PRESS RELEASE

Hepatitis C – “Frozen War” with an Invisible Enemy.

Results of the national testing.

On 10 August 2016, Alliance for Public Health (Alliance) during its press briefing in the Ukrainian Crisis Media Center announced the results of the national rapid testing for hepatitis C among general population, which was organized together with partner civil society organizations in all regions of Ukraine on occasion of the World Hepatitis Day within the traditional all-Ukrainian “Demand Treatment!” advocacy and awareness-raising campaign.

The testing results raise serious concerns. In total, 3,844 individuals were tested in 26 cities in all regions of Ukraine (except occupied areas), with rapid tests showing the presence of antibodies to hepatitis C in 324 cases (8.5%).

It should be noted that testing was conducted among general public as the campaign was organized in parks and on central streets of cities and towns. For many of people who tested positive, their test results were totally unexpected as the trickery of hepatitis C is that it does not develop clinical manifestations for a long time.

There were both young and senior people among those who tested positive for hepatitis C. “Among those tested there was a guy of about thirty years of age, who decided to get tested only because it was free of charge, so he joined his friend – he was confident that he had no virus, but his result came back positive,” – told the campaign coordinator from Sloviansk, Mykhailo Karelin. “There was an elderly woman, who was just passing by on her way to the railway station with her suitcase. She had ten minutes of spare time, so she decided to get tested. She tested positive and it was a real shock for her. Her reaction was quite unexpected: “Why did I have to run into you? I don’t know how it could happen! What should I do now?” We invited her for a counseling session with an infectious disease doctor and referred her to a healthcare facility”, – told us the campaign coordinator in Poltava, Kristina Kryzhenko.

It is disturbing that most people who were tested within the campaign have never been tested for hepatitis C before (from 85 to 98% depending on the location); in particular, only one person out of 160 people tested in Severodonetsk had been tested before, and in Sloviansk none of 150 people tested went through such testing in the past (meanwhile 14 positive results were received there).

All previous national testing campaigns as well as this-year campaign confirm once again that the situation with hepatitis C is becoming more and more alarming! Hepatitis C diagnostics is still critical as hepatitis testing is not included to the list of mandatory medical examinations, so most patients (even the military who took part in the armed conflict in eastern Ukraine) become aware of their disease at advanced stages.

Since 2012, Alliance ran over 119,000 tests among the members of key affected populations (first of all people who use drugs), and during five years of all-Ukrainian campaigns over 13,500 people from among general public were tested, with the percentage of positive results always ranging from 8 to 12%.

The situation with treatment is still alarming. According to the chief consultant specialist on the infectious diseases of the Ministry of Health of Ukraine Olha Holubovska, MD, PhD: “Today there are at least 90,000 people in need of treatment in Ukraine, though due to the low level of primary diagnostics we still do not know the exact number of people living with the virus. With such approach and the level of government funding the epidemic is growing – and hepatitis C is turning into a real threat to the public security of Ukraine as later the government will have to spend enormous amounts of money in disability benefits and incapacity allowances due to the consequences of this disease. However, the problem of blood-borne infections may not be solved only with treatment. The WHO strategy stipulates reformation of the public health system as a whole.”

The situation with government funding is also critical. In 2016, the current National Targeted Social Program of Viral Hepatitis Prevention, Diagnostics and Treatment is coming to its end. In its official response to Alliance as for the development of a new program for the period till 2021, the Ministry of Health replied that in 2013 – 2016 only very limited amounts of budget funds were allocated to procure medical drugs; as for other activities – they were not financed from the budget at all! The total funding shortfall of the activities stipulated in the national program is 79% of the amount planned back in 2013.

The formal reason of refusal to develop a new national program on viral hepatitis, which was supposed to come into force in 2017, voiced by public officials is the ban on the use of public funds approved with the resolution of the Cabinet of Ministers of Ukraine N 65 dd. 1 March 2014[1].

