We are pleased to finally share the results of the charity collection for ambulances for Ukrainian doctors, which we held at the 24th International AIDS Conference AIDS 2022, held in Montreal (Canada) from July 29 to August 3, 2022.

“Ukraine is unconquered, and Ukrainians are unbreakable. We will stand and win, because we have no other way. But we need the support of the world more than ever!
Personally and on behalf of the Alliance and all Ukrainians, I am sincerely grateful to everyone who contributed to raising funds for minibuses to evacuate the wounded from the war zone to the nearest hospitals, – said Pavlo Smyrnov, Deputy Executive Director of the Alliance for Public Health. And we managed to buy not 1 but 2 cars. I shake hands with everyone and report that we quickly managed to buy buses in the Netherlands. Both buses were successfully delivered to Kyiv, where they underwent the necessary repairs. Already in excellent technical condition they went to the zone of active hostilities. They were also camouflaged for greater safety of medics and wounded. Used cars now have a new mission – to #save human #lives at the front. And I really believe they will serve this mission as long as possible.”
So, a detailed story about how Ukrainians were supported by conference participants from all over the world, how we raised funds and talked about Ukraine, how and where the cars were purchased, brought to Ukraine, technically improved and transferred to the front line!

Many thanks to all participants of #AIDS2022 who supported with donations and not only, sincere thanks to all partners who helped at every step, the Alliance for Public Health team and #SoS_project – you are incredible, you always do more!

Thanks to everyone who helped to organize the whole process: from the ambitious idea “to raise funds for at least 1 car in a couple of days” and to organize everything to the final transfer of 2 cars to the front line.

A new report on the Global State of Harm Reduction 2022 shows an increase in the global use of solutions to reduce harm from HIV and the overdose epidemic.

According to the report, the number of countries implementing harm reduction services that prevent overdose deaths and the spread of infectious diseases has increased for the first time since 2014.

For the first time, the foreword to the report was written by a representative of the community of people who use drugs and he is Ukrainian – Anton Basenko, Community, Rights and Gender Advisor at the Alliance for Public Health and Program Manager at EATG.

Thus, he told the story of a woman from one of the eastern regions of Ukraine who uses drugs, which is an illustration of the strength and solidarity of the community of drug users. “Her story is one of many stories of networks of people who use drugs helping each other. Despite the number of destroyed facilities and displaced people who use drugs due to the war, I am proud to say that our global harm reduction family is unstoppable and our desire to help each other is so strong that we can only move forward…”

“…The report shows where we are today, colorfully and clearly, with facts and evidence. It shows the world we can create when people who use drugs, people who work in nongovernmental organizations, people who make laws and policies at the national and local levels come together; a world based on mutual respect that supports diversity, health, rights and freedom, a world free from judgment and stigma.”

Regarding the war, the report highlighted the extraordinary efforts of NGOs and civil society organizations in Ukraine and neighbouring countries since the Russian invasion of Ukraine in February 2022 to provide shelter, food, medicine and harm reduction supplies to Ukrainian regions that were cut off logistically or where people could not leave their homes. Support for the evacuation of people who use drugs from Donetsk and Luhansk was noted, as well as ensuring that community and civil society organizations could continue to provide harm reduction services in Donetsk.

To get acquainted with the Alliance’s situational reports on the work of the Humanitarian Committee, the situation with SMT, prevention, de-occupied regions, etc.

It should be noted that as of 01.10.2022, more than 19 thousand patients are on the state substitution maintenance therapy program in Ukraine, of which almost 1600 patients are IDPs. The largest number of IDPs as of 1.09.22 was in Lviv, Dnipropetrovsk, Zaporizhzhia, Ivano-Frankivsk, Kirovohrad regions. The percentage of patients receiving SMT for self-administration for 7-30 days increased to 91%, compared to 84.9% in early February.

Despite all the positive changes and development of the OST program during martial law due to the coordinated work of the Alliance, the Public Health Center, NGOs and patient organizations, unfortunately, the program is experiencing extremely negative consequences, so the % of retention in the OST program for at least 6 months from the start of treatment decreased from 83.1% (as of 23.02.2022) to 78.6% as of 01.10.2022. In July-September alone, about 676 patients in Kherson region stopped receiving OST without the possibility of continuing treatment, as the drug at most sites ran out and was seized by the occupying authorities, and it is almost impossible to leave Kherson region for safer regions. Also, since the beginning of the war, patients from the entire Luhansk region, Donetsk (Mariupol and Bakhmut) and Zaporizhzhia (Berdiansk and Melitopol) have partially left for safer regions to continue treatment, some of them have not managed to leave the temporarily occupied territories.

