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Media about us
26/10/2024. Panorama Nyheter: Ukraine has avoided a tuberculosis epidemic.
In the spring of 2022, international experts predicted an outbreak of a major tuberculosis epidemic in Ukraine after Russia’s ground invasion.
29/09/2024. The Lancet: Mobile screening for Ukraine’s wartime tuberculosis epidemic
Conflict is driving up tuberculosis cases in Ukraine, while displacement and damage have put many health facilities out of action. Lily Hyde reports.
19/09/2024. NPR: Ukraine keeps up the fight against HIV while fighting a war
The Alliance for Public Health, a Ukrainian advocacy group working to fight HIV/AIDS, tuberculosis and other infectious diseases in the country, was able to procure emergency antiretroviral supplies through U.S. donors such the Global Fund and PEPFAR — treatments previously purchased in large quantities by the Ukrainian government. But the Alliance still faced challenges in administering care, as many trained health-care professionals with expertise in managing HIV left the country.
01/09/2024. The Lancet: Setbacks and advances in the global HIV response
7/08/2024. The Guardian: Russian influence in eastern Europe is aggravating HIV epidemic, say experts
Andriy Klepikov, the executive director of the Ukrainian charity Alliance for Public Health, said it had been forced to take a wider humanitarian approach than before the war. He said: “If someone asks for food, I cannot say, ‘Sorry, I have only condoms for you.’”
1/08/2024. Clinical Trials Arena: AIDS 24: Prioritise at risk populations for trials, testing and treatment
The International AIDS Society’s (IAS) 25th International Conference, AIDS 2024, was filled with calls to ensure at risk populations who are most at risk of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are at the top of the agenda for access to testing, treatment at trials.
30/07/2024. Welt-sichten: Letting up is not appropriate
One stand in the Global Village hall at the venue in Munich was particularly well attended: Ukrainian activists presented their app, which social workers use to reach at-risk groups virtually under the difficult circumstances of the Russian war of aggression. It enables counseling or shows the way to often mobile laboratory or testing stations.
29/07/2024. Inquirer.net: AIDS conference discloses 7th HIV case apparently cleared of virus
Ukrainian Anton Basenko of the International Network of People Who Use Drugs—who is also the first drug user to address the conference—said “We have all the means to end HIV but what we don’t have is time.” He enjoined leaders to act now with the affected communities.
29/07/2024. Eurasianet: Eurasia facing rising HIV cases
With 140,000 new cases in 2023, Eurasia has seen a dramatic 20 percent increase in new infections over the past 13 years. Kazakhstan, Russia, Ukraine, and Uzbekistan are among the hardest hit, accounting for 92 percent of newly diagnosed cases. “While most other regions around the globe have managed to stabilize the rates of HIV infections, in Eurasia, it is rapidly increasing,” said Andriy Klepikov, regional co-chair of the AIDS 2024 conference. For the first time in history, there are more new infections outside sub-Saharan Africa than within the region.
25/07/2024 JOY Podcasts: International AIDS Conference 2024
Andriy Klepikov, AIDS 2024 Regional Co-Chair & Ukranian Advocate discussing the hybrid war being waged in the region including on the LGBTIQ+ people, drug users, TGD communities and science more broadly
23/07/2024. Health Policy Watch: Germany Pledges Continued Global AIDS Support Amid Fiscal and Political Pressures
The AIDS 2024 conference includes a special focus on eastern Europe and central Asia, a region with one of the fastest-growing HIV epidemics in the world.
“While most other regions around the globe have managed to stabilise their HIV epidemics, in eastern Europe and central Asia, it is rapidly increasing,” Andriy Klepikov, AIDS 2024 Regional Co-Chair, told delegates to the event.
22/07/2024. New Business Ethiopia: World International AIDS Conference opens in Germany
AIDS 2024 includes a special focus on eastern Europe and central Asia, a region with one of the fastest-growing HIV epidemics in the world.
“While most other regions around the globe have managed to stabilise their HIV epidemics, in eastern Europe and central Asia, it is rapidly increasing,” Andriy Klepikov, AIDS 2024 Regional Co-Chair said. “Only half of people living in our region are on antiretroviral therapy, nowhere near the global target of 95%. At the root of the region’s epidemic are drug use, stigma and harmful policies – exacerbated by violent conflict.
22/07/2024. Health Policy Watch: UNAIDS Blames Punitive Laws and Stigma for HIV Surge in Eastern Europe and Central Asia
Speaking at a press briefing Monday at the opening of the 2024 conference, Andriy Klepikov, AIDS 2024 Regional Co-Chair, charged that Russia’s influence in the region is having ripple effects on stigmatization of LGBTQI populations and people who inject drugs – leaving them further than ever outside the circle of treatment.
“Eastern Europe and Central Asia have the least number, percentage, of people on treatment. Only 50%. This is a very worrisome signal,” he observed.