“Hepatitis C is a curable disease. Nevertheless, in our country the situation has turned into an epidemic. Under such conditions, freezing resources to fight hepatitis C means capitulation and betrayal from the side of the state towards its citizens who are in need of treatment. Keeping in mind the disturbing results of the national testing, we demand to lift the “veto” from the development of a new national program on viral hepatitis. Alliance appealed to the President and the Prime Minister with a request to urgently approve the National Plan towards Hepatitis C Elimination, the implementation of which will help Ukraine to eradicate this disease in our country and save the lives of millions of Ukrainians. The experience of Alliance, which two years ago launched the first in Ukraine treatment program using a new-generation drug, clearly demonstrates that this goal is achievable! We were able to access innovative drugs and have already treated over 600 patients with most complicated cases – and in 93% of those who received the treatment the virus is undetectable, which is currently the best treatment success rate for hepatitis C in Ukraine,” – said Andriy Klepikov, Executive Director of the Alliance for Public Health.

***

Over 150 million people are infected with hepatitis C globally, with up to 4 million people living with HCV in Ukraine. Most of them are not aware of their disease as in 80% cases the acute stage of disease is asymptomatic. One of the priority areas of activities of the Alliance for Public Health is fighting the spread of the epidemic of hepatitis C in Ukraine and providing HCV diagnostics and treatment for key affected populations. In 2012, Alliance initiated all-Ukrainian “Demand Treatment!” advocacy campaign primarily aimed at scaling up access to diagnostics and treatment of hepatitis C in Ukraine. Since 2015, the Alliance Center on HIV, Hepatitis C and Drug Use has been implementing a global campaign, Unite to Eliminate HepC: Know It, Test It, Treat It.

[1] Paragraph 16 of the Resolution of the Cabinet of Ministers of Ukraine dd. 01.03.2014 N 65 “On budget savings and prevention of budget losses” terminates the development of new national targeted programs or amendments to the approved targeted programs, which require additional budget funding.

Official press-release

On 5 August 2016, the Ministry of Health of Ukraine hosted the second meeting of the Interdepartmental Working Group on Medication Assisted Treatment at the MoH.

On 5 August 2016, the Ministry of Health (MoH) of Ukraine hosted the second meeting of the Interdepartmental Working Group on Medication Assisted Treatment at the MoH (hereinafter – IWG). The meeting was held with technical and organizational support of the Alliance for Public Health (within the project “Improved Quality and Sustainability of Medication Assisted Treatment in Ukraine”) together with the Ukrainian Center of Socially Dangerous Disease Control.

The key issue of the meeting was introducing the Methodology of calculating the need in drugs to provide medication assisted treatment to patients with mental and behavior disorders associated with the use of opioids for the purposes of drugs procurement within the state budget.

The above Methodology was developed in line with the resolution of the IWG as of 1 July 2016 by representatives of the Ukrainian Center of Socially Dangerous Disease Control and the Alliance for Public Health.

Other questions discussed at the meeting also included organization of an International center for substance abuse treatment and HIV prevention technologies in Ukraine; situation with introduction of the practice of MAT drugs delivery to patients for unsupervised administration in outpatient settings (prescriptions for drugs, delivery within “home care” or directly from treatment institutions), protection of the rights of patients.

During the meeting, information was presented on the current situation with issuance of a joint order of the Ministry of Health of Ukraine, the Ministry of Internal Affairs of Ukraine and the Ministry of Justice of Ukraine “On approval of the procedure of cooperation among healthcare institutions, departments and bodies of the National Police, National Guard of Ukraine, pre-trial detention centers, penitentiary facilities and criminal and executive inspections to ensure the delivery of medication assisted treatment to patients with opioid dependence”. According to the information presented, the draft order is currently in the process of approval by the MoH of Ukraine and will soon be published for public discussion.

Based on the results of the meeting, a decision was made to urgently finalize the developed Methodology of calculating the need in drugs to provide medication assisted treatment for its approval with an order of the MoH of Ukraine, with further steps defined to enhance the partnership in response to patients’ appeals related to violation of their rights and to provide clarifications to regions on the delivery of MAT drugs for unsupervised administration.

More than 390 refugee and IDP OST patients from the Crimea and the ATO area can continue the life-saving treatment!

The Alliance of Public Health (the Alliance) completed the humanitarian project on support of the OST patients – refugees from the Crimea and internally displaced persons from the ATO area, which had been funded by the international organizations for more than 2 years. From May 2014 to June 30, 2016 more than 390 opioid substitution therapy (OST) patients being the refugees from the Crimea and the ATO area, were able not only to relocate in the safe regions of Ukraine, but continue the life-saving treatment and start over again at the new place. (Based on the survey results, 95% of the clients after the completion of the project are planning to stay in their new places of residence and receive OST services on general conditions.

