11-12 of September, 2018, in the frame of the “Fast-track TB/HIV responses for key populations in EECA cities” and under cooperation between Executive Committee of Odesa City State Administration, ICF “Alliance for Public Health” and CBO “Center for Youth Development” Odesa have conducted the seminar “The Icelandic Model for Substance Use Prevention among Youth” under the name Planet Youth  for the specialists of education institutions, police and CBO partners.

Seminar was conducted by the Director of The Icelandic Center for Social Research and Analysis Jon Sigfusson and Dr.Adrian Sarbu.

The coaches introduced for the participants of the event with the Icelandic model for the prevention of substance use among young people, which has led to an almost double decrease in the number of adolescents who smoke and drink alcohol in Iceland from 1998 to 2007. The Model is based on the three “logical” pillars of success: it is evidence based; it is conducted in communities; strengthening the dialogue between policy makers, practitioners and researches.

On September 13-14, 2018, the city of Odesa will host City Health International conference for the first time in Central and Eastern Europe. This is the seventh event dedicated to the public health issues in urban areas, which is hosted by the Alliance for Public Health (Ukraine), AFEW International (the Netherlands), City of Odessa (Ukraine) and Knowledge Action Change (United Kingdom).

The theme for City Health International 2018 is ‘Developing healthy responses in a time of change’. This includes changes in political and societal norms, as well as changes in perceptions and expectations within communities. It also provides scope to tackle the important principle of inclusion, with regard to marginalized individuals and groups.

“In today’s world dynamics we must see health in politics in the first place. Here in Ukraine we deal more and more with health challenges of maintaining health in non-governmental controlled territories, finding health solutions for internally displaced people, supporting health of soldiers; Europe is looking for effective solutions for health of migrants. In this diversity of challenges healthy cities are best placed to become hubs of stability. This is what this conference will be speaking about,” – says Andrey Klepikov, Executive director of Alliance for Public Health.

More than 300 delegates from around the world will gather to examine how, in the increased urbanization of society, cities respond to changing populations, changing economic and environmental pressures and adapt to changing health behaviours.

CHI 2018 is an ‘inclusive’ conference, with presenters and participants including NGOs, community projects, advocacy groups, as well as urban and health planners, academics, policy makers and those who deliver services and interventions.

Program of the event: https://cityhealthinternational.org/2018/programme/programme

List of speakers: https://cityhealthinternational.org/2018/programme/speakers-bios/david-wilson

Registration for press: https://goo.gl/forms/i5sJac3Em99GAJLh2

Alliance for Public Health is the International charitable foundation founded in 2000 in Ukraine. It became a leading non-governmental professional organization making a significant impact on the epidemics of HIV/AIDS, tuberculosis, viral hepatitis and other socially dangerous diseases in Ukraine. In cooperation with state partners and civil society organizations, it provides financial and technical support to programs, covering over 250,000 representatives of most vulnerable populations: the highest such coverage indicator in Europe. For more information on Alliance please visit http://aph.org.ua/en/about-alliance/

On August 31, 2018, Alliance for Public Health (Alliance) in cooperation with Ukrainian Network of People Who Use Drugs (PUD.UA) and other partners held an awareness-raising campaign “Silence Kills” in front of the Ukrainian Government building. The campaign was dedicated to the International Overdose Awareness Day, which is marked globally on August 31. Members of the PUD (people who use drugs) community, media representatives and other people had a chance to get free medical counseling in mobile clinics, receive professional advice of doctors and social workers, get information materials on overdose and receive the medicine, which can save the life of a person in case of opioid overdose with one injection.

Every year, about 200 thousand people all over the world die of drug overdose!

In the United States, more than 60 thousand deaths were caused by overdose last year! The official statistics on people who died of overdose in Ukraine is only formal and does not reflect the real situation. Usually, in Ukraine such death cases are registered as “acute heart failure”, with only about two hundred deaths every year being recorded with causes related to drug use.

Since 2001, on this day, August 31, hundreds of thousands people all over the world express their sympathy to the families and friends of overdose victims and remember those whose lives were lost to overdose. Not a single person should be persecuted or discriminated due to drug dependence or drug overdose.