The HIV epidemic in eastern Europe and central Asia: challenges and opportunities. Guest Editors: Miłosz Parczewski, Deniz Gökengin, Andriy Klepikov
17/03/2024. Sueddeutsche Zeitung: “War is tuberculosis’ best friend”
Andriy Klepikov’s assessment is – and it also sounds friendly and sober: “Tuberculosis is like war. The situation is worrying, but we are resisting.” There is simply no alternative.
For the foundation, this meant adapting its strategies. “We had to become mobile,” says Klepikow. Aid organisations now drive to emergency shelters in converted vans to find infected people and provide treatment. They are working more closely with social services, as these are often the first places that people who have lost their homes go to. And aid organisations are now also providing humanitarian aid.
They are distributing food, hygiene products, blankets, torches, power banks and setting up emergency shelters. They have also long been active across borders and support TB patients who have fled abroad. They have also stayed in touch with some patients who came to Germany, says Klepikow. The alliance helped to translate medical documents and establish contacts between doctors in both countries.
13/03/2024. Tagesspiegel Background: Gesundheit & E-Health, Interview with Andriy Klepikov
It doesn’t work without help. The German Society for International Cooperation (GIZ) has financed the equipment of the MTPs with 490,000 euros. Funding will expire in May of this year. Without any more money, it looks gloomy. Because 60 percent of Ukraine’s gross domestic product goes into defense. There is nothing left for public health promotion. “We are completely dependent on the help of our international partners,” says Klepikov. The USA currently provides all HIV drugs, including the Global Fund to Combat AIDS, Tuberculosis and Malaria – Germany is one of the largest donors there – supports APH. “We hope that we will find a way to continue the important help of GIZ,” says Klepikov.
07/03/2024. Lviv City Council: Ukraine’s first habilitation centre for veterans and civilians opened in Lviv
This is an initiative of the Alliance for Public Health in cooperation with the National Rehabilitation Centre UNBROKEN. The centre is a transitional, barrier-free space that allows people to safely survive the experience of war in order to move on. Veterans and civilians who have already undergone physical rehabilitation at the UNBROKEN centre and need to adapt to new living conditions will learn new skills here.
“The Lviv Habilitation Centre is becoming an extremely important area of work for us, as it is intended to help veterans and civilians affected by the war. We also want to draw public attention to the problem of inclusive spaces. After all, it is the convenient infrastructure that will enable our veterans and civilians to continue living their lives,” said Andriy Klepikov, Executive Director of the Alliance for Public Health.
29/02/2024. NYU: How War Worsened the Opioid Crisis in Ukraine
Russia’s invasion has shuttered drug treatment programs since 2014 and forced people from their homes. New research shows the challenges Ukrainians have faced in accessing care.
23/02/2024. Health Policy Watch: How Criminalisation and Prejudice Is Undermining HIV Prevention
The war between ideology and science
“It is a war between ideology, prejudice and stereotypes on the one side and evidence-based science on the other side,” said Andriy Klepikov, executive director of the Alliance for Public Health, one of the largest HIV and TB NGOs in Ukraine and Eastern Europe.
“Countries like Russia are neglecting all the evidence [which shows] where the HIV epidemic is going up as a result of punitive law and repressive policies,” he added. He was speaking at a World Health Summit event on Ending the AIDS Epidemic in Light of the Shrinking Civic Space in October, 2023.
“We even have UNAIDS data showing how vulnerable people who use drugs, men who have sex with men, sex workers, and transgender people are.”
23/02/2024. Frontline AIDS: Providing healthcare two years on from the Ukraine invasion
February 24 marks the second anniversary of Russia’s brutal full-scale invasion of Ukraine. Two years on, Frontline AIDS’ partner, Alliance for Public Health (APH), a Ukrainian NGO renowned for its dedication to combating HIV and tuberculosis, is using innovative approaches to provide crucial humanitarian support and healthcare to those on the frontline.
22/02/2024. RND/dwg/AP: How targeted Russian attacks are putting a strain on the Ukrainian healthcare system
Andriy Klepikov, who heads the Alliance for Public Health, an organisation that provides mobile clinics to towns on the front lines, is concerned about the diseases that remain undiagnosed.
But he is confident about his country’s ability to bounce back. The healthcare system is not about walls, buildings or even equipment. “It’s about people,” he says. “The Ukrainian military is known for its strength and resilience, but when it comes to public health, we are equally strong and resilient.”
How it works: Ukraine has traditionally used a peer-referral voucher model which sees people testing for HIV to refer their potential high-risk contacts for testing, usually with a small incentive. Under the pre-war model, it was up to a social worker to carry out a risk assessment and decide on the incentive level based on the person. But when the war began, the number of social workers fell, as did the availability of services. The new AI approach uses a machine learning algorithm that predicts the probability of an individual to refer a number of HIV positive peers and bases the incentive level on that.
The results: The NGO said it has led to a 37 percentincrease in HIV case finding, compared with the previous social worker-only approach. Klepikov said that the model gets rid of biases that a social worker might have. “Artificial intelligence showed better results because some of the human assessments are based on stereotypes,” he said. “The number of sexual partners is automatically seen as highest risk factor, but AI found that a history of incarceration was identified as a higher risk.”
