On December 1, the World AIDS Day is observed for the 30-th time around the world.

This year, this day is held under the slogan #Know your status (#ДізнайсяСвійСтатус), because the timely testing of HIV becomes increasingly important throughout the world. 37 million people live with HIV, but at least 9 million of them are not even aware of their HIV-positive status.

This trend is also characteristic for Ukraine – according to official data, as of October 2018, there are 144.6 thousand HIV-positive people enrolled in the dispensary record, although their estimated number exceeds 240 thousand. Thus, almost half of those living with HIV in Ukraine are unaware of their status and, therefore, cannot receive efficient treatment in a timely manner, maintain their health and prevent the transmission of HIV to other people. That is why it is important to popularize regular and timely HIV testing as widely as possible, both among most-at-risk populations and the general population.

The Alliance for Public Health has been testing MARPs for over 10 years, and more than 250,000 people get tested each year due to our activities. This has been made possible by one of the largest HIV prevention programs in the world, enabling 300,000 people who are most vulnerable to infection to receive the necessary prevention services. The next year will become a turning point for this program, which is in line with best international practices and has already made it possible to reduce the number of new HIV cases – the program funding is transferred from the Global Fund to Fight AIDS, Tuberculosis and Malaria to government budget. This is also a pivot point for the Alliance, as we share our experience and best practices. We support state policy on the availability of HIV testing at health facilities at all levels.

The Alliance, based on the recommendations of the World Health Organization, has been introducing the practice of HIV self-testing for several years now. Nowadays a wide range of high quality and accurate rapid tests are available, using both capillary blood and saliva. This test is very easy to do at home and find out the result in 15 minutes, one can just buy it at the pharmacy. To help people choose from among the tests of different manufacturers, the Alliance has prepared detailed guidance on various types of tests available in Ukraine. They can be found at www.selftest.org.ua. Here you can also obtain information on where to get quick tests, what to do in case of a positive result, how to receive free and effective treatment, if necessary.

Ukraine’s successful experience in implementing comprehensive HIV prevention and treatment programs has become exemplary for the entire region of Eastern Europe and Central Asia. This year, the Global Fund has supported a new project of consortia of organizations headed by the Alliance on working in 14 countries. This is the largest regional HIV project that will start on January 1 next year. The Alliance continues its active work on combating the epidemic!

From November, 12 to 16, the Alliance for Public Health had training for members of Harm Reduction Academy that arrived from different parts of the world. We exchanged about most effective solutions on HIV response among PWID, integration with other health agendas, financing interventions.

Our participants from Bosnia and Herzegovina, Ethiopia, India, Macedonia, Romania, Serbia, Tanzania, UK represent public health institutes, municipalities, international organizations with a richness of background and experience to help leverage global response to HIV among PWID.

This time we had several participants from Southeast Europe countries who are in the middle of transition of HIV programs from donor funding to national funding — the challenging path that Ukraine is making these days — and we learned from their experiences of successful and not so strategies.

In order to strengthen the partnership network with state institutions, namely, the Ministry of Youth and Sports of Ukraine and oblast state administrations, the ICF “Alliance of Public Health” on November 14-16, 2018, held a seminar for partners – public and youth and other institutions and organizations – in the Dnipro Children’s Recreation Camp in Kozyn town of Kyiv oblast.

The holding of this event is extremely important in the context of the transition of the program transition from Global Fund support to public funding and in the context of the reforms that are currently taking place in Ukraine.

During the seminar, the specialists got acquainted with the state program “Youth of Ukraine 2016-2020”, the study on the youth situation, the program “Youth worker” and the activities of the Association of Youth Centers.

The workshop was organized by the Alliance to engage its partners as active participants in state programs aimed at improving the health of young people. This activity includes prevention actions and ensuring rights of representatives of key populations, prevention and treatment of HIV/TB and other socially dangerous diseases.

The workshop reviewed the conditions and criteria for funding under the Youth of Ukraine 2016-2020 Program, the competition announcement and financing deadlines, established for each region of Ukraine.

