THE YEAR 2017 WAS CRITICAL IN BUILDING SOLID GROUND FOR THE FUTURE UKRAINE –WE WOULD LIKE TO ACKNOWLEDGE STRONG LEADERSHIP OF THE MINISTER OF HEALTH ON HEALTH REFORM AND INCREASE IN DOMESTIC FUNDING FOR HIV AND TB. CIVIL SOCIETY ORGANIZATIONS INCLUDING ALLIANCE FOR PUBLIC HEALTH HAVE BEEN WORKING HARD TO ACHIEVE SIGNIFICANT RESULTS IN FIGHTING HIV, TUBERCULOSIS AND HEPATITIS.

HERE ARE OUR SEVEN HIGHLIGHTS OF THE OUTGOINGYEAR WHICH HAVE FORMED A SOLID GROUND FOR 2018:

1 With all its partners Alliance makes great contribution in achieving 90-90-90-90 in Ukraine. In 2017 HIV prevention services were provided to 218 829 people who inject drugs, 37 571 sex workers and 40 406 men who have sex with men. Alliance has made significant input in HIV case finding at the national level. 237 000 representatives of key affected populations were tested. Moreover, in 2016 and in the first half of 2017 85% of all officially registered cases among PWID were confirmed as a result of successful referral from harm reduction projects.

2 Scaling up Opioid Substitution Therapy to over 10 000 patients – making it the largest program in Eastern Europe and Central Asia. Being able to nurture this program over from a seed level of less than 100 patients to 10034 patients in 178 sites all over the country, Alliance started transitioning this program to the Ministry of Health. The transition has transferred the first 8% of the OST patients as of 1st of December 2017 with the clear road map and further scale up plans.

Transition of the Ukrainian OST program from Alliance to the Government

3 Alliance has directed half of its 2017 funding to stopping TB. During 2015-2017 every second MDR-TB patient receiving treatment in Ukraine was treated with drugs that were procured, donated and delivered by the Alliance. Starting from 2018 the government will be in charge of treating all MDR-TB patients with governmental resources. As for the treatment model we are proud that patient-oriented approach implemented by civil society organizations allowed for a nearly twofold increase in treatment success rate – 46% to 79%! Policy support is provided by the recently established in Ukraine Parliamentary TB Platform with 47 MPs joioned!

4 We have made DAA Hepatitis C treatment a reality in Ukraine! Over 2000 patients representing key populations got access to treatment using Sofosbuvir and Harvoni. Those who completed treatment and were tested (1679 patients) showed incredible results – in 95% virus was not detected! The treatment was focused on patients from key populations with or without HIV co-infection, among them 83% of patients were people who inject drugs. Treatment was also provided to 50 military veterans. This year Alliance supplied 1000 HCV rapid
tests to the prison population allowing diagnosis and treatment for 50 prisoners.

5 Ukraine became a model for other countries requesting to learn from us. During 2017 Alliance has been supporting ongoing projects in 15 countries, mostly in Eastern Europe and Central Asia. In 2017 in partnership with Alliance Consultancy technical support was provided to 24 countries:
Armenia, Azerbaijan, Afghanistan, Belarus, Bulgaria, Georgia, Ethiopia, Iran, Kazakhstan, Kenya, Kyrgyzstan, Kosovo, Malawi, Malaysia, Moldova, Nigeria, Pakistan, Russian Federation, Seychelles, Sudan, Tajikistan, Tanzania and Zanzibar, Uganda and Uzbekistan.

6 Exploring new areas and bringing innovations was another feature of 2017 – PrEP, self-testing, starting new program with transgender population, working with Ukrainian military personnel and in conflict areas in the East of Ukraine, boosting TB/HIV fast-track cities response. Alliance was the key advocate to scale up work with transgender people, including allocation of special resources from the Global Fund. We supported transgender movement in the region, conducted a unique assessment with over 600 transgenders in 3
EECA countries. Jointly with PLWH Network the Alliance launched campaign on HIV testing, focusing on self-testing with the visuals and referral to the web-site selftest.org.ua. New oral HIV tests were demonstrated during WAD and piloted in key populations programs.
7 Alliance, PLWH Network and Public Health Center by joining efforts with all key stakeholders together mobilized over USD 150 million for Ukraine’s HIV, TB and Hepatitis response for 2018-2020. The major external funding sources for the country are the Global Fund and PEPFAR. During the year Alliance has managed to attract new funding from 7 other donors.

