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03/12/2022. TheJournal.ie: Ukrainian charity worker speaks of colleagues deaths in missile attack
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.
Про щоденну нелегку роботу Альянсу, спрямовану на забезпечення пацієнтів лікуванням пише Associated Press.
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’Стаття у Daily Telegraph про те, як війна впливає на життя ВІЛ-позитивних людей в Україні.
Анастасія з Немішаєвого, що неподалік від Києва, довідалась про свій ВІЛ-статус перед самою війною. Зараз вона тимчасово проживає у Вінниці – і у неї залищилось небагато препарату. “Я не знаю, що мене вб’є першим – ВІЛ чи бомби», – каже Анастасія. Втім, нею опікуються соціальні працівники і все має бути добре.
«Це дуже страшно, коли починається бомбардування, люди мусять покинути дім за декілька хвилин, багато хто забуває ліки, – каже виконавчий директор Альянсу Андрій Клепіков. – Ми підрахували, що майже 100 000 ВІЛ-інфікованих (з них 59 000 отримують АРВ-терапію) живуть у районах, які постраждали від конфлікту. Найважче надати лікування тим, хто знаходиться на діючих військових територіях, де їх щодня бомбардують».
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.
Епізод третій документального фільму “Ukraine: The Human Price of War (Україна: Ціна війни у людських життях)” Центру стратегічних і міжнародних досліджень розкриває стратегічну неспроможність росії захопити Київ, зокрема те, як це сприяє росту терору та звірств проти мирного населення. Маріуполь і Буча стали символами російського варварства, як і стало зрозуміло, що путін і його командири здійснюють військові злочини. Розпочався другий етап війни: похід на спустошення на південний схід.
В епізоді взяли участь: Сьюзен Глассер, штатний письменник The New Yorker; д-р Анна Кухарук, лікар-педіатр Житомирської центральної дитячої лікарні; Нік Шифрін, кореспондент із закордонних справ і оборони в PBS Newshour; Андрій Клепіков, виконавчий директор Альянс громадського здоров’я Alliance for Public Health; Дмитро Шерембей, голова Координаційної ради «100% життя» – Мережа ЛЖВ; Марті Флакс, голова CSIS Хосраві та директор CSIS Ініціативи з прав людини; Наташа Холл, старший науковий співробітник програми CSIS на Близькому Сході; Сет Джонс, директор програми міжнародної безпеки CSIS і старший віце-президент CSIS; та Дж. Стівен Моррісон, старший віце-президент CSIS і директор Центру глобальної політики охорони здоров’я CSIS.
«Уже впродовж 30 років увесь світ відзначає Всесвітній День боротьби зі СНІДом, цього року він проходить під гаслом «Дізнайся свій статус». Від так у Києві влаштували марафон безкоштовних акцій, одна з яких «Тест під хмарами». Уперше в Україні провели тест на висоті більше сорока метрів. Скористалися новими технологіями, для швидкого результату, використали експрес-тест, який не потребує здачі крові і є безболісним»
“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.
В журналі The Lancet опубліковано статтю про загрозливу ситуацію з туберкульозом, що склалася в Україні та Європі через військові дії на території нашої країни.
В статті Альянс громадського здоров’я та партнери з Донецької обласної організації Товариства Червоного Хреста України діляться своїм досвідом роботи з протидії ТБ та підтримки людей з туберкульозом в умовах війни протягом останнього місяця, а також пересторогами, які вбачають в нинішніх обставинах.
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”.
Гості подкасту «Україна та ВІЛ: здоров’я на передовій» – Андрій Клепіков, Виконавчий директор Альянсу громадського здоров’я, Валерія Рачинська, Директор з питань прав людини, гендеру та розвитку спільнот БО «100% – Життя» та Мішель Казачкін, радник Всесвітньої організації охорони здоров’я в регіоні та колишній спеціальний посланець Генерального секретаря ООН з ВІЛ у Східній Європи та Центральної Азії. У цьому епізоді гості розповіли як російське вторгнення впливає на стрімке поширення епідемії ВІЛ/СНІДу в Україні. А в регіоні з уже швидко зростаючою епідемією ВІЛ це може стати катастрофою для громадського здоров’я.
https://www.news24.com/health24/podcasts/podcast-hiv-unmuted-ukraine-and-hiv-health-on-the-frontlines-20220422
https://www.poz.com/blog/hiv-unmuted-ukraine-hiv-health-frontlines#search-query=andriy%20klepikov
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 to Fight AIDS, Tuberculosis and Malaria,” he said.
The Ukraine-based humanitarian organization has operated for more than 20 years. It has received millions of dollars from the U.S. Agency for International Development as well as the Centers for Disease Control and Prevention, and other federal programs to counter HIV globally.
Додатково:
Ще були такі матеріали про роботу Альянсу:
The Lancet від Ed Holt:
– https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00214-6/fulltext
– https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(22)00064-9/fulltext
– https://www.sciencedirect.com/science/article/pii/S2468266722000834
https://www.independent.co.uk/news/world/europe/ukraine-russia-hiv-aids-war-b2051692.html
https://www.unaids.org/ru/resources/presscentre/featurestories/2022/april/20220422_odesa
A crisis of faith’ in the U.S. global Covid response https://www.politico.com/newsletters/global-pulse/2022/04/07/a-crisis-of-faith-in-the-u-s-global-covid-response-00023574
Цитують Андрія: https://dnevnik.hr/vijesti/svijet/rat-u-ukrajini-3-travnja-2022—717961.html
11:11 “Dvije osobe poginule su u napadu na vozilo humanitarne pomoći“, rekao je Andriy Klepikov, izvršni direktor Saveza za javno zdravstvo. Njegova organizacija isporučuje lijekove za HIV pacijente i nastavlja to činiti čak i na okupiranim područjima.
On je u nedjelju rekao da je takav zadatak postao opasan, ispričavši kako je vozilo partnerske organizacije koje je prevozilo volontere i pomoć granatirano na putu prema Černihivu.
Во время родов из-за пандемии украинское правительство начало выплачивать лекарства от ВИЧ и туберкулеза в течение трех месяцев. Однако многие украинцы, которые были вынуждены покинуть свои разрушенные города, смогли взять только ограниченные запасы лекарств, необходимых для выживания. Считается, что по меньшей мере 1200 человек с туберкулезом покинули Украину.
Альянс за общественное здравоохранение, некоммерческая организация, помогает более чем 400 из этих пациентов в таких странах, как Польша и Молдова. ВОЗ также подготовила резерв противотуберкулезных препаратов в Польше для беженцев из Украины. Но большинство беженцев – женщины и дети, в то время как большинство украинцев с лекарственно-устойчивым туберкулезом – мужчины, которые должны оставаться в стране и бороться, по словам Андрея Клепикова, исполнительного директора альянса.
В стране члены Альянса доставляют лекарства больнейшим в городах, где все еще можно путешествовать, и отправляют лекарства по почте в общины, где все еще работают почтовые отделения.
Более одного из четырех новых случаев ВИЧ-инфекции в Украине происходит среди примерно 350 000 потребителей инъекционных наркотиков в стране. До войны украинская политика снижения вреда позволила более 17 000 своих граждан получить так называемую опиоидную заместительную терапию.
Новий матеріал от Єд Холт
https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(22)00134-5/fulltext
https://www.youtube.com/watch?v=u0hP7BcPAwc
Укhаїна:
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”