Findings of a biobehavioral study conducted by Alliance among people who inject drugs (PWID) in Ukraine in 2017-2018 show that 5% of respondents experienced cases of overdose in the recent 12 months. The highest level of overdose – 14% – was observed among PWID who live in the capital of Ukraine.

Naloxone saves lives!

The research results give us strong evidence that every year over 17 thousand people who inject drugs in Ukraine experience overdose. Many of them die. Opioid overdose is associated with the highest risks. This is what 27% of respondents stated. Since 2010, Alliance has been using a well-known medicine – Naloxone – in its integrated programs to prevent deaths among opioid users.

“As a safety belt saves a person’s life in case of a traffic accident, Naloxone is the most effective method to save the life in case of an overdose. This antidote medicine should be available in such emergencies. The person who happens to be near the one with overdose –an ambulance doctor, a paramedic, a social worker, a friend, a neighbor or a passer-by – should make an injection of Naloxone. Thanks to the distribution of Naloxone and training on its use, Alliance has already saved the lives of thousands of Ukrainians,” says Andriy Klepikov, Executive Director of the Alliance for Public Health.

Over eight years, more than 10.4 thousand units of Naloxone were distributed within the prevention programs supported by Alliance. Considering the proven efficiency of this medicine, this year Alliance ensures the procurement of over 11 thousand units of Naloxone within its prevention programs. It is symbolic that in the beginning of this year, the Ministry of Health of Ukraine excluded Naloxone from the list of restricted prescription drugs, and now it is accessible to all people who need it.

In Ukraine, 226 thousand people who use drugs are already covered by prevention programs!

It is estimated that there are 347 thousand people who inject drugs in Ukraine. In 2017, Alliance covered 226 thousand people who use drugs with a minimum package of services within its integrated HIV and hepatitis C prevention programs. These programs allowed distributing 29 million disposable syringes and needles, testing 164 thousand people who use drugs with rapid tests for HIV (with 3 thousand people receiving positive test results and 2,389 PWID starting antiretroviral therapy) and providing 1.4 million consultations of social and medical workers.

Opioid substitution treatment is a real alternative to the illegal use of dangerous drugs!

Since 2005, one of the areas of Alliance activities has been the promotion of opioid substitution treatment (OST). Today, 10.7 thousand people who use drugs in Ukraine receive OST services in 190 health institutions within the current National Program to Counter HIV/AIDS. Currently, it is the biggest OST program in the countries of Eastern Europe and Central Asia. This year, Alliance ensures its gradual transition to the Ukrainian Ministry of Health: 72.8% of patients are already receiving OST drugs procured within the state budget.

***

Alliance for Public Health has been working in the area of HIV prevention and harm reduction among people who inject drugs for over 17 years. In 2017, Alliance ensured operation of prevention programs for PWID all over the territory of Ukraine, on a regular basis providing services to 226 thousand people who use drugs. The support provided by Alliance allowed conducting 90,755 tests for sexually transmitted infections (STIs) and hepatitis C, with 17,958 positive results detected. 110,721 PWID were screened within the efforts aimed at early tuberculosis detection, with 7,333 positive results received in the course of screening and 5,415 people seeking further diagnostics. 

http://aph.org.ua/wp-content/uploads/2018/08/Richnyj-Zvit-2017__sait.pdf

The Global Fund Observer, which is a leading independent information resource, published an article dedicated to Ukraine. The publication is based on the experience of Ukraine in implementing TB care and prevention programs with support of the Global Fund. Though the Global Fund supports programs in over 100 countries of the world, Ukraine was the one that was able to offer a number of effective solutions to bring down the burden of tuberculosis in spite of the challenging epidemiological context in the country.

Through people-oriented models of care that include social support for patients, Ukraine was able to double TB treatment success rate – from the traditional level of 40% up to 80%! Besides, effective models of care using results-based financing (RBF) were succesfully piloted in Odesa and Odesa region. Such new approaches have already been supported by the local authorities – Odesa approved a program stipulating transparent allocation of funding for the detected TB cases as well as for cured patients. The role of civil society organizations is set forth in the new procedure of providing social support to TB patients.