THE YEAR OF 2018 WILL BE A YEAR OF ENSURING SUSTAINABILITY AND TRANSITION OF ESSENTIAL PREVENTION AND TREATMENT PROGRAMS, AND IT IS OUR JOINT RESPONSIBILITY TO MAKE IT SUCCESSFUL. FOCUS ON COMMUNITIES AND KEY POPULATIONS IS THE MAJOR PRIORITY IN ALLIANCE WORK.

On the New Year eve we are expressing huge thanks and wishing all the best to our partners – over 300 NGOs and medical facilities we are implementing the programs with in and outside of Ukraine, PLWH Network 100% Life, Public Health Center, Ministries we are working with – Health, Youth and Sports, Social Policy, Internal Affairs, Defense, Education
and Science, Justice , Foreign Affairs and other governmental institutions, Members of Parliament, to The Global Fund, PEPFAR, CDC, USAID, French Agency for International Technical Expertise, Elton John AIDS Foundation, Robert Carr civil society Networks Fund, Open Society Foundation, Levi Strauss Foundation, Gilead Sciences Inc., PAS Center, Right to Care, The Swiss Confederation, The Dutch Government, Aidsfonds, International Renaissance Foundation, Yale University, National Development and Research Institutes, Management Sciences for Health and all other donors, to UNAIDS, WHO, UNICEF, UNFPA, UNDP and all other UN agencies, International HIV/AIDS Alliance, TB Europe Coalition,
Stop TB Partnership, AFEW International, licit, Global TB Caucus, Eurasian Key Populations Health Network (EKHN), ECOM, ENPUD, SWAN, TB People, ECUO, EHRA and many many other partners, stakeholders, community groups and leaders! Together we will achieve more in ending AIDS, Tuberculosis and Hepatitis epidemics and saving more lives!

Merry Christmas and Happy New Year!

Alliance of Public Health in partnership with AFEW International (Netherlands), Odesa City Council and Knowledge Action Change (UK) is organizing City Health International 2018. The Conference will be held in the city of Odessa (Ukraine) on September 13-14, 2018.

Founded in 2012, Сity Health International is focuses on health and well-being of people and looks at the following issues such as the use of alcohol, drugs, healthy eating, safe sexual behavior and prevention of violence, as well as factors affecting the health of urban residents. The conference considers a wide range of topics. Representatives from non-governmental organizations, public projects, advocacy groups, as well as scientists and policy makers were invited to participate. You can find additional information about the conference at https://cityhealthinternational.org/2018/

The key theme of City Health International in 2018 – 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 marginalised individuals and groups.The conference will be held for two days with a planned number of participants of up to 250 people. For the first time a conference of this format will be held in Eastern Europe. Participation of Ukraine in such event opens new opportunities, aimed at resolving public health issues at the city level. It is planned to invite the mayors of Kyiv, Istanbul, Athens and others to strengthen the role of local authorities in strengthening the health of city residents.

Organizers are waiting for abstracts for oral presentations and posters. The deadline for abstracts submission https://cityhealthinternational.org/go2018/ is April 1, 2018. The registration fee for participation in the conference is $ 150 per delegate. A reduced registration fee of $ 100 is provided to participants from Ukraine and low-income and middle-income countries according to the World Bank classification. If you have any questions regarding participation or support of the conference, please contact Maryna Braga, Alliance for Public Health at braga@aph.org.ua

On 20 December 2017, a press briefing and field visit to a substitution maintenance therapy (SMT) site took place on the occasion of state’s undertaking the responsibility for funding the program which has for 12 years been funded exclusively by international donors. The visitors had a unique opportunity to learn about the activities of the first SMT site in Ukraine, talk to doctors, social workers, and patients, and see with their own eyes how the patients receive SMT drugs are medical and social support. They could also hear opinions of representatives of the Ministry of Health of Ukraine and civil society organizations with regard to the future of development of this important program as a component of HIV prevention for people who inject drugs.