The Alliance expresses its appreciation to all the partners involved in this event and the co-organizers of the event: the Department of Youth Policy of the Ministry of Youth and Sports of Ukraine and the team of the Kyiv Regional Youth Center.

On November 6, with the support of the ICF “Alliance of Public Health” a round table was held in the Ukrainian Parliament on the occasion of the first anniversary of the Parliament Platform to Fight Tuberculosis.

Representatives of the Ministry of Health of Ukraine, the Public Health Center, the ministries of Justice and Social Policy and other national institutions, international organizations, civil society and patients’ organizations together with parliamentarians discussed the most important issues dedicated to TB control in Ukraine. As well, the following topics were highlighted during the meeting: the state policy in fight against TB, development and implementation of a multi-sectoral accountability mechanism after UN High-Level Meeting on TB and Strategic Plan on advocacy, communication and social mobilization.

MP Sergiy Kiral, the Head of the Parliament Platform to Fight Tuberculosis told that the success achieved by the parliamentary association during the first year of activity was the result of a joint work. The role and importance of civil society organizations and their capacity in overcoming the epidemic in Ukraine were noted during the meeting.

Significant work in the area of TB control is carried out by the ICF “Alliance of Public Health”, which is the focal point of the civil society organizations to work with the Global TB Caucus in Ukraine.

Zahedul Islam. Director: Treatment, Procurement & Supply management, on behalf of civil society expressed gratitude to the Head of the Parliamentary Platform for the openness to cooperation and prominent results achieved during the year.

Opioid substitution therapy is the efficient method of opioid dependence treatment and one of the most efficient HIV/AIDS prevention ways. Currently the state takes leadership in OST program development and fully ensures the procurement of medicines.

To improve the quality and efficient treatment of opioid dependence, the ICF “Alliance of Public Health” in cooperation with the U.S. Centers for Disease Control and Prevention (СDС) and with the support of the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and by the technical support of the UNODC office in Ukraine translated into Ukrainian and published the «National Guidelines for Medication-Assisted Treatment of Opioid Dependence», of the Department of Health of Australia 2014).

Currently the printed copies are being delivered to HCFs, and the electronic version of the Guidelines is available at the link.

Thus, HCFs will be able to use this document on the facility level after its approval by the internal order of the HCF (according to the provisions of the Decree of the MoH of Ukraine No. 1422 dated 29.12.2016).

We express our gratitude to all partners contributing to the improvement of OST quality and sustainability in Ukraine – Public Health Center of the MoH of Ukraine, UIPHP, the Network of PLWH, UNODC, PEPFAR, civil society organizations and associations.

Andriy Mykhaylovych Yarovoi,  b. 06/11/1967, a citizen of Ukraine from the city of Kyiv, since 27 August 2018 he has been kept prisoner in the city of Luhansk. He is currently kept in an underground prison of so-called “Ministry of Security of the LNR” on suspicion of drug smuggling according to part 3 of article 282 of “criminal code of the LNR”. His alleged smuggling involved officially registered in Ukraine substitution maintenance therapy (SMT) drugs — buprenorphine hydrochloride, a 10-day stock of which he had legally received at Kyiv City Narcologic Hospital “Sociotherapy”. Andriy Yarovoi has been an SMT patient since 2009.

Andriy Yarovoi has worked as an advocacy coordinatory of All-Ukrainian Association of People Living with Drug Dependence (VOLNA, Kyiv), a consultant on monitoring of accessibility of HIV/AIDS prevention and treatment at ICF “Alliance for Public Health”. He is a member of the Steering Board of Eurasian Network of People who Use Drugs (ENPUD, Vilnius) and holds membership in Eurasian Harm Reduction Association (EHRA, Vilnius).

Recently, Andriy has been given opportunity to talk to his lawyer and receive necessary items and food.

We will be grateful to all local, national and international organizations or persons for their support and actual efforts and actions aimed at his release and soonest return to Kyiv.