The essence of OST as drug dependence treatment is that a patient regularly takes an OST drug under doctor’s control, being able to quit criminal activities, find a job, improve their health, fully integrate into the society. Currently there are 8,152 OST patients in Ukraine. Before the occupation of the Crimea and a part of Donbas there were about two thousand persons on treatment, and only a third of them was able to continue the treatment on non-occupied territories. Others were deprived of this opportunity, having their life and health threatened. Based on the data by the UN Secretary-General’s Special Envoy Michel Kazatchkine, after OST program discontinuation in the Crimea about 100 patients died, official statistics for the uncontrolled territory of Donbas is not available, but the patients’ situation there is no better.

The Alliance had always held the protection of OST patients’ interests as a cornerstone of its activities and in this critical situation launched active advocacy, awareness and fundraising campaign to protect their rights, laying the foundation for the humanitarian project. The patients were offered to relocate to one of 16 cities in 8 oblasts where they were able not only to continue treatment, but obtain an interim 24-hour social support to help them adapt at a new place, which included the payment for accommodation rental at the expense of the project, organization of meals and providing for household needs, assistance with employment, obtaining documents, etc. Considering that the majority of OST patients are persons with severe chronic diseases, the uninterrupted treatment was ensured for HIV, TB, or, if necessary, the possibility of medical examination and timely prescription of treatment for these diseases.

Oleksandr, OST patient from Horlivka, who is now living in Kramatorsk, tells, “We knew that the drug stock is running low, but then out of a sudden they brought us together and said that the site is closing. OST hotline told me that there is a possibility to relocate, thus I contacted the project coordinator and moved to Kramatorsk. I like this city, they rented me a comfortable apartment and were always ready to help. It’s hard to believe, but while this seems an ordinary city, even the sun is brighter here, there is a friendlier environment of sorts… I have pity for those who stayed on the occupied territory. People understand that they were not right, but not everybody would dare to leave. I was lucky enough…”

From the very beginning the project aimed not only to support the patients in the first months after relocation, but comprehensively facilitate their integration in the local communities. As the result, 99% of the project clients were registered as IDPs and receiving the governmental allowance, 19% were receiving disability allowance, 5% received childcare support. As of the moment of project completion 41% of patients have full-time or temporary jobs helping them to pay for accommodation on their own after the project completion.

According to the project participants currently residing in Dnipro, “The assistance program organized by the Alliance allowed us to survive and adapt in the new unfamiliar city. At this stage of our life we were not left alone, Alliance staff was helping us so much, that’s why we successfully started adapting to the life in the new city rather than sink into despair”.

The Alliance aimed to achieve the sustainability of services even after the completion of the project funding, that’s why key attention was paid to seven healthcare facilities, on the basis of which OST services were provided on the controlled territory of Luhansk and Donetsk oblasts (Slovyansk, Kramatorsk, Mariupol, Krasnoarmiysk, Lysychansk, Severodonetsk, Rubizhne), because they were the most demanded by the relocated persons, concentrating 51% of all project clients. The project budget funded the procurement of equipment, repairs of the site premises which allowed, among other things, to open the new OST cabinet in Rubizhne city where as of the moment of project completion 44 OST patients were serviced, including 6 IDPs.

Meanwhile… On June 23, 2016 the treatment on the uncontrolled territory of Donetk and Luhansk oblasts was completely discontinued. Due to depletion of the stock of drugs the last OST site which had still been functioning in Donetsk got closed. 23 HIV-positive patients for the last time received a minimal dose of methadone (5 mg). Not everybody managed to relocate on the territory controlled by Ukraine to continue treatment, the majority faced harsher fate. Based on the information available to the Alliance, during the involuntary decrease of OST dosage 20 patients, most of them HIV-positive, died in Donetsk only. This further emphasizes the importance of the project implemented by the Alliance, as it was saving lives rather than just simply providing treatment.