In 2018, the SMT program that will be funded largely from the state budget will remain the largest program of the kind in Eastern Europe and Central Asia. While at the beginning, in 2005, it reached less than 100 patients, next year it will be covering over 10 thousand patients at 178 healthcare facilities throughout Ukraine. The dry numbers belie more than 12 years of hard work of international and domestic NGOs, the Ministry of Health of Ukraine and healthcare facilities: awareness raising, training staff, engaging patients, procurement, distribution and delivery of the medications to the regions, and protection of the rights of patients.  First patients have recently begun receiving medications paid for by the state, which is a good precondition for the transition to state funding to be gradual and smooth.

Michel Kazatchkine, the UN Special Envoy for HIV/AIDS in Eastern Europe and Central Asia, welcomes the move: “Today’s announcement is great and, certainly, has an important political meaning for the whole of Eastern Europe where HIV epidemic has been and remains connected will illegal drug use. With the support of the Global Fund, the Alliance have for many years supported the largest substitution therapy program in the region. The Government of Ukraine is now taking the leadership in the program acknowledging that no-one must be denied access to healthcare”

“The Government understands its responsibility before patients and assumed the responsibility to purchase medications for opioid substitution therapy in order to ensure its sustainability and further development”, – said Iryna Chybisova chief specialist of the State Institution “Ukrainian Center for Social Disease Control of the Ministry of Healthcare of Ukraine during the briefing.

“Alliance is transferring to the Government the OST program currently providing services to over 10 000 patients. This program has been implemented according to the highest international standards ensuring high treatment adherence. 10 years ago Alliance had transferred to the Government responsibility another program – antiretroviral treatment. Since that time ART coverage increased by several times, and we expect that it will be the same with OST program as the real need in Ukraine exceeds 50 000”, – highlighted Andriy Klepikov, Executive Director of Alliance for Public Health.

The event took place at the Kyiv City Narcological Hospital “Sociotherapy”, one of the 178 healthcare facilities, serving 775 patients as of 01.11.2017. This is a facility with the highest number of SMT patients in Ukraine! Behind each patient is his or her own story, problems, path to socialization and overcoming dependency from illegal drugs. Anton Basenko, a patient, tells about his experience on the program: “Just saying that SMT has changed my life is saying nothing. SMT has saved my life and returned me to my family, I have married my girlfriend and we are planning to have children; finally, SMT has made me what I am, an employee of an international organization, public activist and representative of the community of people who inject drugs and SMT patients at the National Council to Fight Tuberculosis and HIV/AIDS. And trust me, every one of more than 10,000 patients can tell his own positive story.

Yet we sometimes forget that all these lives were saved only through financial support of international donors that cannot be provided forever and would simply end one day. And without a state support, all these people are doomed.  Today, we are really happy that the government have finally turned their attention to the drug-dependent people and for the first time provided funds to procure SMT medications, but we are still worried about whether this is a final decision and whether they are ready to ensure secure and stable procurement of medications as well as provision of the complex of necessary psychosocial support of the patients”.

Effective response to HIV/AIDS epidemic, which includes SMT program as an efficient component, demands united efforts of government agencies and non-government organizations. And it is very good that this process is characterized by mutual understanding and cooperation.

Substitution maintenance therapy is a globally recognized method of treatment of people who inject drugs (PWID) aiming at prevention of spreading of HIV/AIDS among PWID. It also facilitates re-socialization of PWID, returning them to living full life in the society. In Ukraine, implementation of the SMT program started in 2005, and legislative support for the program was provided in 2008. SMT is implemented at healthcare facilities (narcological dispensaries, AIDS centers, TB dispensaries, city and rayon hospitals, primary healthcare facilities). Overall, there are about 180 HCFs in Ukraine providing services to about 10 thousand patients of whom 42% are HIV-positive. All patients receive integrated services of medical (diagnostics and treatment of HIV/AIDS, TB, hepatitis, or other somatic diseases) and psychosocial support (employment, restoring interpersonal relations, creating families, having children, reintegration to the social life). In 2017, for the first time SMT medications for the amount of UAH 13 mln were procured using state budget funding, the medications are being delivered to HCFs and issued to the patients. Bidding procedures to procure the next batch of SMT medications with the funds of the State Budget of Ukraine for 2018 are going on.