When Anna Aryabinska fled from Kyiv in March 2022 with her ex-partner’s children, she had little idea that she would end up supporting not only his family, but many HIV-positive Ukrainians in Poland. Until Russia’s full-scale invasion, Aryabinska had been an activist for the Ukrainian organisation Positive Women, supporting women with HIV. Now she is one of a group of volunteers assisting fellow Ukrainian refugees to keep taking medication for HIV, as well as integrate into healthcare systems in European countries which have very different epidemic profiles and standards of treatment.
30/11/2023. Eurosurveillance: HIV diagnoses among people born in Ukraine reported by EU/EEA countries in 2022: impact on regional HIV trends and implications for healthcare planning
19/11/2023. NRC: Ukraine is not only a front in the military sense, but also in the epidemiological sense
Health care in Ukraine Partly because of the war, tuberculosis is a major problem in Ukraine. But due to the lack of care, the disease often remains hidden.
20/10/2023. Medscape: A War on Another Front: Ukraine’s Fight Against Hepatitis C
Zhanna Tsenilova, MPH, coordinates the APH’s HCV micro-elimination program, which cares for people with HCV as well as those co-infected with HIV or tuberculosis have shared data on its HCV treatment model during the country’s war emergency at conferences, including the recent International Conference on Health and Hepatitis Care in Substance Users.
APH started in 2015, and in those 8 years approximately 12,500 people from key populations in Ukraine have received assistance from the organization, which includes those helped since the start of the war. APH works in cooperation with state partners and civil society organizations across Ukraine and in some of the occupied Russian territories to perform healthcare-related services in the local communities. Fourteen community nongovernmental organizations, cooperating with field healthcare facilities in 16 regions of Ukraine, have provided an HCV cascade of care, including linkage with harm reduction, outreach routes, opioid substitution treatment sites, peer treatment monitoring, and re-infection prevention education.
But efforts to deliver healthcare are constantly overshadowed by a state of fear, with four major healthcare facilities remaining in occupied territories.
“We experience bombings daily, but we have set up two new treatment sites within 20 kilometers of the frontline, with other sites further out, including Pokrovsk, Selidovo, Dobropolie in Donetsk [region], Nikopol, and Novomoskovsk in Dnipropetrovsk [region],” Tsenilova said.
“Sadly, we’ve lost some people from the program,” she said. “For example, in Mariupol, 27 patients started treatment, but since the war, we have no idea where they are. It’s a similar picture elsewhere.”
09/08/2023. The New Humanitarian: Inside the desperate effort to keep healthcare alive on Ukraine’s front line
In some areas occupied by Russia, people have had little or no access to medicinesince late February 2022. Where Russian forces have retreated, lack of transport and utilities, and the dangers of shelling and landmines, complicate the restoration of even basic health infrastructure.
Inhabitants of villages that have been retaken by Ukraine have to make expensive, difficult, and dangerous trips to less damaged areas for medical services – or wait for volunteers and aid agencies to risk bringing medicines and doctors to their frontline regions.
Over the past six months, The New Humanitarian travelled with Alliance for Public Health (AHP), a Ukrainian NGO, to a dozen villages and towns near the front lines in the Kherson and Kharkiv regions in the east and southeast of the country.*
13/07/2023. Wired: Doctors on Bikes Averted a Humanitarian Catastrophe in Ukraine
When Russia invaded Ukraine, people living with HIV faced losing access to lifesaving treatment. Volunteers took enormous risks to keep the supplies moving.
Andriy Klepikov, the executive director of the Alliance for Public Health, a nonprofit organization that focuses on HIV and tuberculosis, says his teams deployed 37 mobile clinics from Lviv in the west to Kharkiv in the northeast, providing more than 109,000 consultations, testing more than 90,000 people for the communicable diseases, delivering close to 2,000 metric tons of humanitarian aid and medical gear to 200 health care facilities, and connecting with small villages that would otherwise have been abandoned to their fate.
Equipped with bulletproof vests, helmets, and metal detection gear, the Alliance’s staff headed into recently liberated cities and villages, some only a few kilometers from the front line. “We work where nobody else works, where there are no hospitals, no pharmacists, no doctors,” Klepikov says.
When fuel became hard to find last summer, they switched their vans for bicycles. In his office in Kyiv, Klepikov proudly showed me a photo of one of the Alliance’s doctors hand-delivering care in a shelled-out city while riding one of the bikes his organization had provided.
Preliminary data shows that disaster has—for now at least—been averted. At the end of 2021, just two months before the war began, about 132,000 Ukrainians living with HIV were on ART. Since then, the latest available figures show that this number has only slightly dipped to 120,000. Since the onset of the full-scale invasion, Ukraine’s public health sector has connected 12,000 new people to ART. That latest available data from February 2023 also shows that during 2022, more people began taking PrEP (pre-exposure prophylaxis) than in the previous four years
23/06/2023. Medpage today: Ukraine’s Mobile Medical Teams Duck Rockets — Public health expert describes pivot to provide medical aid in war-torn Ukraine.