Your support and help could include the following:

• writing letters/petitions (“to whom it may concern”)
• informal personal negotiations with any persons that may facilitate release of A. M. Yarovoi or alleviation of his confinement conditions
• spreading this information among people and organization that may facilitate his release

Contact phones: +380503825178 or +380503894674

Thank you very much for your help and support!

On October 18-20, the 18th National LGBTI Conference of Ukraine, a national scale event, takes place in Kyiv. The event brought together more than fifty hundred male and female activists of the civil society movements pursuing human rights and freedoms for lesbian, gay, bisexual, transgender and intersex people; experts on epidemic well-being; specialists involved in ensuring access to medical and social services for gay, bisexuals and trans* people; representatives of many partner organizations and international assistance projects to Ukraine. The event takes place at the initiative and with the support of the ICF “Alliance of Public Health” and a number of other partners.
“The purpose of this all-Ukrainian gathering is to determine the priorities of the LGBTI movement in the human rights and health sector, as well as to include the LGBTI issue on the political agenda”, said Andriy Chernyshev, the coordinator of the preparation of the national conference, a representative of Kyiv civil society organization “ALLIANCE.GLOBAL”.
“The Country of Free People: Equal Opportunities for All” is the motto of this year’s national LGBT-conference. The versatile program of the 18th Conference included in-depth discussions on the development of the LGBT-movement, the report on the latest national and regional achievements related to health and community access to health and social services, presentations with the results of the innovative revolutionary research. This year’s innovation is that a number of sections of the National Conference are open to all interested parties, however, upon preliminary registration.
A significant number of studies and reports at the Conference will address the health of LGBTI community, in particular, post-exposure prevention, or PrEP, the cutting-edge HIV prevention method for the most sexually active people, which has already gained wild popularity in Western Europe and is beginning to conquer Ukraine. The participants will learn about the main trends in the spread of HIV and choose strategies to foster a friendly attitude of doctors to LGBTIQ patients.
“The Alliance of Public Health was one of the two co-organizers of the First National LGBTI Conference of Ukraine. Since then, more than 10 years have passed, but we continue to support and develop the LGBTI movement in Ukraine. The Alliance was the first in Ukraine to introduce pre-exposure prevention (PrEP) in Kyiv from November 2017 and is continuing this activity. The CDC funded 100 annual courses for men who have sex with men and for transgender people. Moreover, within this project, 1,500 annual courses were procured for the further scale-up of PrEP in other Ukrainian cities”, said Pavlo Skala, Associate Director: Policy and Partnership of ICF “Alliance of Public Health”.