Growing coverage of SMT program in Ukraine and growing share of public funding (2005-2018):

The Alliance of Public Health in collaboration with the Stop TB Partnership have implemented project “Tools for Evaluation of Communities, Rights and Gender Aspects in TB Context in Ukraine”. The project involved a study involving a broad circle of stakeholders.

This study is based on tools developed by the Stop TB Partnership, namely: HIV/TB Gender Assessment Tool (Stop TB Partnership, UNAIDS) and Data for Action Framework on Key, Vulnerable and Underserved Populations (Stop TB Partnership). The results of the study provided useful information to strengthen national TB and TB/HIV response.

Socio-cultural norms in many countries may lead to different levels of stigma, discrimination and gender inequalities. Therefore, gender has a critical impact on health seeking and treatment behavior, determining how men, women, transgender people, boys and girls seek health services and bear different kind of barriers. Using gender-based approach to evaluate TB program helped to identify barriers, which will facilitate development of corresponding interventions considering certain risks for men and women, boys and girls, as well as people with other gender identities under TB programs.

Beside desktop review, two focus groups with men and women affected by TB were conducted. Also, the study included in-depth interviews in four regions of Ukraine involving different groups and stakeholders to collect quality information for further analysis and preparation of recommendations on strengthening the national TB response.

Among key findings of qualitative data collection were specific needs of women, men and transgender people with regard to TB diagnostics and treatment. For example, participants of the focus groups stressed the need of separation of “gender flows”, i. e. separation of queues of patients wishing to do sputum tests, providing wards for separated stay of people with transgender identity receiving inpatient treatment; providing gender-sensitive physiological and hygienic conditions at healthcare facilities, including having separate toilet and shower rooms for men and women or equipping such rooms with soundproof partitions; creating psychologically comfortable conditions for diagnostics, for example, setting up a screen behind which women may comfortably strip to the waist, etc.  Considering the significant number of gender-related needs of patients, outpatient mode of treatment appears to be the best prepared to satisfy them without placing a substantial additional financial and administrative burden on the healthcare system.

The second tool was applied with the focus on the key, vulnerable and underserved populations that face an increased risk of development of TB because of biologic and behavioural factors. Such populations differ in different countries, but they are always people that are likely not reached with health services and suffer severely from TB. The project reflected existing approaches to key populations, which will ensure healthcare system’s taking account of all populations facing increased risk. Carefully selected factors influencing the risk of disease in different key populations allowed preparing an exhaustive list of such populations. It is suggested to revise the tool on the annual basis and update it on the national and regional levels as required. It may also be used by NGOs as a strong advocacy tool. The Alliance for Public Health will, in turn, recommend to approve it on the national level, and a representative of the Public Health Center of the MoH of Ukraine noted that the Center fully agreed with the conclusions of the study and would take them into consideration and advocate the changes together with the civil society.

During implementation of the project, two stakeholder meetings were conducted to introduce the evaluation tools and enable public consultations. The broad circle of stakeholders invited to the meetings contributed to the evaluation through sharing their experience and expertise and participation in development and implementation of measures based on recommendations of the study.

Strategic insights and results of the study on gender barriers and key populations in the context of TB conducted in Ukraine by Alliance for Public Health in collaboration with Stop TB Partnership will be incorporated in the national TB regulations.  Presentation of a detailed study report is scheduled for January 2018.

World Health Organisation (WHO) headquarters requested a study tour to Ukraine for representatives of Ministry of Health, WHO and civil society of Pakistan to learn about HIV prevention, diagnosis and treatment services for people most at risk of HIV. WHO sees this as an excellent opportunity to show case Ukraine achievements and provide much needed assistance to other countries struggling with similar epidemics.