The gradual transition to state funding is planned not only for HIV, but also for TB programs, and the role of civil society organizations (SCO) here is also very important. We developed some models of SCO activities which proved to be effective and have been recognized at the international level. A number of best practices implemented by Alliance for Public health – “Early TB detection in most-at-risk populations” and “Results-based financing to provide DOT at the outpatient treatment stage” –  were included in summer 2018 in a UNAIDS publication Ending tuberculosis and AIDS – a joint response in the era of the Sustainable Development Goals.

“We are grateful to all our partners – Public Health Center, Ministry of Health, Parliament Platform to Fight TB, Red Cross Society, Stop TB Partnership Ukraine, Network of PLWH, organizations of people with the experience of TB, doctors, partners from health facilities and civil society organizations, international organizations, in particular WHO, Stop TB Partnership, TB Europe Coalition, PAS Center, Zero TB Cities, Global TB Caucus, our donors, in particular the Global Fund and USAID – those are the results of our joint efforts!”, said Andriy Klepikov, Executive Director of Alliance for Public Health. – In September, the Ukrainian delegation is going to the UN High-Level Meeting on Tuberculosis with demonstrated achievements recognized at the international level!”

Global Fund grant to Ukraine finds treatment success for multidrug-resistant TB with two-pronged approach

7^th International City Health Conference “Developing healthy responses in a time of change” 13-14 September 2018, Odesa, Ukraine

Just before the Ukraine’s Independence Day, Alliance for Public Health (hereinafter – Alliance) receives international accreditation with the highest standards. It has been accredited by the International HIV/AIDS Alliance (UK). This news is shared with donors, UN agencies and other international institutions.
Alliance has received the highest professional accreditation to confirm that it complies with nine principles in the areas “Governance and Sustainability”, “Organisational Management” and “HIV Programming” based on 38 standards. Currently it is the only organization in Eastern Europe and Central Asia with such accreditation.
It means that Alliance for Public Health has officially confirmed its compliance with a list of the highest standards applied to all the organizations, which are part of the global partnership of the International HIV/AIDS Alliance – international charitable organization supporting projects in response to the epidemics in cooperation with communities in over 40 countries of the world on four continents. The accreditation will be valid for four years until 2022.
“Alliance for Public Health demonstrates strong governance and organizational management skills, ensures the highest quality and the best practices in its program activities. The committee extends its compliments to the Alliance for Public Health for being a strong organization and part of the global Alliance partnership,” emphasized Warren Buckingham III, Chair of the Alliance Accreditation Committee.
“In our activities, we adhere to the highest standards, and it is not only our choice, but a strong requirement. If we could not comply with it, we would fail our accreditation. We are grateful to the International HIV/AIDS Alliance and to all our national and international partners for their support and longstanding partnership in countering the dangerous epidemics,” said Andriy Klepikov, Executive Director of Alliance for Public Health.
Alliance for Public Health has been working in Ukraine for over 17 years. It is an official co-implementer on the National Targeted Social Program to Counter HIV/AIDS in 2014-2018 approved by the Law of Ukraine N 1708-VII dated October 20, 2014. Within this program, over 300 thousand members of key populations receive HIV, tuberculosis and hepatitis C treatment and prevention services. Alliance implements the biggest program in the region of Eastern Europe and Central Asia.
International professional accreditation will allow Alliance to continue working even more successfully not only in Ukraine, but also at the international level. Today Alliance is already implementing projects in Armenia, Azerbaijan, Belarus, Bulgaria, Estonia, Georgia, Hungary, Kazakhstan, Kyrgyzstan, Moldova, Netherlands, Russia, Tajikistan, Uzbekistan, and Switzerland. As of mid-year 2018, Alliance Technical Support Hub was providing its services in 57 countries.

Accreditation standards guidance-ENG-V6

On August 13-15, 2018, Kyiv hosted a workshop “Integrated Approach to Treating MAT Patients” organized by Alliance for Public Health within the project “Improved Quality and Sustainability of Medication Assisted Treatment (MAT) in Ukraine” (CDC) in cooperation with the Addiction Transfer Technology Center in Ukraine or ATTC-Ukraine (SAMHSA).

The workshop was attended by doctors, nursing personnel, psychologists, case managers and social workers of MAT sites from the priority regions of the PEPFAR (US President’s Emergency Plan for AIDS Relief) program.