With the support of the Alliance for Public Health in Ukraine, NGOs provide comprehensive support to OST patients: psychosocial, humanitarian assistance, transportation services.

Link to the report: https://bit.ly/3UbKkt5

Despite the war, there is still an HIV epidemic in Ukraine. According to the national statistics, about 260,000 people are living with HIV, while one third of them are not aware of their status.
For five years, Alliance for Public Health in partnership with 100% Life Network have been implementing the HealthLink Project “Accelerating Ukraine’s Efforts to End HIV” supported by the United States Agency for International Development (USAID). The main aim of this project is to end the HIV epidemic in Ukraine by offering an opportunity of free, rapid and safe HIV testing and treatment. This is the biggest HIV testing project in Ukraine, which is aimed at improving service delivery in health facilities, partner organizations and communities as well as targeted marketing of the key services provided within the project.
The fifth year of the project was the most challenging one, due to the war, occupation of territories, ruined health facilities and constant migration of population. However, the project was able to reach almost all the target indicators:
• 59,985 people tested for HIV (157% of the indicator for the year),
• 1,991 people with newly diagnosed HIV infection (89%),
• 1,944 people registered at health facilities (80%),
• 1,981 people started ART (98%).
The general HIV testing yield within the project is 3.3%.
Challenging times call for extraordinary solutions, that is why the main efforts were aimed at implementing new ideas to find new clients and motivate them to test for HIV, building sustainable adherence to treatment (ART), motivating partners of PLWH for index testing, preventing new infections by offering PrEP to members of high-risk populations, distributing oral HIV tests, etc. A number of innovative approaches have been implemented, including:
Launch of the Video Doctor app to improve the index testing indicators. Doctors received tablets, which they used during their consultations to show videos to their patients, share useful information about HIV, explain further steps in case of HIV detection and give advice on how to invite a partner for testing. The app was actively used by health and social workers of the project. The videos were shown to 884 clients. The activities were implemented in the following regions: Kyiv and Kyiv region, Poltava, Kherson, Kirovohrad, Dnipropetrovsk, Mykolaiv, Odesa, Zaporizhzhia, Chernihiv and Donetsk regions.
Online services became very popular during the COVID-19 pandemic and especially during the war. The services offered at the https://oraltest.org.ua website are in high demand among the LGBT clients. On the website, they can order a SafeBox or take a survey on risk behavior and learn about the risks of getting infected with HIV, syphilis and hepatitis. SafeBox is a prevention package, which includes an oral HIV test, condoms, lubricants, information materials and trendy souvenirs. SafeBoxes are especially popular in smaller towns and villages, where the LGBT community is hidden. They allow people to protect their confidentiality and get tested for HIV at home using the guide provided in the box. In total, 3,286 boxes were ordered at the website in one year.
Besides, a Telegram bot Assistant Dan has been launched in the fourth quarter to carry out a survey among the clients on their use of oral HIV tests and their satisfaction with the website services. The survey responses were analyzed and the results were part of the research “Oral HIV tests.” Besides, the bot helped to form a group for online testing of the LGBT community members. In total, 1,692 people took part in the online survey, which proves the efficiency of the online tools. In addition, the Telegram bot is used for online outreach or navigation, leading the clients to online consultations of friendly doctors, psychologists and lawyers.
Another gem of the project is the Seducer simulation game for MSM. As we all know, there are no drafts in life, so it is important to make right decisions from the first time. Unfortunately, we do not always have time or experience to understand, which decision is right and what consequences it can lead to. Participants of the simulation game are able to put themselves in the shoes of the game heroes, try different scenarios, and see the consequences of their choices. The game is a very effective education tool. NGOs offer to use this tool in their workshops for MSM.
Vending machines were widely used to distribute oral tests. They allow clients to access HIV tests and do self-testing in a comfortable place. Also, there are free condoms available in the vending machines. The mechanism is quite easy: you go to the website, answer the questions, generate a QR code, scan it and get what you need. In one year, 1,107 oral HIV tests were distributed through such vending machines.
For successful project implementation, it is important not only to encourage new clients to get tested, but also care about motivation, awareness and support of the project staff. That is why supervision has been launched as an important project component to provide ongoing help and support to the NGO staff members and health workers engaged in the project. The key topics discussed at the supervision sessions:
• peculiarities of HIV testing and counseling (in particular using a questionnaire to screen clients for risky behaviors and medical indications for testing);
• motivational counseling with skill building exercises (including index testing);
• prevention of professional burnout among the staff;
• maintaining emotional and psychological stability during hostilities, etc.
Both face-to-face and online sessions were organized. Due to the war, the number of face-to-face supervision sessions – both in NGOs and in health facilities – reduced greatly. However, despite all the challenges, supervisors were able to carry out 74 supervision sessions in NGOs and health facilities. The face-to-face supervision sessions were attended by 146 NGO representatives and 547 health workers, including nurses and doctors of different profiles, offering HIV and hepatitis testing and counseling. The number of online supervision sessions – both group and individual – was much bigger. In total, there were 1,434 online supervision sessions.
Providing support to the newly diagnosed patients was another focus of our work. When patients learn about their HIV-positive status, it is much easier for them to cope with the challenges and overcome the obstacles they face when they are supported by a mentor, who has a similar experience, which he is ready to share. One of the innovative approaches used in the project was peer mentoring. Mentors received special training on such topics as living with HIV, providing psychological support, coping with stress, offering motivational counseling to build adherence to ART, etc. After being trained, mentors were supporting their mentees living with HIV who had risks of dropping out of treatment and helped them build their lives with their new status. As for the mentors, it gave them a chance to do things which were socially important, build their capacity and self-esteem through training and cooperation with the project. This approach received a lot of positive feedback both from the mentors and from the mentees.
We would like to separately recognize the adaptability and creativity of our partner NGOs in finding new clients and interacting with them. Due to the war, many clients had to leave their homes and look for shelter in new places, where they sometimes did not have access to ART. That is why social workers organized the delivery of ARVs to their clients living with HIV, in particular internally displaced persons. In total, there were 233 ARV deliveries organized within the project.
Most NGOs started working with internally displaced persons and offering humanitarian support within other projects. Thus, they were able to reach a new target audience. Now, when people come to NGOs to get humanitarian aid, they also get information about HIV and are offered HIV testing. Such information is also distributed in the places where IDPs live.
The donor decided to extend the project for the sixth year, so we continue fighting HIV despite all the challenges we are facing today.

