On September 19-20, a regional working meeting on Pandemic Preparedness, Migration, and Health: Innovations and Adaptation of Global Fund Grants to Migration Realities in Eastern Europe and Central Asia (EECA) was held in Samarkand.

The meeting was attended by the leaders of the Sanitary and Epidemiological Wellbeing and Public Health of the Republic of Uzbekistan, the national and regional AIDS centers, representatives of the Global Fund, IOM, UNDP, EJAF, GIZ, WHO Euro, UNAIDS, the Alliance for Public Health, AFEW, REG, as well as international experts and representatives of organizations from EECA region countries, including Armenia, Albania, Afghanistan, Georgia, Kazakhstan, Moldova, Kyrgyzstan, Kosovo, Tajikistan, Montenegro, Uzbekistan, and Ukraine.

A special focus was placed on speeches by two Ukrainian women, Natalia and Iryna, along with Iryna’s 9-year-old daughter, who were forced to move to Poland due to the war. Natalia shared her personal experience of living with HIV in the context of migration. She spoke about how she initially became a client and later a consultant and activist for the #HelpNOW HUB, helping other Ukrainians facing similar issues. Iryna shared the tragic story of her family, which lost their father to multi-drug resistant tuberculosis, while her young daughter continues to battle the disease. The presence of the little girl deeply moved all participants. These stories highlighted the incredible challenges Ukrainian refugees face when seeking medical help in foreign countries, such as language barriers, unfamiliar legal systems, and bureaucratic obstacles.

Dumitru Laticevschi, Regional Manager of Eastern Europe and Central Asia Team, The Global Fund, said that the experiences presented at the meeting regarding work with migrants would influence the development of new grant programs. He emphasized the importance of this work in achieving global HIV/AIDS and tuberculosis goals in the region. Migrants are not just program clients; they are people with diverse needs who often face significant challenges adapting to new living conditions. One of the main barriers to receiving necessary medical care is the language barrier, as people tend to delay seeking medical assistance without understanding the language.

Tatiana Deshko, Director of the International Programs Department of the Alliance for Public Health, presented the experience of the regional project #SoS 2.0 (2022-2024). She outlined approaches to ensuring service continuity for migrants at a cross-border level. From 2022 to 2024, Ukraine experienced an unprecedented migration crisis, with over 8 million Ukrainians forced to leave their homes, marking the largest population movement in Europe since World War II.

As a relevant example, Tatiana Deshko shared the lessons learned from the #HelpNOW HUB platform, which assisted 37.5 thousand Ukrainians in 50 countries worldwide between 2022-2023. This platform connected migrants receiving HIV, TB, and addiction treatment with services both within and outside Ukraine. She emphasized the following key points:

1. The Importance of Humane State Migration Policies: The policies of host countries play a crucial role in the treatment of migrants. The EU and Moldova, for example, became models of support for HIV and TB patients, particularly those from Ukraine.

2. The Critical Role of Digital Solutions: Digital platforms such as #HelpNOW HUB and the telemedicine service Help24 were pivotal in providing assistance to migrants. For example, Telegram became one of the most popular messengers for communicating with the #HelpNow service. However, in countries with established hotline infrastructures (Poland, Germany), 60% of inquiries were received through traditional hotlines, indicating that a combination of digital and conventional communication channels is most effective.

3. The Human Factor and the Development of AI Consulting Technologies: Personal communication with consultants remains vital for providing comprehensive support to migrants. At the same time, innovative technologies like the AI-based digital consultant TWIIN (www.twiin.aph.org.ua), an online assistant available 24/7, can greatly enhance the capabilities of social workers. 
4. Expanding Telemedicine Services: The Help24 platform (https://help24.org.ua) was significantly expanded, providing telemedicine services through public clinics, adding medicine delivery and psychological support services. For migrants, this serves as an essential link to medical professionals in a language they understand.
   
5. Mental Health: Migrants’ mental state upon contacting services was often very poor. Migrants frequently experience high levels of stress, making it crucial to focus on burnout prevention. 
6. Productive Partnership Between NGOs and the State: From the early days, the Ukrainian Center for Public Health actively promoted the service in Ukraine and abroad. It was the primary provider of referral and remote medical support services and quickly developed a mechanism to restore and provide patient documentation in friendly clinics online. 
7. Use of Long-Acting Medications: The introduction of long-acting drugs (Buvidal for OST and Cabotegravir for PrEP) in Ukraine was an important step in ensuring service availability for migrating key populations. 

The Alliance for Public Health has documented the lessons learned from program adaptations in Ukraine, with results available on their website.

Participants noted that these lessons are relevant not only for working with migrants but also for reforming the healthcare system towards a more patient-centered, effective, and cost-efficient model.

In summarizing Tatiana Deshko’s presentation, session moderator and Global Fund Program Specialist Vira Zemlyanska highlighted that the #HelpNOW service, created through the leadership of the Alliance for Public Health and unique support from over 100 global organizations, is effectively a patient-oriented one-stop shop for Ukrainians, regardless of where they are in the world. The #HelpNOW experience can be adopted by other countries or used on other regional platforms.

“We welcome the recommendation from the Global Fund meeting in Samarkand to include migrant-sensitive services in current Global Fund applications for country financing and, if necessary, to reprogram existing grants. We also note significant calls from meeting participants to conduct research to build an evidence base and, where necessary, identify migrants as a key population,” said Daniel Kashnitsky, Coordinator for Academic Relations at the Regional Expert Group on Migrant Health. “The Regional Expert Group on Migrant Health also welcomes the readiness of healthcare authorities in EECA countries to implement remote diagnostic and treatment practices for citizens living abroad. We hope that similar high-level donor meetings on migrant health will be held regularly.”