The project was a challenge for the Alliance, because it was quite unique. According to Tamara Tretska, project manager, “It was a complicated project. Many activities were developed and changed in the course of the project. Sometimes we had to start virtually from zero; we had to provide patients with clothes, footwear and other necessary items, because the first patients from the ATO area sometimes arrived without any possessions, having just escaped the bombing. Due to successful cooperation with the healthcare facility managers and OST doctors we could promptly solve the issues of admitting the patients who often had no medical documentation with them. We greatly respect the doctors’ attitude, who treated the clients as first and foremost people in need of help. There were no refusals to admit patients. However, all the difficulties and barriers the project team had to overcome are fully rewarded, when we realize that we were able to fully change people’s lives, and did not abandon the patients, making them face all the problems of therapy interruption on their own. The patients had a real possibility to fit in the new conditions”.

***

Reference: the project for the support of OST patients who were refugees from the Crimea or IDPs from the ATO area was funded by different donors:

· International Renaissance foundation (08.05.2014 – 31.03.2015)

· Elton John Foundation(1.10.2014 – 25.12.2014)

· Pompidou Group of the Council of Europe (1.02.2015 – 31.05.2015)

· Global Fund to Fight AIDS, Tuberculosis and Malaria (1.06.2015 – 30.06.2016).

The total amount of funding exceeded USD 750,000

On July 25-29, 2016 the Alliance for Public Health (METIDA project) in collaboration with the State Institution “Ukrainian Centre of Socially Dangerous Disease Control of Ministry of Health of Ukraine” carried out the International Summer HIV Modelling School in Odessa. This event was a unique opportunity to meet the highest level national and international experts on HIV modelling. During the meeting were discussed algorithms of HIV/AIDS epidemic projections in four major modelling tools: SPECTRUM, AEM (AIDS Epidemic Model), Optima and ECDC HIV modelling tool.

  The international trainers of summer school were:

• Ard van Sighem, PhD, developer of ECDC HIV modelling tool, Senior Researcher at Stitching HIV Monitoring Foundation (Netherlands)

• Wiwat Peerapatanapokin, East-West Center / Thai Red Cross Society Collaboration on HIV / AIDS Modelling, one of the developers of AEM, international expert in SPECTRUM (Thailand)

• Clemens Johannes Benedikt, The World Bank, modelling consultant at Optima (Austria)

The following representatives of national partner organizations working on HIV in Ukraine participated in the International Summer HIV Modelling School: CDC, UNODC, UNAIDS, The World Bank, State Organization “Institute for Economics and Modelling, Ukrainian National Academy of Sciences”, State Organization “Institute of Epidemiology and Infectious Diseases named after L. Gromashevskyi of the National Academy of Medical Sciences of Ukraine”, regionals AIDS centers and other national partners.

During the event all the participants developed projections in different modellingtools, compared the projections with each other and concluded the further steps in HIV modelling at the national and regional levels, first of all, to identify and approve the data about PLHIV size estimation and key groups, main epidemic indicators (incidence, prevalence, mortality) among the general population and key groups.

On July 28, 2016 the Alliance of Public Health jointly with partner organizations carried out the traditional all-Ukrainian information and awareness event within the framework of “We Demand Treatment!” campaign in all the oblasts of Ukraine. The key message of this year’s event was the request to ensure efficient treatment with direct-acting antivirals.

The following speakers participated in the press briefing at the all-Ukrainian public event in the city of Kyiv:

– Executive Director of the Alliance of Public Health Andriy Klepikov.

– Chief consultant specialist on the infectious diseases of the Ministry of Health of Ukraine (MoH), Head of the Department for Infectious Diseases of O. Bohomolets National Medical University Olha Holubovska, MD, PhD.

– Representative of the World Health Organization (WHO) office in Ukraine Oleksiy Bobryk.

– Patients with HCV who currently completed the treatment or are still waiting for it.

195 people passed hepatitis C screening tests, 15% of results were positive. All people who have received positive results of rapid test were consulted by doctor and received information on further steps in the diagnosis.

The action received wide coverage in the media:

First National Channel.

5th Channel.

Hromadske TV.

TV Channel ‘Ukraina’.

24th Channel.

NTN.

‘Kyiv’ TV company (was on news programm at 21.00).

Hromadske Radio.

Radion Era.

Official press relealse of the action.

#AIDS2016

Alliance for Public Health (Ukraine) is implementing one of the biggest key populations response programs that reversed the pace of HIV epidemic in Ukraine. Its experience informed the development of a number of EECA programs as well as responses to drug use driven epidemics in East Africa and Asia. We will be sharing our experiences during AIDS 2016: oral presentations, workshops, poster presentations, 2 booths will be ran during the conference:

SATURDAY, JULY 16

11:30 – 13:00. Oral Presentation: Leaving No One Behind – Prioritizing Key Populations. (Pavlo Smyrnov)

Place: International Conference Center (PEPFAR, pre-meeting).