After 20 years of battling an epidemic of HIV and hepatitis fueled by injection drug use, Tetiana Deshko, PhD, woke up February 24, 2022, to a whole new challenge as director of the Kyiv-based Alliance for Public Health, Ukraine — providing services to a country torn apart by invading Russian forces and bombers.
“The Russian invasion has brought enormous challenges to the Ukrainian health system because war puts the most vulnerable at vastly more risk,” said Deshko, in discussing the health consequences of the war during a press conference at the annual meeting of the European Association for the Study of the Liveropens in a new tab or window.
“Ukraine has succeeded in maintaining core health services in large part due to the selfless commitment of civil society. We fight for our people and our communities, and our victory will be our prize,” she said.
06/06/2023. EURACTIV: Tetyana Deshko, Director of International Programs at Alliance for Public Health, told how the war in Ukraine has created new risks of viral hepatitis infection.
“It’s 1.3 million people, it’s a massive population,” she said.
Moreover, as viral hepatitis does not show symptoms until serious health complications occur, only one in 10 people infected with the hepatitis C virus are aware of their condition, Deshko said. Because of this, the disease is known as the “silent killer”.
23/04/2023. The Sydney Morning Herald: ‘Life goes on’: Meet the Ukrainians who stayed to help the most vulnerable
Nadia Yanhol, whose organisation, the Alliance for Public Health, now operates 25 shelters preventing the spread of HIV, said before the war they were providing harm-reduction services to about 300,000 people a year, but that increased to more than one million since the Russian invasion on February 24 last year.
“Our clients expanded because it was not just simple clients [such as people] who inject drugs or sex workers, it will also be their families, and the shelters needed to have more services. Food. Clothes. A very good psychologist. Support facilities for children and elderly people.”
09/04/2023. Mirror of the week: PROVISION OF MOBILE MEDICAL CARE AS A RESPONSE TO THE CHALLENGES OF WAR
A major challenge for Ukraine’s healthcare system is the return of medical services to the de-occupied areas and regions where the standard model of medical facilities is not possible due to active hostilities. Due to their close proximity to the frontline, residents of many settlements are now effectively deprived of the opportunity to receive the necessary medical care and medicines due to the lack of doctors and pharmacies in these areas. One of the options to ensure access to medical care is to set up mobile medical teams or so-called mobile outpatient clinics. This model has already been implemented in some cases (usually with the assistance of international, volunteer and charitable organisations and foundations).
29/03/2023. EURACTIV: Ukraine’s fight against tuberculosis (podcast)
Marking world Tuberculosis day (24 March) we are talking with two Ukrainians about how Ukrainians are fighting not only Russia’s invasion but also one of the highest incidences of TB cases in the European region.
27/02/2023. Nonprofit: Temporary shelters are a safe place for people fleeing enemy bombs and trying to live on
Currently, the Alliance for Public Health coordinates twenty-five shelters throughout Ukraine and opened its own shelter called Safe Place.
27/02/2023. Nonprofit: War not only causes casualties, but also makes it difficult to treat sick people
The large-scale Russian invasion of Ukraine has caused many critical situations for Ukrainian society, such as damage to civilian infrastructure, government and military buildings, medical facilities, damage to energy systems, etc.
Enormous damage has been done to the healthcare system because now there is an acute shortage of medical workers. Some people have lost their homes, jobs, and relatives, so it greatly impacts mental health…
23/02/2023. CSIS: Ukraine crisis (7 video episodes)
The CSIS Commission on Strengthening America’s Health Security presents Ukraine: The Human Price of War, a short documentary series examining the shocking attack on the country and whether Russian President Vladimir Putin and his armed forces will continue their past behavior in Syria and Chechnya – targeting civilian populations and infrastructure – including the medical sector. Our exploration includes voices of Ukrainians on the ground and leading experts on security, humanitarian issues and international law.
23/02/2023. Nonprofit: One year of the russian invasion in Ukraine: how initiatives and programs of humanitarian assistance to people work
Alliance for Public Health – an organization working on the front lines and fighting for Ukraine and its people.
21/02/2023. AP News: Ukraine’s health care on the brink after hundreds of attacks
Andriy Klepikov runs the Alliance for Public Health, an organization whose mobile clinics reach towns near the front lines. He worries about cases of tuberculosis or HIV that are going undiagnosed, but remains optimistic about his country’s capacity to overcome.
“The health system is (not about) walls or buildings or even equipment. It is about people,” he said. “The Ukrainian military are known for their strength and resilience, but in the area of public health, we are equally strong and resilient.”
Andriy Klepikov is the Executive Director of the Alliance for Public Health in Ukraine and in Dublin to deliver a lecture and meet a Dáil committee. A UKRAINIAN charity worker has spoken of how his colleagues were killed while delivering critical medicines to HIV patients.