Dr Marthe Everard, WHO Representative and Head of WHO Country Office Ukraine is saying: ‘WHO congratulates Ukraine for its efforts in responding to one of the largest HIV epidemics in the European region. We recognize the critical role of civil society organizations in reaching those key populations most at risk of and affected by HIV. We are delighted to facilitate and support the sharing of the Ukrainian experience in delivering evidenced-based HIV prevention, testing and treatment services with countries in other regions such as Pakistan’.

The tour is being received in Ukraine 11-14 December, 2017, in Kyiv. During the visit Alliance for Public Health, PLHA Network and other NGOs, Centre of Public Health of the Ministry of Health of Ukraine, AIDS and Narcology hospitals are visited and their experience shared with Pakistani specialists.

Special focus of the study tour is the technology to increase access to HIV treatment for people most at risk which is a global challenge. This technology was developed by Ukraine civil society organisations under the leadership of Alliance for Public Health and received international recognition. It is based on case management approach focusing on individual client’s treatment path. Alliance shared this learning during multiple international dialogues as well as supported introduction of these approaches in Indonesia, Kazakhstan, and Kenya.

‘Current HIV treatment coverage in Pakistan is 7% and we are struggling to increase it, – says Dr Safdar Kamal Pasha of WHO Pakistan while in Kyiv. – It is really exciting what Ukrainians did to link people with HIV to care. We very much appreciate exchange with colleagues and will adapt this technology in Pakistan. Look forward to continuous collaboration’.

On December 14th 2017 the street action dedicated to International Day to End Violence Against Sex Workers was held on Maidan Nezalezhnosti in Kyiv. During the action the sex-workers, human rights activists, representative of non-governmental organizations in the form of street performance demonstrated the current situation with the observance of the rights of one of the most marginalized categories of population in Ukraine, which have no less than 80 thousand people.

The action was organized by All-Ukrainian League ‘Legalife’ and Alliance for Public Health.

On 4 December 2017, an official ceremony was held to sign a Memorandum of Understanding and Cooperation between the Executive Committee of the Odesa City Council and the International Charitable Foundation “Alliance for Public Health” (hereinafter – Alliance). This is an important step to deepen the cooperation within implementation of the relevant state programs to fight HIV/AIDS, tuberculosis and viral hepatitis. The fact that the Memorandum has been signed personally my the Mayor of Odesa, Gennadiy Trukhanov, once more proves his strong commitment to countering socially significant diseases and positive trends in further coordination of the efforts of government authorities and civil society in response to the epidemics.

Alliance as an official co-implemented of the National Targeted Social Program to Counter HIV/AIDS in 2014–2018, in particular within the program “Investing for Impact against Tuberculosis and HIV” supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria, making a significant contribution to curbing the epidemics in Odesa. In particular, in 2017 the amount of funding allocated to implement comprehensive interventions to counter the spread of the above-mentioned diseases is over UAH 28.8 million.

Every tenth Ukrainian citizen with HIV lives in Odesa. Odesa region and the city of Odesa have the highest HIV rate:  861.8 per 100 thousand people, which is over 2.5 times higher than the average national level (323.7 per 100 thousand people). However, thanks to the well-coordinated efforts of five civil society organizations, working in the city, HIV prevention services cover about 21 thousand people from among the key populations, with a clear trend towards reduction in the risky behaviors among the vulnerable groups, which contributes to lowering the risks of further HIV transmission in the general population.

Apart from the activities in the area of HIV/AIDS, Alliance also helps the city to counter the epidemics of tuberculosis and viral hepatitis. Medical and social support is provided to 500 patients with multidrug-resistant tuberculosis. Besides, Alliance helped the city to launch hepatitis C treatment with new-generation direct-acting antivirals Sovaldi and Harvoni for 24 patients.

Odesa became the only city in Ukraine to implement the program “Fast-track TB/HIV responses for key populations in EECA cities” (supported by the Global Fund) aimed at developing the models of sustainable city responses to the epidemics of HIV and TB in key populations to achieve 90-90-90 targets, which will help to reduce HIV and TB mortality rates and increase the municipal funding of the programs for key populations.