Viktor Liashko, Minister of Health of Ukraine, and Andriy Klepikov, Executive Director of the Alliance for Public Health, joined the #POLITICOHealthCare Summit 2022, organized by POLITICO Europe, and spoke about the new threat to the country, how it is countering it and the TOP 3 urgent needs of Ukrainians.
Special attention was paid to the sustainability of the healthcare system and the biggest challenges for Ukraine caused by Russia’s large-scale military aggression.

Thus, Viktor Lyashko said that today in Ukraine more than 1000 medical institutions have been destroyed or damaged. This perfectly illustrates how negatively the war affects the civilian infrastructure.
It should be noted that today more than 7 million forced war refugees have left Ukraine and about 8 million people have moved inside the country. This happened only during the Second World War.
Andriy Klepikov said that the Alliance for Public Health and other NGOs are working side by side with the state and medical institutions. In some areas of the eastern part of the country, where hospitals are either destroyed or severely damaged, there are people who still need medical care. So civil society and communities are using mobile clinics to help.
“Previously, we used them only for HIV testing, but now mobile clinics have a wide range of services, including basic services such as blood pressure measurement and others. This is a good example of how civil society modifies services in response to existing needs. Today, health programs need more mobility and digitalization, which we are also working on. Because it is obvious that all people who have moved use online services, chatbots, telegram channels to get access to treatment.”
It should be noted that on March 1, the Alliance for Public Health, with the support of The Global Fund, launched an international support service for internally displaced persons and migrants #HelpNowHUB on the basis of SoS_project. The hub’s services provide online access to HIV, tuberculosis, hepatitis treatment, access to substitution and hormone therapy around the world, as well as the opportunity to get an online consultation with a doctor and restore the “prescription / history of HIV treatment”, which was lost due to the war.
“Our system is quite stable, even in wartime. And Ukrainians are very inventive. For example, we found a way to deliver medicines during the fuel shortage. We promptly purchased bicycles and did it without interruption. And when there were no bicycles, social workers walked! This is an illustration of incredible resilience and dedication,” said Mr. Klepikov.
Answering the moderator’s question, Andriy Klepikov noted that today a new threat hangs over Ukraine. “Russia wants to kill civilians with cold this winter. This is a really well-thought-out strategy of a terrorist state and a crazy person who gives orders. Therefore, it is very important to resist it. We desperately need to add a humanitarian element to health programs.”
Recently, the experts of the Alliance for Public Health conducted a survey of urgent needs among representatives of key communities and according to its results, it is possible to identify the TOP-3 needs that are most relevant for Ukrainians today
access to food in Ukraine, a European country, is the main need(!!!????);
access to heat, clothing and to be warm in order not to freeze;
support for mental health.
You can watch the full speech of Andriy Klepikov in the attached video.
Other interviews and discussions of the summit: https://www.politico.eu/healthcare-summit/#Program 