“In the territories that are occupied or where active hostilities are taking place, patients cannot get to ART sites to receive medicines, and it is also impossible to send medicines, because the post office and other logistics services do not work,” said Olga Denysyuk, representative of the Alliance for Public Health, to Interfax-Ukraine.
Andriy Klepikov, head of Ukraine’s largest health NGO, the Alliance for Public Health, told Playbook the drone attacks were particularly challenging for people seeking shelter. As terrible as recent missile attacks were, they were comparatively short-lived: The air raid siren lasted for half an hour to an hour maximum. Slow-moving drones mean people have to be holed up in cold, humid bomb shelters for up to five hours at a time, creating conditions ripe for illness, especially for the elderly and children.
Andriy Klepikov, Executive Director of the Alliance for Public Health, a non-governmental organisation that works with The Global Fund in Ukraine and eastern Europe on harm reduction services and treatment for infectious diseases, told The Lancet that it is crucial that The Global Fund is fully funded. “When the Russian war against Ukraine started on Feb 24, 2022, The Global Fund was the first donor to react quickly and effectively [and] provided additional emergency funding to support ongoing programmes.”
“When the war started on February 24, Global Fund was the first donor to react quickly and effectively. Global Fund provided additional emergency funding to support ongoing programs. With its support we saved hundreds of thousands of lives of our clients, patients and their families members. Now it’s time to save 20 million lives. The Global Fund Replenishment is not measured in $ or €. It is measured in human lives and we shouldn’t allow anyone to cross from this list!“, – said Andriy Klepikov, Executive Director, Alliance for Public Health.
Civil society in Ukraine rode bicycles to deliver HIV and tuberculosis medications during a fuel shortage during the Russia-Ukraine conflict; if there were no bicycles, they walked.
Russia’s war against Ukraine includes a “hidden war against evidence-based medicine” that poses a number of threats on the “health battlefield,” said Andriy Klepikov, executive director of the Alliance for Public Health, one of the largest HIV- and TB-focused nongovermental organizations in Ukraine and nearby areas. More so than for HIV or TB treatments, opioid-agonist treatments are most likely to be affected by war-related interruptions, which may have a cascade of consequences for patients with HIV and TB. “Unfortunately, we’re facing the situation in Russia where ideology, prejudice has taken over science, particularly in the area of harm reduction, which is prohibited,” he said at a press conference during the International AIDS Society (IAS) Conference 2022 here. “Methadone, buprenorphine, opioid agonist treatment is prohibited in Russia
01/08/2022. TIMES: How Russian war battered Ukraine’s health system and HIV services overnight
01/08/2022. MOVIMENTO POSITHIVO (Brazil): AIDS 2022: Andriy Klepikov, representative of Ukraine, asks for financial aid for long-term and mental health treatments for Ukrainians, who lives with HIV
APH modified its activities to meet humanitarian needs and provide emergency support. At the beginning of the war, he lost contact with 20,000 people with HIV who were undergoing treatment. It took effort to find these people and motivate them to return to treatment in the midst of an armed conflict.
Executive director Andriy Klepikov said shutting down was not an option during the invasion. Ukraine has one of the most serious HIV epidemics in Western Europe, and patients need their medications daily. He said his group made a “risk management plan” to continue its work if fighting broke out. But it did not envision the scale of the onslaught unleashed by Russian forces, and that has forced the group to adapt.
“What has been gained over these 20 years can be destroyed in days,” Dr. Klepikov said. “We will not allow this — we will fight for sustaining these gains.”
Women who use drugs face particular stigma and discrimination from state organizations and medical institutions, said Tetiana Koshova, regional coordinator in Kyiv for the Ukrainian Network of Women Who Use Drugs. Before the war, the organization helped 50 to 70 women each month, but now that number has doubled, Ms. Koshova said. Ms. Koshova got her diagnosis of H.I.V. in 2006, at age 27, and said she worried about the availability of H.I.V. drugs as the war grinds on. Although warehouses still hold stocks of antiretroviral medicines, “the situation can change in any moment, because rockets fly anywhere and destroy everything indiscriminately,” she said.
The Associated Press writes about the Alliance’s daily hard work to provide patients with treatment.
Ukraine faces many dangers – disruption to healthcare compounds themThe hard-won introduction of effective harm reduction services – led by civil society organisations like our partner in Ukraine Alliance for Public Health (APH) – has dramatically reduced the proportion of infections acquired through sharing needles and other injecting equipment. Indeed, thanks to APH and the community partners they work alongside, Ukraine had been a driving force for harm reduction compared to its neighbours in the region. But these types of services, vital though they are, are likely to be among the first jettisoned as the humanitarian crisis deepens.
In some cities, APH offices have been repurposed as shelters for marginalised groups, while the organisation’s mobile HIV testing units are being deployed to deliver food and medicines, and in some cases to evacuate its clients and their families to safety. As the humanitarian crisis in Ukraine grows, APH is providing a lifeline to thousands of people, including many of those who may struggle to access humanitarian support.