The Conference will also focus on systematic analysis of the human rights situation for LGBTI in Ukraine and information on Ukraine’s successful implementation of the recommendations of the United Nations Global Commission on HIV and the Law on the protection of human rights and freedoms for LGBT people.
A lot of attention at this year’s Conference will be devoted to building trust and cooperation with political parties, because sooner or later open representatives of the LGBTI community will have to sit in the Parliament and the Government. Methods of addressing homophobia and transphobia will be discussed in detail. The topic of the rising Pride Movements will become a special highlight of the Conference, since this year, the Marches of Equality took place not only traditionally in Kyiv and Odesa, but also in the city of Kherson, the pearl of the South of Ukraine, and Kryvyi Rih, one of the major mining industry hubs.
The family topic will be profoundly explored debated in a brainstorming on the prospects of marital partnerships for LGBTI in Ukraine and in the therapeutic “momma-therapy” session, where parents of LGBTI children will share their stories. The voice of youth and adolescents will have a special prominence, whose representatives will talk about their motivation in activism, and “adult” LGBTI-organizations will include in their agenda a sensitive topic of work in the interests of LGBTI youth and teens.
Transgender people will speak in a narrow circle of stakeholders about the barriers to access to health services and the problems of the visibility of trans-communities in Ukraine. A plan to host the European Lesbian Conference in the Ukrainian capital will be presented to homo- and bisexual women.
A constellation of foreign guests was invited to participate in the landmark 18th Ukrainian LGBTI Conference. Among them are the LGBTI-organization “Da se zna!”, which resists hate crimes in Serbia; one of the leading LGBT organizations in Central Asia, Kyrgyz Indigo; a representative of the international organization Women`s March Global, a well-known Canadian transgender activist Mrs. Michelle Emson, as well as activists and activists, specialists and specialists from Sweden, Estonia, Latvia and Armenia.
The initiators and partners of the 18th National LGBTI Conference are the following organizations and projects: CO “100% Life”, National MSM Consortium founded this year by the NGO “Alliance.Global”, the League of LGBT “LIGA” Association and the “Gay Forum of Ukraine”, the Eurasian Coalition for Male Health (ECOM), KyivPride civil society organizations, Fulcrum-UA and Gay Alliance Ukraine, HPLGBT Transgender Self-Organization, National Democratic Institute for International Relations, USAID “HIV Reform in Action” international technical support project, Freedom House, Inc. in Ukraine, the United Nations Development Program (UNDP), the Joint United Nations Program on HIV/AIDS (UNAIDS), the International Charitable Organization “East Europe and Central Asia Union of People Living with HIV”. Importantly, for the first time in the history of national conferences, this year’s event is supported by the state represented by the Center for Public Health of the Ministry of Health of Ukraine.
“An extremely wide range of organizations and projects that support the National LGBT Conference politically or in terms of resources, including government bodies, demonstrates the commitment of our country to the transformative pursuit of human rights for all citizens, regardless of gender identity and sexual orientation, that Ukraine is strongly determined to take comprehensive efforts to support epidemic well-being among bisexuals, transgender people and gay people, which, by the way, are hundreds of thousands of citizens of Ukraine”, Svyatoslav Sheremet (photo),National Coordinator of the MSM Consortium on Policy and Legislation.
National LGBTI Conferences are held in Ukraine regularly since 2008, complementing the Ukrainian pride events as the key catalyst for the national LGBT-movement, which was recognized by the President among one of the top ten political and social movements of our country in his annual appeal to the Verkhovna Rada of Ukraine.

On September 26, 2018, Alliance for Public Health held a final meeting of the partners involved in implementation of the project “Scaling up Accessible and Effective HCV Treatment Through a Community-Based Treatment Model for Most Vulnerable Populations in Resource-Constrained Ukraine” to present the results of the most large-scale program of hepatitis C treatment in Ukraine. Speeches were delivered by representatives of the Ministry of Health (MoH), the World Health Organization (WHO), the Public Health Center of the MoH of Ukraine, and the US Centers for Disease Control and Prevention (CDC). In the course of interactive discussions, doctors and representatives of civil society organizations shared their experience in treatment and support of the project patients. Success stories of the happy patients cured thanks to the project moved all those present at the meeting.

Until recently, treatment of hepatitis C-infection was not on the donors’ list of priorities: none of the international donors funded hepatitis C treatment, while substantial funding was allocated for HIV treatment. However, with no hepatitis C treatment available thousands of members of key populations were doomed to death. The main obstacle for funding was an exorbitant price of the modern therapy – in United States it was as high as USD 86,000 per three-month course.
However, Alliance for Public Health was able to turn the tide in 2014. Thanks to our persistent and targeted efforts, we managed to ensure the price of hepatitis C treatment at 1% of its cost in the United States. For Ukraine, it was a tipping point in hepatitis C-infection treatment – by purchasing the first consignments of drugs at USD 300 per pack, Alliance set the bar for further drastic decrease of public procurement prices. Today, this price remains unchanged – one course of treatment with original drugs (for 3 months) per person costs the Ukrainian government about USD 900. This price is one of the lowest in the world to purchase modern drugs for hepatitis C treatment. At the meeting Michael Martin from the US Centers for Disease Control and Prevention pointed out that in the United States one tablet of direct-acting antivirals (DAAs) costs one thousand US dollars.