Trainers delivering the workshop were recognized experts in prevention and treatment of addictions from the USA, who provide their expertise and training support to improve the quality of HIV prevention and drug treatment in Ukraine. The group of trainers was headed by Dr. Igor Koutsenok, international expert in prevention and treatment of addictions, Professor of Psychiatry at University of California, San Diego (UCSD), Director of the UCSD Center for Criminality & Addiction Research, Training & Application, Director of ATTC-Ukraine.

At the workshop, the participants had a chance to learn about the international evidence-based approaches to motivational interviewing, the methods of cooperation for multidisciplinary teams and the development of patient management programs. They studied the theoretical concepts presented and were able to review clinical cases with further demonstration interviews. A focus was made on the achievement of Fast Track targets.

Besides, the participants learned about problem-based learning and the ECHO model. At the end of the workshop, the participants and the trainers discussed the most pressing issues of implementing MAT in Ukraine to plan further improvement of the quality of MAT programs.

Currently, Alliance is an official co-implementer on the National Targeted Social Program to Counter HIV/AIDS in 2014-2018 approved with the Law of Ukraine N 1708-VII dated October 20, 2014, under which access to medication-assisted treatment is provided to over 10.5 thousand patients in 190 treatment institutions of various profiles in Ukraine.

Alliance would like to express its gratitude to the partners of ATTC-Ukraine project, Ukrainian and international experts for delivering this workshop as well as its hope for further fruitful cooperation.

On July 31, 2018, the Global Fund announced its decision on the approval HIV multi-country project

‘Sustainability of services for key populations in EECA region’ submitted by consortium of regional organizations from Eastern Europe and Central Asia (EECA) – Alliance for Public Health, All-Ukrainian Network of PLWH 100% Life, Central Asian PLWHA Association and Eurasian Key Populations Health Network (EKHN), together with technical partners and TB People. The proposal incorporated contributions from Belarus, Georgia, Moldova, Kazakhstan, Kyrgyzstan, Russian Federation, Tajikistan, Uzbekistan and Ukraine.

The Global Fund informed that the application from Alliance-led regional consortium was approved in full amount with the total budget over $ 10.5 million for three years (2019-2021).

The main objective of this project is to ensure the sustainability of services for key populations and to substantially improve the HIV cascade in the key countries of the EECA region.

“EECA is nearly the only region globally with rising HIV infections. We have very ambitious targets: to stop this dangerous trend and to make services for key populations accessible and sustainable in our region. We are ready to cooperate and join efforts with all partners to make national funding for key populations a reality!’, – stated Andriy Klepikov, Executive Director of Alliance for Public Health.

“Nine countries with high levels of HIV in the region will be able to use technologies and solutions that have already proven effective. We, as the largest patient organization, are ready to partner with our colleagues to provide access to treatment, services and resources for all key populations and patients,” – said Dmitry Sherembey, Head of Coordination Council, 100% Life.

Although the main focus of the project is HIV, the consortium of regional organizations will be working closely with the multi-country TB project which will be implemented by a consortium led by PAS Center (Moldova) in 2019-2021 with the support of the Global Fund.

This is the joint victory of national, regional and international partners and the consortium is looking forward to implementing the work together.

On July 27, 2018, the Alliance for Public Health (Alliance), together with 10 partner organizations in Kyiv, held a traditional all-Ukrainian awareness-raising event dedicated to the World Hepatitis Day. Those wishing to be tested for hepatitis C had the opportunity to do this in the mobile ambulances absolutely free of charge, receive a qualified consultation from doctors and social workers, and receive information materials on the transmission, testing, prevention and treatment of viral hepatitis.

300 million people in the world are suffering from viral hepatitis, among them 71 million people have viral hepatitis C!

Unfortunately, our country continues to maintain a sad leadership in the rate of increase in the number of patients with hepatitis C and B. World Health Organization (WHO) included Ukraine, the only country from European continent, in the list of 28 countries with the highest burden of viral hepatitis. According to the WHO, from 3% to 5% of the population of Ukraine has been infected with hepatitis C, in absolute terms – from 1 to 2 million people. That means that every twentieth patient who sits in the dentist’s chair or every twentieth client who has manicure done may be the carrier of this infection. At the same time, the overwhelming majority of them even do not guess about it!