In 2022, a new three-year regional project, #SoS_project 2.0, was launched in Eastern Europe, Central Asia, and South-Eastern Europe.
This is the largest Global Fund project on a regional scale, involving 14 countries: Albania, Armenia, Azerbaijan, Bosnia and Herzegovina, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Northern Macedonia, Serbia, Tajikistan, Montenegro, Ukraine, Uzbekistan.
In a prolonged military invasion situation, the Alliance managed to maintain the full-fledged project’s work and, more importantly, develop and launch new services for internally displaced persons and migrants. It is important to note that the manual developed in the previous project was used to implement this approach: “Guidelines for contingency planning in the provision of HIV-related services for key populations during COVID-19 and other emergencies”.

• Cooperation and partnership
• Progress on Goal 1: Institutionalize effective HIV response models and processes in the EECA region to influence the HIV care cascade in the region
• Progress on Goal 2: Removal of barriers to services for key populations to promote quality health interventions based on human rights principles; overcoming gender barriers to services
• Progress on Goal 3: Budget advocacy for sustainable services for key populations in the EECA region
• Strategic initiative to digitalize the HIV response in EECA countries
• Strategic Initiative for Emergency Response. A package of standardized services has been developed
• Strategic priorities for 2023-2025

Read the Digest in a web browser

Thank you for your attention, and enjoy reading.

Starting January 2023, the implementation of Fast Track Cities initiative is planned for Baku within SoS 2.0 regional program.

Info on global Fast Track Cities initiative: https://www.fast-trackcities.org/about
The text of Paris Declaration: https://bit.ly/3eagEx4

Goal of this call for proposals is to select country-coordinating organization (CCO), which will be responsible for implementation of Fast Track Cities initiative in Baku in 2023-2024 and reach expected outcomes stated below.

Implementation period: 01.01.2023 – 31.12.2024

Target groups of project implementation: Mayor, Deputy Mayors, members of city parliament, heads of specialized deputy commissions, head of health department of city administration, representatives of NGOs and key populations.

FTC approach and plans for Baku in 2023-2024:
• Conduct baseline assessment on municipal response to HIV, budgeting, gaps, problems and challenges (the assessment tool will be provided by Alliance for Public Health).
• Advocacy work with Baku municipality to sign Paris Declaration on HIV by the Mayor of Baku in 2023.
• Establish municipal working group on HIV with inclusion of representatives from key affected populations.
• Make available HIV care cascade data on city level with disaggregation by KPs, age, gender.
• Develop municipal HIV program/plan aiming 95-95-95 and zero new HIV infections.
• Increase in municipal funding allocation to HIV programs – $ 500 000 cumulative increase during 2023-2024

Download all tender documents
The application and supportive documents should be submitted by e-mail not later than by 14 November 2022, 23:59 Kyiv time, at the address kushnir@aph.org.ua.

Questions regarding the call for proposals could be submitted at the same email address, until November 8, 2022.

Ukrainian civil society and supporters from European organisations unfurled a giant Ukrainian flag on Square Schuman (Brussels) ahead of the State of the Union Speech which will be given by European Commission’s President Ursual von der Leyen on September 14. The flag, which aims to draw the attention of the EC President on the need to scale up investments in the fight against HIV, tuberculosis and malaria, carried the following message: “Dear European Commission, please pledge 715 million to the Global Fund. Ukrainian CSOs”.