Ukraine’s health crisis: ‘I don’t know what will kill me first – HIV or bombs’An article in the Daily Telegraph about how the war is affecting the lives of HIV-positive people in Ukraine.
Anastasia from Nemishayevo, near Kyiv, found out about her HIV status just before the war. Now she is temporarily living in Vinnytsia and has little left of her medication. “I don’t know what will kill me first – HIV or bombs,” says Anastasia. However, social workers are taking care of her and everything should be fine.
“It’s very scary when the bombing starts, people have to leave their homes in a few minutes, many forget their medicines,” says Andriy Klepikov, Executive Director of the Alliance. – “We estimate that almost 100,000 HIV-positive people (59,000 of whom are on ARV therapy) live in the conflict-affected areas. It is most difficult to provide treatment to those who are in active military areas where they are bombed daily.”
Sky News: Ukraine war: Tens of thousands of people with HIV ‘at risk’ as medicine delivery disrupted by Russian attacks.
Andriy Klepikov, from the Alliance for Public Health, told 59,000 people are on antiretroviral therapy in areas affected by the war, and less than 40% managed to move outside of the war zones so we are talking about tens of thousands of people at risk. Mr Klepikov said: “People with HIV and TB were already vulnerable in normal life but during the war their vulnerability increased many times, and most of the people living with HIV are actually located in the eastern and southern part of Ukraine, affected by war the most.”
Mr. Klepikov told about the deaths of two volunteers trying to continue delivering treatment during the Russian invasion: “It is a very challenging task… so it’s not only governmental agencies and medical facilities but NGOs like mine delivering ART drugs to the patients, it’s difficult and very challenging as we are continuing to do this even in occupied territories.
Ukraine’s Alliance for Public Health is helping patients with HIV/Aids, tuberculosis and hepatitis. Its ambulances are now delivering medicines and food, as well as evacuating people from heavily shelled areas such as the town of Irpin. The charity has also set up a helpline to ensure people can get the drugs they need. The Alliance’s Inna Gavrylova came up with the idea after fleeing with her family to the relative safety of the Ivano-Frankivsk region in western Ukraine.I could not sleep at night,” she said, as she realised those in need of constant treatment were especially vulnerable.
“The safety of his drivers is a major concern for Pavlo Skala, policy director for Ukraine’s biggest health-focused NGO, the Alliance for Public Health. Skala, a former police officer and U.N. peacekeeper, has seen his role change since the invasion. Now he manages APH’s drug distribution operations, overseeing two-dozen drivers and 16 vehicles.
APH vans bring medicines from safe zones like Lviv, near Ukraine’s western border with Poland, to cities like Kyiv and Lutsk. The vans were formerly mobile HIV and tuberculosis labs that have been converted to transport aid. Traveling in convoys of eight to 10 vehicles, each can carry a cargo of 2 metric tons. Supplies are dropped off at a hospital or city center, where local drivers pick them up and bring them closer to the front line. Skala said that deliveries included insulin for diabetics, cancer drugs and HIV medicines — as well as common drugs like paracetamol and ibuprofen. Medicines for people with chronic diseases, who could get sick or die without them, are a priority”.
The hard-won gains made in recent years risk being swept away in days, said Andriy Klepikov, executive director of the Alliance for Public Health.
He leads the biggest health-focused nongovernmental organization operating in Ukraine. APH rolled out the country’s first opioid replacement program, key to getting drug users off street drugs and no longer sharing needles — a major avenue of HIV spread — and into health and social services systems.
The most immediate problem facing officials and activists working in public health is making sure that patients living with disease are able to get ahold of medicines they need.
“Most regions are already under fire and out of treatment medications, or with limited supply already,” said Pavlo Skala, an associate director at APH who is coordinating operations from the organization’s office in Kyiv.
However, the organization has found a new use for special armored vehicles intended for transporting methadone in an innovative project offering substitution therapy to clients in hard-to-reach areas. The U.S.-backed project never had time to get up and running, but with volunteer drivers the vans are evacuating besieged civilians trapped in towns near Kyiv, like Irpen, Bucha and Pushcha-Vodytsia, that are bearing the brunt of the Russian attack on the capital.
“They are going to dangerous places and evacuating people from there,” said Skala.
He had to withdraw from the headquarters in Kyiv, and now Andriy Klepikov is holding the fort in Lviv – and is in contact via the Internet with his seventy colleagues at the “Alliance for Public Health” and their numerous partners at home and abroad. The Ukrainian aid organization is dedicated to fighting AIDS and tuberculosis, TB, and has built up a network of around 3,000 helpers, including doctors, social workers and nursing staff, who have been providing medical care and psychological support to those affected for years. With the ambitious goal of putting an end to both epidemics. It is known that some helpers and patients died as a result of Russian attacks, and there is still no sign of life from others, for example in Mariupol.