“The main objectives of our action are to attract public attention to the problem of viral hepatitis and raise the level of awareness of the population about the ways of transmission, testing and treatment of viral hepatitis,” said Anna Vorotyntseva, the Head of the International Charitable Foundation “Vertical”. – Therefore, those who want can take the hepatitis C test free of charge during the event and immediately receive qualified counseling on the prevention and diagnosis of viral hepatitis and immediate action in case of an infection. After all, the problem of hepatitis concerns everyone.”

“Because of the spread of the epidemic in Ukraine, nobody can feel safe, because the virus is waiting in a variety of places – beauty salons, dental offices, tattoo and piercing studious, etc. The disease has long gone beyond the marginalized groups. In order to protect themselves and their relatives from hepatitis C it is necessary: ​​first, to have information about the virus, ways of transmission of the disease, and secondly, at least once a year to pass a quick test, in order to monitor your own health. Only by joining forces – will we be able to beat the hepatitis and save thousands of lives! “- notes Eugene Sklyarenko, Project coordinator of the All-Ukrainian Charitable Organization “Convictus Ukraine”.

That is why the main objective of this year’s campaign, in addition to the importance of testing, was the need to inform the public about the expansion of the opportunities for the treatment of hepatitis C in Ukraine and the need for timely treatment. Indeed, nowadays in Ukraine, thanks to many years of work of the Alliance for Public Health, partner organizations and leading medical institutions, the treatment of viral hepatitis C has become even more affordable and effective.  Alliance was the first to begin to use the highly effective hepatitis C treatment with modern direct-acting antiviral (DAA) treatment even when nobody heard about them in Ukraine. The advantage of DAA products is that they are well tolerated by patients, almost do not cause side effects and provide a high treatment result.

“To date, the Alliance for Public Health has already provided free treatment for viral hepatitis for 2162 patients with the most advanced drugs available through partner hospitals. We have established a rather high level of confirmed level of successful treatment at 95%, according to clinical research data. The percentage of retention on treatment within the Alliance’s programs is 98%. We even provided a separate quota for 40 courses for antiterrorist operation participants. Such results stimulate the state to appropriately expand treatment for the state budget and purchase medicines from producers at the lowest price that we managed to achieve four years ago, ” – Pavlo Skala, Associate director of policy and partnership, regarding the experience of the Alliance for Public Health

 Today, the procurement cost of one course of treatment (for 3 months) per person costs for the state budget  about $900. This price is, perhaps, one of the lowest in the world for the procurement of medicines from hepatitis C. For comparison, in 2015, the course of treatment for viral hepatitis C with direct antiviral drugs in Ukraine cost thousands of dollars and was almost unattainable for most of our fellow citizens due to the high cost. But, precisely thanks to the work of the Alliance and our partners, the cost of direct antiviral drugs for Ukraine has been reduced tenfold.

In 2017, the Alliance for Public Health, in cooperation with the Ministry of Justice of Ukraine, for the first time introduced a set of measures for the examination and treatment of viral hepatitis C for 50 HIV-infected prisoners. Today, according to the results of the research carried out among inmates s who have already undergone hepatitis C treatment, we see its effectiveness is 98%!

This year’s campaign “Hepatitis C: Time to test. Time to treat!” in Kyiv was organized by the Alliance for Public Health in partnership with the International Charitable Foundation (ICF) “Vertical”, the Kyiv City Center for Social Services for Family, Children and Youth, All-Ukrainian Charitable Organization “Convictus Ukraine”, the Kyiv City Public Health Center, ICF “Drop In Center”, Charitable Organization (CO) Club “Enei”, Charity Fund “Hope and Faith”, CO “ALLIANCE. GLOBAL”, Red Cross Society of Ukraine and ICO “Positive Women”.

It is possible to do a test for viral hepatitis in 10 minutes independently at home, by purchasing an ordinary quick test in a pharmacy network. WARNING! The positive result of a quick HCV test is not the basis for establishing a final diagnosis. It is necessary to consult a doctor!