This flag is a symbol of solidarity and shows Ukrainian civil society support for the work of the Global Fund. “When the war started on February 24, Global Fund was the first donor to react quickly and effectively. Global Fund provided additional emergency funding to support ongoing programs. With its support we saved hundreds of thousands of lives of our clients, patients and their families members. Now it’s time to save 20 million lives. The Global Fund Replenishment is not measured in $ or €. It is measured in human lives and we shouldn’t allow anyone to cross from this list!“, – said Andriy Klepikov, Executive Director, Alliance for Public Health.

The action closed an international flashmob “Let’s win together: #FightForWhatCounts”, started in Kyiv and Lviv (Ukraine), and was part of Ukrainian civil society’s efforts to advocate for a fully funded Global Fund. It was launched by more than 100 Ukrainian NGOs with the support of European partners, as a follow up to an Open letter calling on the President of the European Commission and leaders of other Global Fund donor countries to increase funding for the Global Fund by 30%.

“As we have seen from numerous examples in the recent past, a country at war is also at risk of an increased spread of HIV amongst its population. Solidarity with Ukraine should include the fight against the HIV pandemic. Global Fund, having a great track record for their work in the EECA region, should continue to be a central instrument to combat HIV in the whole region, with special attention to the Ukrainian situation”, – said Pieter Vanholder, Executive Director, European AIDS Treatment Group.

Organizers of the international flash mob ‘Let’s win together: #FightForWhatCounts’: the Alliance for Public Health, Aidsfonds, the European AIDS Treatment Group and Global Health Advocates. 

Materials of the flashmob:  https://bit.ly/3Bx9vzH 

A new GF report: ow.ly/QLHu50KGyNz

Contacts:

– Inna Gavrylova, Alliance for Public Health, +380 96 753 8150 (/WhatsApp), gavrylova@aph.org.ua 

– Kasia Lemanska, Aidsfonds, +32 489 04 48 22, KLemanska@aidsfonds.nl 

In response to the humanitarian crisis caused by russia’s military aggression in Ukraine, the Public Health Alliance, with the financial support of Cristian AID and the Disasters Emergency Committee (DEC), launched a comprehensive program of humanitarian support in Ukraine during the war and post-war reconstruction of Ukraine.

So far, the project’s first stage, which lasted 3 months from June to August, has already been successfully implemented, resulting in more than 70,000 Ukrainians receiving real assistance. The total budget of the humanitarian investment amounts to 1.4 million pounds.

The main directions are support of vulnerable communities representatives, aimed at ensuring urgent humanitarian, social, and medical needs and dignified life in crisis conditions through implementing crisis response measures.

Andriy Klepikov, executive director of the Alliance for Public Health: “In the conditions of large-scale russian military aggression, millions of Ukrainians, who were living in difficult circumstances before, found themselves on the verge of survival. A humanitarian program supported by Christian Aid directs aid to those who need it most. For those who at the moment do not receive it from the state or international organizations. In the first months of its activity, the Alliance has already supported over 75 humanitarian projects to help communities and initiative groups across the country. This is a significant investment to support and restore Ukraine, and we are grateful to our partners for their trust and support.”

It is worth noting that the program’s approach to solving the crisis situation is distinguished by the support of community initiatives that independently find ways to improve life in war conditions. “This is a focused support of people’s natural ability to overcome difficulties and help each other in crisis situations, and this stimulates people’s faith in their own strength, encourages, and deepens the self-esteem in the community. Communities are rebuilding new lives independently, focusing on what matters most. Our task is only to listen to the needs and provide comprehensive support.”

“It is difficult for me to recall how our family survived the war,” said Ms. Olha, a mother of several children from the village of Stary Bilous, which was occupied by the russians in March, about her experience of receiving help from the “Nation Revival” organization. “I can only say that we didn’t move anywhere. It didn’t work out because the middle child had an appendicitis attack in the first days of the war, and he had to be taken to the hospital. He spent 10 days there, and then the bridges were already blown up, and there was no way to leave. It was challenging and scary for the small children. They saw how their neighbors’ house was on fire and spent the night in the basement, which was not suitable for this (it was freezing). However, I don’t want to mention all this again. Thank you very much for your understanding, help, and support. My children and I started the necessary treatment.”