Besides, on this day another important document was signed – the Memorandum of Understanding on holding the City Health International Conference 2018 in Odesa. The City Health International Conference first held in 2012 is focused on the health and well-being of people and covers the topics of alcohol and drug use, healthy nutrition, safe sexual behavior and prevention of violence as well as other factors influencing public health in cities. Odesa will become the first city in the Eastern Europe, which will host this high-profile forum on 13-14 September 2018. Participation of Ukraine in this event opens new opportunities to resolve the public health issues at the city level and participation of the mayors from a number of European cities will become a powerful instrument to share the best practices and strengthen the role of local authorities in enhancing the health of people in the city.

At the signing ceremony, Alliance Executive Director, Andriy Klepikov said: “Alliance makes an essential contribution to the response to the epidemics of HIV, tuberculosis and hepatitis in the region – over 28 million hryvnias in 2017. Such funding allowed stabilizing the situation with HIV in Odesa. We are convinced that leadership of the Odesa Mayor, Gennadiy Trukhanov, will allow increasing allocations of funding from the city budget, launching innovations to prevent the spread of HIV, timely identify the existing HIV infections, and increasing the number of people who have access to vital therapy, such as antiretroviral treatment, opioid substitution treatment and hepatitis treatment in Odesa.”

On 1 December 2017, marking the World AIDS Day, for the first time in Ukraine patrol police officers of the capital city pinned the symbolic red ribbons on their uniform, when starting their shift on duty, and had voluntary anonymous testing for HIV and hepatitis C in specially equipped mobile clinics.

Co-organizers of the campaign were the Kyiv City Patrol Police Department and the Alliance for Public Health (hereinafter – Alliance), with involvement of Convictus Ukraine and Club Eney NGOs.

This is the first campaign to raise the awareness of patrol police officers on HIV, viral hepatitis and other socially dangerous diseases as in their routine work they often face high risks of such infections.

“Our task is to ensure the public security! Public security starts with the personal safety of the patrol police officer, who faces serious risks, in particular related to socially dangerous diseases, such as tuberculosis, viral hepatitis, and HIV, when performing his everyday duties in the street. Today, by our personal example, we demonstrate to our fellow citizens the importance of prevention and personal protection, which starts with a simple and painless procedure – rapid tests for HIV and hepatitis C. We care about the health and safety of the patrol policemen, who take care of the public security and public health!” underlined in his speech at the press briefing Oleksiy Biloshytskyi, First Deputy Head of the Patrol Police Department.

“Today a media campaign “HIV is dangerous as long as you don’t know about it!” has been launched in Ukraine. It is very symbolic that the officers of Kyiv patrol police, first among the Ukrainian law enforcers, today wear the traditional red ribbons and are tested for HIV with rapid tests. Every tenth of the 15 thousand new HIV cases registered this year was registered in Kyiv. Rapid test for HIV or hepatitis C is a rapid and effective procedure, which so far has not become routine for our people. However, only a test may show presence of the virus in a human body, and timely initiation of the treatment allows HIV-infected people to live long and happy lives. Modern drugs give an opportunity for people with hepatitis C to cure their disease just in 3 months. Alliance welcomes the readiness of the Patrol Police administration to hold such campaigns and hopes for further productive cooperation!” said Andriy Klepikov, Executive Director of the Alliance for Public Health.

“The success in implementation of the National Program to Counter HIV/AIDS depends of the effective cooperation among the law enforcement agencies, health and social services, and civil society organizations. Such cooperation may be established only as partnership aimed at improving the conditions to provide people vulnerable to HIV and other infections vital prevention, treatment and support services. UNODC, UNAIDS and other UN agencies contribute to building such partnership. Law enforcement agencies play a vital role in protecting and enhancing public health. Knowing your status, drawing the attention of people who may be infected to ensure their timely access to treatment – those are our vital issues!” summed up Rostyslav Havrylov, Coordinator of the UNODC Office in Ukraine.