TUESDAY, JULY 19

12:30 – 14:30. Poster presentation: Economic analysis of effectiveness of investments in HIV prevention services among key population groups in Ukraine (Tetyana Salyuk)

Place: Poster Exhibition area, First Level (by the Arena Entrance)

14:00 – 15:00. Oral presentation followed by moderated discussion: Harm Reduction Academy learning course: How to learn the decades of experience in harm reduction in 3 weeks? (Tetyana Deshko)

Place: HIV/AIDS Alliance Exhibition Booth at AIDS 2016 (#374)

15:00 – 16:00. Oral presentation followed by moderated discussion: SyrEx Cloud: Leave the paperwork behind! Client tracking software (Pavlo Smyrnov)

Place: HIV/AIDS Alliance Exhibition Booth at AIDS 2016 (#374)

18:30 – 20:30. Oral Presentation: Leaving No One Behind: How to Bring Key Population HIV Services to Scale (Tetyana Deshko)

Place: International Conference Center, Session Room 7

WEDNESDAY, JULY 20

9:00-10:00. Workshop “EECA Regional Platform: TA needs of PLWHA in Eastern Europe and ways to address them for better decision making”. Discussion of Assessment results (Kateryna Maksymenko).

Place: Global village: the European Networking Zone

12:30 – 14:30. Poster presentations:

· EECA Regional Platform: building regional civil society partnership for better decision making in HIV/TB response (Kateryna Maksymenko).

· Using mixed-methods to understand HIV treatment cascade among opioid agonist therapy (OAT) patients and people who inject drugs (PWIDs) in five Ukrainian cities (Alyona Mazhnaya)

Place: Poster Exhibition area, First Level (by the Arena Entrance)

12:50 – 12:55. GV Film screening. Lost Childhood: urgent response needed in order to save lives of adolescents who use drugs (Iryna Zharuk)

Place: GV Film screening room.

16:30 – 18:00. Oral Presentation: The Development and Pricing of HIV Medications and Diagnostics: Recent Controversies and Priorities for the Future (Andriy Klepikov)

Place: International Conference Center, Session Room 6.

18:00 – 20:00. Oral Presentation: Development Assistance for Health in the Age of Inequality: What does it mean for the AIDS response? (Andriy Klepikov)

Place: The Southern Sun Elangeni & Maharani, 63 Snell Parade

THURSDAY, JULY 21

12:30 – 14:30. Poster presentations:

· HIV counseling and testing decreases risk of HIV seroconversion among people who inject drugs in Ukraine (Tetyana Salyuk)

· Implementation and validation of PIMA CD4 program in Ukraine (Alyona Shost)

Place: Poster Exhibition area, First Level (by the Arena Entrance)

14:30 – 16:00. Oral Presentation: Community’s Role in the Health System. (Andriy Klepikov).

Place: International Conference Center, Session Room 11.

14:00-14:45. Session “TA needs and ways to address them for better involvement of key affected communities into decision making in the area of HIV/TB response in EECA: Assessment results”. (Kateryna Maksymenko).

Place: Global Village: Global Fund Networking Zone

We will be present in 2 booths during the entire conference:

· International HIV/AIDS Alliance Exhibition Booth #374

· Alliance for Public Health, Booth №518

Join our events in Durban!

On 22-24 June 2016, Bratislava hosted the 7th Union Europe Region Conference organized by the International Union Against Tuberculosis and Lung Disease. The key speakers included Marieke van der Werf (ECDC, Stockholm), Mаrio Raviglione and Knut Lonnroth (WHO, Geneva), Lee B. Reichman (New Jersey Medical School, USA), Giovanni Battista Migliori (Italy), Aksmit Timothy (USA), Martin van den Boom (WHO, Copenhagen), Viorel Soltan (PATH Center, Moldova) and others.

 Alliance for Public Health (Alliance) was represented by Andriy Klepikov, Executive Director, and Yuliya Chorna, Project Manager: TB Advocacy, who made a valuable contribution to the conference. At the session ‘Transforming and optimizing patient-centred models of TB care in countries of the former Soviet Union (FSU)’, Alliance was presented to the participants by Martin van den Boom (WHO Regional Office for Europe) as one of the partners of the TB-REP Regional Project.