So instead of continuing the successes of recent years – further reducing infection rates of HIV or the tubercle bacillus, increasing the number of contacts traced or making sure that TB patients actually stick with their treatment, which 88 percent are now doing, where half used to be gave up – the “Alliance” is now taking on other roles. Among other things, they organize treatment in neighboring countries, distribute food packages or help with papers, and the manager comforts employees who were only able to save themselves from an attack with a backpack, and then found their apartment and car completely destroyed. “It’s not safe here in the West either,” Klepikov wrote last Thursday, sending a photo of a burned-out car to document the aftermath of a rocket attack. The alarm of the sirens is wearing, employees are scattered everywhere, some fled to Poland or Germany, which overrides the usual geographical order for the virtual meetings since the Corona pandemic, but they keep going.
«We are still in shock. No one expected this war. – Andriy Klepikov, executive director of the International HIV/AIDS Alliance in Ukraine, one of the largest organizations dedicated to the fight against this disease in Europe from the East, accuses the blow. In peacetime, he already has a lot to do: Ukraine is the second country in the region most affected by the HIV epidemic, after the Russia
Since the start of the Russian aggression, he and his colleagues have been striving to carry out their missions of prevention and care for the 260,000 HIV-positive people in the country. And this under nightmarish conditions and, until recently, still unimaginable: on April 11, the World Health Organization (WHO) recorded more than 100 attacks against health establishments in Ukraine. More than 40 of them, who provided prevention, treatment and anti-HIV care for thousands of patients, had to lower the curtain.
For patients, in regions controlled by the Russians, or under their fire, access to treatment is now an obstacle course. There is, however, an emergency. “Before the war broke out, the patients received their medication for one, two months, at most. We are more than fifty days into the war. They don’t have any more or almost no more,” alarms Andriy Klepikov from Lviv, in the west of the country. In the event, associations can count on their international partners: thanks to the Emergency Plan of the President of the United States for the fight against AIDS (Pepfar, President’s Emergency Plan for AIDS Relief), a first delivery of more than 18 million doses of antiretroviral drugs – the reference treatment for HIV/AIDS – arrived in Lviv on 6 April. The count is good: the stocks will be enough to cover the needs of Ukrainians living with HIV for six months.
The Alliance for Public Health, a partner of the Global Fund, started distributing drugs for people under opioid agonist treatment.
The work is challenging, and at times life-threatening. In certain regions, or oblasts, deliveries are only possible with the help of volunteers. In particular areas, deliveries are being made secretly, and some NGOs would rather not discuss them for fear of jeopardizing the little openings they have to get medicines there, and to ensure the safety of their volunteers.
Andriy Klepikov, executive director of Alliance for Public Health, one of the largest NGOs in Ukraine focused on HIV and tuberculosis programs, told Devex the situation became even more difficult for many of the people they were assisting before the war. So in addition to the usual core package of services they provide, they’re also trying to assist these people in response to other needs, such as documentation, housing, transportation, or even evacuation. But he said resources are limited, as they are still working with the same level of resources as they did before the war.
“In such a situation, we are hoping that more resources will be provided, in addition to some flexibilities [already provided] by some donors like the Global Fund,” he said.
Епізод другий документального фільму “Ukraine: The Human Price of War (Україна: Ціна війни у людських життях)” Центру стратегічних і міжнародних досліджень we hear from besieged Ukrainian health and humanitarian organizations and explore the increasing brutality of the Russian military’s barbaric offensive and the reasons behind it with International Rescue Committee President & CEO David Miliband, Insecurity Insight and Aid in Danger Project Director Christina Wille, Ukrainian Medical Club International Communication Manager Alla Soroka-Krotova, Alliance for Public Health Executive Director Andriy Klepikov, CSIS International Security Program Director and CSIS Senior Vice President Seth Jones and CSIS Global Health Policy Center Director and CSIS Senior Vice President J. Stephen Morrison.
Episode three of the documentary “Ukraine: The Human Price of War” by the Centre for Strategic and International Studies reveals Russia’s strategic failure to capture Kyiv, in particular how it has contributed to the growth of terror and atrocities against civilians. Mariupol and Bucha have become symbols of Russian barbarism, as it has become clear that Putin and his commanders are committing war crimes. The second stage of the war began: a campaign of devastation to the southeast.
The episode featured: Susan Glasser, a staff writer for The New Yorker; Dr Anna Kukharuk, a paediatrician at the Zhytomyr Central Children’s Hospital; Nick Shifrin, a foreign affairs and defence correspondent for PBS Newshour; Andriy Klepikov, executive director of the Alliance for Public Health; Dmytro Sherembey, Chairman of the Coordination Council of the 100% Life Network; Marty Flax, CSIS Khosravi Chair and Director of the CSIS Human Rights Initiative; Natasha Hall, Senior Fellow, CSIS Middle East Program; Seth Jones, Director of the CSIS International Security Program and Senior Vice President at CSIS; and J. Steven Morrison, Senior Fellow, CSIS International Security Program. Stephen Morrison, Senior Vice President at CSIS and Director of the CSIS Center for Global Health Policy.