During the campaign, each patrol team received special notebooks and pads to fill in working documents, which, at the same time, contain useful information about governmental and non-governmental services to prevent HIV and other socially dangerous diseases. Working with the members of key populations, such as people who inject drugs and sex workers, Alliance registered numerous cases of prejudiced attitude to them from the side of police and various problems, which often were based on the lack of accurate information and contacts. In the recent year, Alliance representatives held numerous workshops for the staff of the National Police to tell about the human rights and interests of the key populations and present current regulations in this area. Now every team of the patrol police will have telephone numbers of the hotlines on HIV, tuberculosis and substitution treatment, contact details of civil society organizations and social services working with vulnerable populations. It should make the work of patrol police officers easier and contribute to faster resolution of problematic situations, which may arise when performing their duties.

The campaign supports the key messages of the global UNAIDS campaign dedicated to the World AIDS Day, My Health, My Right (#myrighttohealth)

Alliance for Public Health is a leading Ukrainian civil society organization, co-implementer of the National Targeted Social Program to Counter HIV/AIDS and recipient of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Although the main activities of the Alliance are aimed at HIV prevention in the key populations, it also pays considerable attention to working with the general population as well as with defense and law enforcement agencies – the Ministry of Defense and the National Guard as well as the National Police of Ukraine. Promotion of HIV testing is one of the important tasks of Alliance as according to the official statistics blood-to-blood transmission of HIV, which was typical for Ukraine in the first decade of the epidemic, is no longer prevailing – according to the recent statistic data, over 70% of people get infected through sexual contacts. In 2017, within the programs implemented by Alliance 237 thousand people were tested for HIV in all regions of Ukraine, with 7.8 thousand (3.3%) positive test results! The biggest share of HIV positive results were detected in Kyiv city as well as Kyiv, Dnipropetrovsk, Donetsk and Odesa regions.   

Every second HIV-positive Ukrainian, namely 50%, does not know about his/her status. In Europe, only about 20% of people do not know about their status.

Currently, the highest HIV prevalence in Europe is registered in Ukraine; according to estimates, 238 000 people of all ages had HIV at the beginning of 2017.

The All-Ukrainian Network of PLWH and the Alliance for Public Health have come together for the common purpose of removing an unofficial taboo on HIV/AIDS, raising awareness of the various HIV testing possibilities and encouraging people to test in any way convenient for them:

– At official testing sites. On the website HIVtest.com.ua  http://www.hivtest.com.ua/ua/  , you can find the nearest testing sites using geolocation.

– Individually, using rapid HIV test. How to get tested using self-test within 15 minutes is explained in detail on the website Selftest.org.ua https://selftest.org.ua/

– Using the online test on the website HIVtest.com.ua  http://www.hivtest.com.ua/ua/    or using the mobile HIV test application, which will identify the risks of infection and advise you to be tested for HIV in reality, if necessary.

“Ukraine has a real chance to stop the epidemic. For the first time, we have conditions when free modern treatment is available to patients with HIV, which allows them to live a full life. The main challenge today is the public’s awareness of its status,” said Dmytro Sherembey, the Head of the All-Ukrainian Network of PLWH. “It is important for people to realize that ignoring HIV is deadly. The sooner you detect the disease, more quickly you start the therapy, which is the key to save health and life. We have specially developed a mobile HIV test application that will allow anyone to evaluate the risk of infection anonymously and find out where and how to get tested for HIV.”

“The major task today is to draw people’s attention to the necessity of timely and regular testing for HIV. It’s simple, just as never before,” said Andriy Klepikov, the Executive Director of the Alliance for Public Health. “Testing can be absolutely anonymous both in health care institutions and independently; rapid HIV tests for self-testing are becoming more popular and accessible.”

In 2016, the World Health Organization recommended self-testing as one of the most effective methods to access HIV testing services, especially among at-risk populations and young people. On the website Selftest.org.ua, you can receive information about basic steps of self-testing, find out where to find the test system and what to do in case of a positive result.

Since November 15, an all-Ukrainian social and information campaign “HIV is Invisible. Get Tested and Save Life!” has started in the form of outdoor teaser social advertising in the largest cities of Ukraine and on the Internet.