And further on – even more support for Ukrainians. The program’s primary focus is helping internally displaced people and people who suffered from military aggression in Ukraine.

Maryna Varban, head of the Humanitarian Support Program of the Alliance for Public Health:

“We see the terrible humanitarian consequences of russia’s military aggression not only on TV as the whole world does. We live in these conditions and understand the extreme need for emergency intervention and provision of operational assistance to Ukrainians affected by the war. This support is essential for Ukraine. We will use all our experience working with HIV/TB programs so that everyone who needs help receives it as soon as possible. We focus on supporting the work of shelters, evacuation from war zones, direct humanitarian and social assistance, psychological and legal support.”

Cases of implemented support:

Shelter at the Mayak children’s camp in Poltava, with the support of the Public Health Foundation.

In Poltava, the camp director, at her peril and risk, accommodated people who arrived from Donetsk, Luhansk, and Kherson on the area of the children’s recreation camp. 70 people were housed, and 51 remained for permanent residence. These people do not have the opportunity to return home and do not plan to move further, so they put up with the realities as they can: they have started a little farm with vegetables and chickens and are preparing preserved food for the winter. They all live in one space, divided into two zones.

Of course, people did not have enough basic things to arrange their lives: they washed items and bedding by hand, use the only one refrigerator for everyone, there was a limited number of plates, and limited access to cooking appliances.

The application of the initiative group was supported, and a refrigerator, washing machine, induction stove, electric oven, and sets of pots and pans were purchased for the shelter.

 “When they brought the equipment, it was like a small holiday! The women, like little children, circled the plates and appliances. After getting permission to connect the refrigerator and washing machine with the electricity, our husbands did not have to ask too long. They quickly installed everything! Yesterday was the first day of washing!!! We made a schedule, and everyone is happy!!!”

Project “Modular Town,” Zaporizhzhia.

Since 2015, people who were forced to leave their homes in various regions of the temporarily occupied areas of Ukraine (Donetsk, Luhansk, Kherson, and Zaporizhia regions) have been living in the modular town. In 2022, the town’s population grew several times, accepting new families who did not want to go further. Solving fundamental household problems of living is, of course, an urgent component of improving the quality of life.

Installation of stationary dryers on the territory of the Modular town situated on Steshenko st., 18 will help improve the level of life, the participation of residents in the project’s development, and its implementation will help integrate and unite those who have already lived in the town since 2015 with those who have just settled in it. 

Lyudmyla, volunteer coordinator of the town:” We learn “on the go”, we ask a lot of questions because none of the members of our group has experience in this kind of work. We were not ready for war, nor were millions of our compatriots. But today, we continue to expand the range of targeted assistance to internally displaced persons based on our modular town. However, sometimes, some such problems and issues cannot be solved together with the state – either there are no laws, or there are no instructions, or it is not on time. And here, volunteers or organizations like BO BF “Hope” come to the rescue and help us find a solution. And this time, they helped us with the development of the project, financing, and implementation of the installation of dryers on the territory of the town.”

About the Public Health Alliance

It should be noted that the Public Health Alliance team has more than 20 years of experience in implementing access programs and supporting treatment sustainability in HIV/TB programs. Today, our experienced specialists are working to assist those who need it most.

In particular, several initiatives and programs have been launched since the beginning of the war. The Humanitarian Convoy began its work, transporting more than 500 tons of cargo. A “special” long-distance flight was implemented for the transportation of 1.2 million tablets for the RRT programs, purchased by the Ministry of Health of Ukraine and the Public Health Alliance, which will be delivered to 19 medical institutions in 6 regions of Ukraine for patients who were on the verge of interruption of treatment due to the war. The international HelpNow HUB emergency support program has been launched for Ukrainians who were forced to go abroad. More than 9,000 Ukrainians from 31 countries received assistance. Programs for prevention and access to treatment for HIV, tuberculosis, hepatitis, and ART have been adapted, and psychological support programs, etc., have been expanded. More information on wartime work in Situation Reports >>>

Additional information about the Humanitarian Program is available here >>> 

Contact: Maryna Varban, project manager Varban@aph.org.ua