“For 30 years now, the whole world has been celebrating World AIDS Day, and this year it is being held under the slogan ‘Find out your status’. This is how a marathon of free events was organised in Kyiv, one of which was the “Test under the Clouds”. For the first time in Ukraine, the test was conducted at an altitude of over forty metres. We used new technologies to get a quick result, and we used an express test that does not require blood donation and is painless.”
“There are ART drugs in Ukraine”, Zahedul Islam, Director of Treatment at the Alliance for Public Health NGO, told The Lancet HIV. “But they are just not available in some places, for instance warehouses where they are stored are not accessible due to security problems, or infrastructure damage makes them inaccessible.”
Islam said discussions were underway between the Ukrainian government and other organisations, including APH, on creating an external supply of drugs that could be stored in a safe location and given to patients. .
However, despite the difficult situation they are in, some are refusing to give up on providing services, especially support services such as harm reduction. Павло Скала, Policy Director at APH, is still working in Kyiv, handing out syringes and condoms to anyone that needs them. He says he knows this is no more than a basic prevention service, and a fraction of the services he and others at APH provided before the invasion, which included mobile testing, OAT, and other support for key vulnerable populations, but he can do little else. He now spends much of his time delivering humanitarian aid and helping evacuate people in danger zones. “It’s basically just running a survival operation here. We are helping anyone we can—relatives and children of our clients, basically anyone. We aren’t checking the HIV status of people we are helping”, he told The Lancet HIV.
THE LANCET
The Lancet magazine published an article about the threatening situation with tuberculosis in Ukraine and Europe due to the military operations in our country.
In the article, the Alliance for Public Health and partners from the Donetsk Regional Organisation of the Ukrainian Red Cross Society share their experience of working on TB control and support for people with TB in the context of war over the past month, as well as the warnings they see in the current circumstances.
Evgenia Geliukh of the Alliance for Public Health, one of the biggest non-state organisations involved in Ukraine’s TB response, said: “Before, we and our partners provided a wide spectrum of services, but now in some places it’s just checking that TB patients are sticking to their regimen, and in some places finding active TB cases has stopped”.
The guests of the podcast “Ukraine and HIV: Health on the Frontlines” are Andriy Klepikov, Executive Director of the Alliance for Public Health, Valeria Rachynska, Director of Human Rights, Gender and Community Development at the CO “100% Life” and Michel Kazachkin, World Health Organization Regional Advisor and former UN Secretary-General’s Special Envoy on HIV in Eastern Europe and Central Asia. In this episode, the guests discuss how the Russian invasion is affecting the rapid spread of the HIV/AIDS epidemic in Ukraine. And in a region with an already rapidly growing HIV epidemic, this could be a public health disaster.
18/12/2018. Evening Standard: “AIDSfree appeal: How your donation will help lost generation of children in Ukraine”A boom in recreational drugs and ignorance of safe sex is fuelling Eastern Europe’s second worst HIV epidemic in Kiev, Ukraine. According to the Alliance’s internal statistics, recreational drug use has increased by 40 per cent over the last four years alone, with much of that increase down to Kiev’s expanding clubbing scene. This in turn has opened a new front for HIV and other sexually transmitted infections.
18/12/2018. Independent: “Kiev’s children of the revolution: teens, drugs and HIV”The 2014 revolution gave Ukraine a new lease of life. But for many of its children, the upheaval came at a cost, introducing them to a dangerous world of drugs and even sex services.
21/10/2018. KyivPost: “Global effort to eradicate tuberculosis, the infectious disease that burdens Ukraine, still has long way to go”Tuberculosis took center stage for the first time at the United Nations in September, in the first United Nations high-level meeting devoted to this infectious airborne disease that killed 1.6 million people worldwide last year. Held on Sept. 26 alongside the United Nations General Assembly in New York, the meeting was intended to unite countries in a declaration of political will to tackle the leading causes of TB’s spread: poverty and instability; insufficient funding; outdated diagnostic and treatment models, and slow development of new technologies.
14/08/2018. Online media “l’Européenne de Bruxelles”: Ukraine on the edge of fight against hepatitis C
Viral hepatitis nowadays is one of the biggest global health threats, still rarely being in focus of the media. While internationally 9 out of 10 people living with viral hepatitis do not know their status, Ukraine makes no exception. Moreover, Ukraine is the only European country appeared on the WHO alarming list of 28 countries accounting for 70% of the viral hepatitis burden in the world.
13/09/2018. IDHDP: “7th City Health 2018”
“The 7th City Health conferences will take place in Odesa (Ukraine) 13/14 September 2018. The event is hosted by Alliance for Public Health (Ukraine), AFEW International (Netherlands) and the City of Odesa, in association with Knowledge-Action-Change (United Kingdom)”
13/09/2018. Online media “Stadt und Gesundheit”: “7th International City Health Conference 2018 – Developing healthy responses in a time of change”
“The 7th in the series of City Health conferences will take place in Odesa (Ukraine) on 13thand 14th September 2018. The conference-theme 2018 is “Developing healthy responses in a time of change”