in the area, regular supplies of health products, equipment, as well as maintenance of TB laboratories, help effectively reach TB and HIV affected populations there. As of the end of the year, APH efforts ensured high quality MDR-TB treatment for 585 patients (over 95% of all MDR-TB patients on treatment) those and provision of HIV-prevention services for 16 042 people there. The LANCET dedicated a special article to this APH unique experience of successful working in challenging operating environment.
- APH continues to strengthen its contribution to the development of programs in Eastern Europe and Central Asia through its partnership with CSO’s and regional projects. As a key implementation partner of TBEC and PAS (Moldova) APH completed a 3-year TB-REP project focused on advocacy and civil society support in 11 countries of the region. Acknowledging Ukraine’s successful experience, the Global Fund has supported a new HIV regional project with a consortium of organizations led by APH. This new regional HIV project focusing on 14 countries will start from January 2019 with the focus on sustainability of services for key populations.
- Transition of the largest in Eastern Europe and Central Asia opioid substitution therapy program from donor funding to the domestic one is nearly successfully completed with the sufficient budget allocation for further scaling up to over 13 000 patients in 2019:
*allocated budgets/available from different sources for medicine purchase
Alliance congratulates all partners and colleagues on the coming New Year and Merry Christmas!