On the last day of the conference, Andriy Klepikov together with Fanny Voitzwinkler, Head of EU Office of the Global Health Advocates, facilitated the final session “Road to Bratislava 2016: A Uniting Call from TB and HIV Stakeholders for European Political Leadership in the Fight against Communicable Diseases”. This session was organized by the TB Europe Coalition (TBEC) and was of a particular importance as Slovak Republic will take over the Presidency in the Council of Europe on 1 July 2016. The Executive Director of Alliance pointed out: “This is the crucial moment, when the Slovak Republic, coming from its achievements in the fight with TB, will be able to prioritize the question of ending TB in Europe.”

“Co-infection of TB, HIV, hepatitis – all those issues are associated with TB, so TB cannot be tackled alone, but addressed in comprehensive manner. Another important issue is the needs of vulnerable populations, who require all types of support to overcome the crisis situations they face”, – underlined Andriy Klepikov during the closing part of the conference.

Now there are great expectations for the leaders of the countries in the respective region to keep TB among the political priorities and to draw more attention to the issue. They need to not only ensure sufficient attention to TB at all levels, but also enhance all the available mechanisms to fight with tuberculosis and actively involve communities to overcome this problem!

Since it was launched in 2013, the Support Don’t Punish campaign has gone from strength to strength, and activists in more than 100 cities around the world will take part in the Global Day of Action on or around 26th June this year. 2016 has already been a big year for drug policy with the UN General Assembly Special Session on drugs in April, and the UN High-Level Meeting on HIV/AIDS earlier in June.

This month, a huge range of local actions, events, protests and meetings will be held as part of a global show of force calling for drug law reform – including:

· A giant mural in the centre of Melbourne, Australia, accompanied by demonstrations and a petition to government.

· A music concert in Brussels, Belgium to raise awareness of the need for drug policy reform.

· A policy dialogue with politicians, UN officials and community members in Phnom Penh, Cambodia.

· Public debates and discussions on the rights of coca, poppy and marijuana farmers in Bogota, Colombia.

· Events across 12 cities in France.

· A rally and street play in Pune, India.

· A series of debates and workshops in Mauritius.

· A football match between people who use drugs and local law enforcement officials, followed by a bicycle rally in Pokhara, Nepal.

· A public march in Cape Town and an interfaith healing session with different religious leaders in Durban, South Africa.

· “Guerrilla” distribution of naloxone to those in need in London and Liverpool, UK – to highlight the need for better local policies to prevent drug-related deaths.

· A large-scale projection in New York depicting people who use drugs under the heading ‘drugs do not define me’ – as well as smaller actions in several other US cities.

The campaign team are working hard to keep the list of actions up-to-date on the  сampaign website. Please contact campaign@idpc.net if you wish to add a city to the list, or update any information.

The Support Don’t Punish campaign seeks to promote the case for drug policy reform, and to challenge existing laws and policies which impede access to harm reduction interventions – as the harms being caused by the war on drugs can no longer be ignored. The campaign includes the annual Global Day of Action, as well as an Interactive Photo Project – an online photo petition with more than 7,000 supporters from around the world. You can engage with the campaign by following us on Facebook, Twitter or on the campaign website, taking part in the 2016 Thunderclap on social media, watching and sharing our series of videos, sending in your photo for the Interactive Photo Project, taking part in your local event, or organising an action yourself!

For more information on all of this, please visit www.supportdontpunish.org.

Alliance for Public Health (hereinafter – Alliance) decided to make a contribution into marking the International Day against Drug Abuse and Illicit Trafficking, within the global Support. Don’t Punish! advocacy campaign, and inform stakeholders, governmental authorities and mass media about the real microscopic volumes of the leakage of substitution therapy drugs into the illicit market.

Opioid substitution treatment (OST) program – the biggest in the countries of Eastern Europe and Central Asia – has been implemented in Ukraine for 12 years already! Today this effective and evidence-based approach to the treatment of drug dependence and prevention of the spread of HIV and hepatitis C allows 8,727 patients with chronic opioid dependence to receive treatment in 173 healthcare facilities in all regions of Ukraine, apart from temporarily occupied areas in eastern Ukraine. 7,779 patients receive methadone-based substitution therapy (with tablets or liquid methadone) and 948 patients receive buprenorphine tablets.