The unique hepatitis C treatment project implemented by Alliance was highly praised by the World Health Organization and the Ministry of Health of Ukraine. Dr Oleksiy Bobryk from the WHO underlined that Alliance was the first to build the foundation for further scale-up of hepatitis C treatment at the national level.
It was Alliance who started using highly effective treatment of hepatitis C with direct-acting antivirals within its project “Scaling up Accessible and Effective HCV Treatment Through a Community-Based Treatment Model for Most Vulnerable Populations in Resource-Constrained Ukraine” when almost nobody in Ukraine heard about it. Alliance was the first to introduce not only Sovaldi, but even a more innovative drug – Harvoni – within this project. The advantage of those drugs is that they are well tolerated by patients and have almost no side effects, while demonstrating very high treatment success rates! Alliance used those innovative drugs to treat high-priority populations: members of the most marginalized groups with complicated forms of hepatitis C-infection.

2,162 patients from among the key populations received hepatitis C treatment with direct-acting antivirals throughout 2015-2018. The biggest achievement of the project was a high treatment success rate at 95%! Those incredible results have been recognized at the international level. Before, treatment success rate of the old regimens used in Ukraine for hepatitis C treatment did not exceed 50%.
Most of the drugs used to treat 2,162 patients were donated by Gilead.
Besides, an international advisory board consisting of globally recognized experts was established within the project “Scaling up Accessible and Effective HCV Treatment Through a Community-Based Treatment Model for Most Vulnerable Populations in Resource-Constrained Ukraine.” Those experts were involved in the development of the project guidelines, which are currently used as the basis for the current national protocol of hepatitis C treatment.
In 2017, for the first time in Ukraine prisoners also got access to hepatitis C treatment. Within the program, Alliance successfully treated 50 patients in penal settings.

“This is the first time we use this new and unusual term – trendsetter – to describe this project of Alliance. The project for the first time allowed to access innovative treatment with direct-acting antivirals – Sovaldi and Harvoni, reduce the price for modern drugs, implement such a large-scale hepatitis C treatment program in Ukraine, ensure access to the therapy in penal settings, and achieve an incredible treatment success rate of 95%! Those are the trends, which the government not only can, but also must take over and develop! The Alliance project gave us all the evidence necessary to approve a strategic action plan to eliminate hepatitis in Ukraine,” sums up the project successes the Executive Director of Alliance for Public Health Andriy Klepikov.

Alliance would like to thank all those involved in project implementation: Public Health Center and the Ministry of Health of Ukraine, State Penitentiary Service, WHO, CDC, The Global Fund, Gilead Sciences, Yale University as well as all infectious disease doctors, partner organizations and patients. This is our joint victory!

Revolutionary changes in the fight against Tuberculosis in Ukraine were presented in a  joint country document, which you can find below

Alliance for Public Health has joined the country’s document and contributed to the creation of this documents with materials, in particular :

-Improving the MDR TB treatment outcomes (from 40% cured in routine practices to 79 % in pilot settings)

-New models of health care funding that stimulate the transition on TB treatment in outpatient settings and the introduction of a pay-for-performance mechanism (motivation payment)

-Due to the introduction of early detection methods, diagnosis time of MDR TB has shortened from 35 to 2 days

-New medicines for TB treatment : innovative anti-TB medicines (including Bedaquiline) are registered and being used

-A newly created Parliamentary Platform to Fight Tuberculosis

Analytical materials on TB (ukr.)

Analytical and statistical guide (ukr.)

On Wednesday, September 26, 2018, in New York City the UN High Level Meeting on TB (UN HLM)  will be held for the first time in which the Executive Director of  the Alliance for Public Health participating as a member  of the national delegation on behalf of  civil society organizations.

UN HLM  is an unique opportunity to present the achievements, discuss current challenges, and create opportunities for actual implementation of the political commitments undertaken by the countries

Taking this opportunity International HIV/AIDS Alliance, whose global network/family includes the Alliance for Public Health, calls on world leaders to prioritized involvement and effective participation of civil society and communities in the fight against tuberculosis.

Full text ‘’ International HIV/AIDS Alliance Call for TB Strategic Priorities”, which was signed by 35 organizations from  dozens of countries.