Especially for the campaign, vivid and extraordinary visual solutions have been developed to attract the public’s attention by raising interest in the topic and further revealing the idea in the pleaser part of the campaign.

Teaser part of the campaign: (15-30 November):

Pleaser part of the campaign (1-31 December):

The main campaign will last from 1 to 31 December and include webinars and flash mobs for young people with the participation of well-known people, as well as promotion on the Internet and in social networks, and also the opportunity to take a free anonymous HIV test in mobile laboratories in Kyiv, Odesa, Kharkiv, Lviv, Dnipro, and Zaporizhzhia.

About the All-Ukrainian Network of PLWH:

The All-Ukrainian Network of People Living with HIV/AIDS is the largest patients’ organization in Ukraine. The aim of the organization is 100% access to treatment for each patient in Ukraine. We strive for improving the quality of life for HIV-positive people and fully promoting the rights and responsibilities of citizens living with HIV. Together with our partners, we are actively working to stop the HIV/AIDS epidemic, as well as hepatitis and tuberculosis in Ukraine. More information you can find on the website: http://network.org.ua/ or on the Facebook page https://www.facebook.com/All.Ukrainian.Network.of.PLWH

About the Alliance for Public Health:

The Alliance for Public Health is a leading professional organization that fights the HIV/AIDS epidemic in Ukraine through the implementation of HIV prevention programmes and provision of qualified technical support in cooperation with the Ministry of Health, other government agencies and non-governmental organizations. More information you can find on the website: http://www.aph.org.ua or on the Facebook page: https://www.facebook.com/AlliancePublicHealth/

On November 20th -24th, within the project “Improved Quality and Sustainability of Medication Assisted Treatment in Ukraine” it was conducted professional development visit of Ukrainian delegates to Berlin, Germany. The aim of the visit was to learn about best practices in the area of Medication Assisted Treatment (hereinafter — MAT) at primary healthcare level, as well as prevention programs as a response to HIV in key populations.

The representatives of the Ministry of Health of Ukraine, regional Departments of Health from PEPFAR priority regions, SI “Center for Public Health of the MOH of Ukraine”, National Police of Ukraine (Department on Combating Drug-Related Crimes), Shupyk National Medical Academy on Postgraduate Education were participants of the 5-day visit.

Ukrainian delegates had an opportunity to visit German establishments in Berlin related to development of policy and establishment of organizational aspects to service provision in the areas of prevention and treatment of drug addiction and other social diseases: The National Association of Statutory Health Insurance Physicians, The German Medical Association, NGOs, family doctors, who provide MAT program, supervised drug consumption room, Charite University Hospital, where patients are treated with diamorphine (Heroine Substitution Treatment).

During the visit, the participants learned about harm reduction interventions for injection drug users, prevention and treatment of HIV and HCV, issues on service organization, staff training programs, QMIS of MAT at primary health care level. Also, the system of psychosocial support for MAT patients was analyzed.

As of the end of 2016, the number of MAT patients in Germany was 78 5000 people where the approximate number of people with opioid dependency varies from 150 000 to 200 000 people. Patients can receive treatment with all available medications, including diamorphine in conjunction with psychosocial and rehabilitation programs. In such case, financing of treatment is carried out by various entities: federal states, retirement and health insurance institutions, municipalities, communities, charitable foundations.

The visit enabled to discuss the issues on development and functioning of MAT in Ukraine that need to be improved, the possibility of applying best practices ensuring the sustainability and quality of services in the context of primary health care reform, decentralization and regional peculiarities.

We also express our gratitude to our German partners from Deutsche AIDS-Hilfe for helping us in meeting organization, assisting delegates during the visit and helping to learn in-depth peculiarities of the healthcare system in Germany.

The Project “Improved Quality and Sustainability of Medication Assisted Treatment in Ukraine” is a five-year project funded by Centers for Disease Control and Prevention (CDC) under the United States President’s Emergency Plan for AIDS Relief (PEPFAR). The purpose of this Project is to provide targeted technical assistance to medication assisted therapy programs in Ukraine and stimulate its development in order to improve sustainability and quality of programs and long-term health and social outcomes of MAT clients.