Over this period, there were numerous studies, which proved the effectiveness of OST. This therapy for people who use drugs is guaranteed by p. 8 art. 4 of the Law of Ukraine “On Prevention of the Spread of Diseases Associated with Human Immunodeficiency Virus (HIV), Legal and Social Protection of People Living with HIV” dd. 12.12.1991 N 1972-XII and by the National Targeted Social Program on Countering HIV/AIDS in 2014-2018 approved with the Law of Ukraine dd. 20.10.2014 N 1708-VII. A series of orders of the Ministry of Health of Ukraine regulate the procedure of OST provision, volumes of the drugs to be used and control over their turnover.

Since 2005, 1,462 kg of methadone and 34.4 kg of buprenorphine were delivered to the country in accordance with the annual quotas of narcotic substances for OST approved by the Cabinet of Ministers of Ukraine within the relevant National Program, which is co-implemented by Alliance for Public Health. In Ukraine, the average daily dose of methadone in OST programs is 80 mg, buprenorphine – 10 mg per patient.

One of the traditional arguments against introduction of OST, which were voiced by representatives of the previous law enforcement system, which for many years maintained strong resistance to implementation of this method of treatment at all levels, were unjustified assumptions concerning allegedly enormous volumes of the OST drugs leakage and illicit trafficking in those drugs. In previous years, such statements have been repeatedly heard from the head of one of the most corrupted departments of former militia – Department against Drug Trafficking of the Ministry of Interior of Ukraine – mostly with references to confidential “information collected” and “criminal cases initiated”.

Today Alliance decided to inform all interested parties, including current law enforcers and mass media, with the real statistics of the “leakage” of OST drugs and illicit trafficking in such drugs and show that they make an absurdly small share in the total scope of drug turnover in our country.

In the recent months, Alliance analyzed court judgments related to OST or narcotic drugs used in OST, which were entered into the Unified State Register of Court Judgments.

As a result, we identified and analyzed 333 basic and 84 associated with them court judgments on criminal cases and administrative offenses, issued during the period of almost 10 years!

The analysis showed that within those cases law enforcers documented and withdrew only 25 grams of methadone and 0.32 gram of buprenorphine, which got into the illicit market from OST programs.

Thus, the proportion of OST drugs, which leaked into the illicit market in this period of time due to various circumstances is really meager as compared to the volumes of drugs imported or procured in Ukraine during the same period: for methadone it is0.0017% and for buprenorphine – 0.00093%!

For reference, earlier in June during just one police intervention in Kherson officers of the National Police withdrew over 2 kg of illegal methadone (which is in no way related to OST programs) produced in a clandestine laboratory from an organized drug crime syndicate, which is 77 times more than the quantity of the main OST drug, which got into the illicit market in all the years of OST program implementation in Ukraine!

So we have to say that concerns of skeptics and unjustified assumptions of corrupted law enforces on the dangers of OST are in no way confirmed in practice.

By the way, arms from military warehouses, currency assets and valuables from banks or jewelry stores also sometimes fall into the wrong hands. But it seems that in those areas the scope of leakages is not that meager…

***

For information: This press release is issued within the global «Support. Don’t Punish!»advocacy campaign, which is marked on 26 June 2016 in over 100 cities of the world. On this day, tens of thousands of civil society activists from all over the world traditionally appeal to their governments to stop cruel and senseless policy of the War on Drugs. Official website of the campaign: http://supportdontpunish.org

Alliance for Public Health is a leading non-governmental professional organization which makes a significant impact on the epidemics of HIV/AIDS, tuberculosis, viral hepatitis and other socially dangerous diseases in Ukraine through providing financial and technical support to relevant programs, which cover over 280,000 members of most vulnerable populations, which is the highest indicator in Europe. Alliance traditionally takes part in «Support. Don’t Punish»! campaign. Information about last year’s event: http://www.aidsalliance.org.ua/ru/news/pdf/01-12_2015/06/Drugs_Alliance_26.06.2015_ukr.pdf

1 For comparison, according to the official data of the Supreme Court of Ukraine only in 2015 all Ukrainian courts heard 12 thousand cases related to offences in the area of trafficking in drugs, psychotropic substances, their analogues or precursors (articles 305–320 of the Criminal Code).