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

(all calls within Ukraine are free).

***

In the world, more than 71 million people are infected with hepatitis C, and from 1 to 2 million people with hepatitis C live in Ukraine. Most of them are unaware of their disease, since 80% of the disease is asymptomatic. One of the priority directions of the activity of the Alliance of Public Health is to combat the spread of the epidemic of viral hepatitis C in Ukraine and to provide diagnosis and treatment of HCV to vulnerable groups of the population. In 2012, the Alliance initiated an All-Ukrainian campaign “Demanding Treatment”, the main purpose of which is to increase access to diagnosis and treatment of hepatitis C virus in Ukraine. From 2015, with the support of the Alliance, hundreds of patients with viral hepatitis C in Ukraine for the first time began to receive free modern treatment, after which similar medicines were officially registered and started to be procured by the Ministry of Health of Ukraine for the state budget

 http://www.aph.org.ua/hepc/

Media about event:

1. Online media “Novoe vremya”

https://nv.ua/ukr/opinion/klepikov/lahidnij-ubivtsja-jak-zupiniti-epidemiju-hepatitu-s-2484981.html

2. Radio Gromadske

https://hromadskeradio.org/programs/hromadska-hvylya/yak-peresvidchytys-shcho-vy-ne-hvori-na-gepatyt-porady-fahivciv

3. TV-channel “ZIK”

https://www.youtube.com/watch?v=HfnmX1Yl6FE

4. TV-channel “24”

https://24tv.ua/bilshe_milyona_ukrayintsiv_ne_znayut_shho_mayut_infektsiyu_yaka_nepomitno_vbivaye_zseredini_n1006466

5. TV-channel “1+1”

https://www.youtube.com/watch?v=1MW_OvO1ERI

6. TV-channel “112”

https://video.112.ua/pacienty-s-gepatitom-s-v-ukraine-poluchat-besplatnye-lekarstva-275157.html

7. TV-channel “5»

https://www.5.ua/suspilstvo/veterany-ato-opynylysia-u-hrupi-ryzyku-z-hepatytu-s-moz-174519.html

8. TV-channel “NewsOne”

https://www.youtube.com/watch?v=A1NEeOdB7dM

9. TV-channel “Espreso”

https://www.youtube.com/watch?v=ZgUyvpi77Bg

10. TV-channel “STB”

https://www.youtube.com/watch?v=fnSwnnPAeEo

11. TV-channel “TRK Kyiv”

https://www.youtube.com/watch?v=SSW7V8XhAss

12. Radio Svoboda

https://www.radiosvoboda.org/a/29395709.html

13. Radio Gromadske

https://hromadskeradio.org/news/2018/07/28/u-kyyevi-pereviryly-370-prohozhyh-na-gepatyt-s-4-otrymaly-pozytyvnyy-rezultat

14. Online media Ye.ua

https://ye.ua/zdorovya/37053_Pivtori_sotni_hmelnichan_proyshli_test_na_gepatit_S_Rezultati_vtishili_ne_vsih.html

15. TV-channel “Pravda Tyt”

https://www.youtube.com/watch?time_continue=443&v=i3sx4Pf4-EM

On July 15-16, over 90 physicians, implementers, and researchers from 22 countries gathered in Dubai, UAE to discuss implementation strategies for an integrated approach to seeing out and treating both TB disease and TB infection. Among the group were representatives from ‘Fast-Track HIV/TB responses for key populations in EECA cities’ project and Alliance for Public Health. The group first reviewed the scientific evidence showing that actively searching for and treating both TB disease and TB infection is necessary to eliminate TB, presenting case studies from both historical and recent examples. Representatives from several coalitions including Zero TB Karachi, Zero TB Bangladesh, and TB Free Chennai then presented the ways in which they have designed and implemented integrated programs to search for and treat both TB infection and TB disease, highlighting the practical considerations important in designing such programs. The Zero TB Initiative (ZTBI) is working across the world to create islands of elimination with strong local partners in high-burden areas. You can learn more about the initiative here. The Heads of TB Service from Almaty, Odesa, Sofia and Tbilisi and the Head of Health from Balti shared information on TB programs in their cities among each other and identified ways to improve the situation with TB in the cities.