For more information on the SoS 2.0 regional project, visit the official websites:

– Alliance for Public Health – https://aph.org.ua 

– SoS Project 2.0 – www.sos.aph.org.ua 

“HAB | Lviv Habilitation Center” is the first habilitation center in Ukraine that enables combat veterans and people affected by the war to acquire new and much-needed skills before returning to normal life in society, taking into account their individual physical changes. We are talking about adapting to a “new life” for people with amputations, in wheelchairs, recovering from mental pressure, etc.

The Habilitation Center is a pilot project of the Alliance for Public Health in collaboration with UNBROKEN and supported by Gilead Sciences and Frontline AIDS. Serhiy Titarenko, head of the habilitation process at Lviv Habilitation Center (HAB), a veteran of the Russian-Ukrainian war, told us what is so unique about the facility.

Habilitation is my Superpower

Serhiy is a retired major in the Ukrainian Army Aviation after being seriously injured and now he has to use a wheelchair to get around. During his rehabilitation, he mastered another profession – a psychologist – and now helps people with disabilities of various nosologies, wounded soldiers, veterans and their families.

“Since I myself went through the path of treatment, rehabilitation, and adaptation, I realized that it is already the eleventh year of the war, and we still do not have a route for veterans to return to society,” said Serhiy Titarenko. – ” It was really an abyss, because you were discharged from the hospital to nowhere: in our country practically nothing is equipped for wheelchair mobility, and people are not trained and have not tried to do anything on their own in this new condition.

Anna Gorkun, the head of this program, involved me in a project that was about to open in Lviv, and together we developed a concept of habilitation to close the existing gap between medical and rehabilitation facilities and the return of veterans to community life.

The term “habilitation ” comes from the adolescent psychology and means the transition from childhood to adulthood through the acquisition of useful skills that will be used for normal adaptation, realization and self-realization. If we draw a parallel between adolescent habilitation and the reintegration and socialization of a war veteran, the same thing essentially happens: a person finds himself or herself in a new state for which he or she is not prepared, finds himself or herself face to face with his or her disability, and must acquire useful skills to integrate into society in a new status. That’s how the idea to create a habilitation center came about.

A client story
We had a patient who was ashamed to be photographed because of a mine-blast injury to his face. He was also ashamed to go out “in public” because his face was severely damaged. After 3 weeks at the HAB we managed to get him to the point where he could use public transportation on his own. This is an extremely big achievement in such a short time!

There are No Such Facilities in Ukraine

Anna Gorkun, project manager of the Lviv Habilitation Center, said that HAB | Lviv Habilitation Center is a unique institution in Ukraine that has gained very wide popularity in 4 months and needs to be expanded to other regions.

Anna has been actively involved in the development of shelters for over 2 years and has received many requests for rehabilitation from war veterans.

“People who have completed the rehabilitation course and stabilized their psycho-emotional and physical condition can move on and return to society, but it is at this stage that they really need help,” says Anna Gorkun. – “With the help of physical therapists and psychologists, our residents learn to cook on their own, go shopping and use public transport – that is, they learn to do what they will need to do in their normal lives”.

The Habilitation Center is located in Lviv at 86B Stryiska St. At the same time, 23 residents can live here in 9 rooms, 6 of which are fully adapted for wheelchair users. Also, if a person lives in Lviv or is in a medical rehabilitation facility, he or she can undergo inpatient habilitation without living in the HAB.

“Our work goes beyond the rehabilitation of veterans and people affected by the war. We are actively working to prepare society for changes in the perception of people with disabilities and war veterans. It is important for us that everyone understands the importance of a proper communication and support for these people. We are actively developing our information outreach work, conducting lectures both online and offline, reaching more than 10,000 people across Ukraine. Among the listeners were UCU professors, residents of our building where the HAB is located, and representatives of Diya, etc.

We also provide support to the families of veterans and people with disabilities, organizing various events to help them distract from the heavy memories about the war. For example, we recently held a floral master class together with the “Blyzki” (“Close Ones”) foundation, where they could enjoy the beauty and get a little distraction.”

Since the HAB is not a medical facility, people can get here by self-referral or with a doctor’s recommendation.

The resident route consists of the following steps:

● An introductory meeting, during which the resident learns about the services available, additional programs and house rules.

● Selection of an individual program in accordance with the person’s request (for example, learning to ride public transport independently). This is done through a psychological test, which takes into account the specific goals that the person wants to achieve during the 3 weeks of stay at the center.

● Based on the information gathered, rehabilitation therapists develop a program of supportive rehabilitation classes, and psychologists, on their part, develop a program for re-entry into society.

We had a woman from Avdiivka who was injured during the shelling. Her request was that she did not understand how to hold a cooking pot staying on one leg. That is, the requests of residents are things that we do not think about in everyday life, but for people with disabilities who have just acquired them, it is a challenge. And this challenge needs to be overcome.

The residents can get the following services at the center:

● Accommodation for people with disabilities of various nosologies
● Assistance in cooking in an inclusive kitchen
● Supportive physical rehabilitation
● Manual therapy
● Psychological individual and group interventions
● Pet therapy
● Art therapy, breathing practices
● Body-oriented practices
● Physiological and sports activities
● Yoga-nidra
● Joint activities with a large number of organizations that are adapted for people with disabilities (jiu-jitsu, yoga, swimming)

“During the three weeks of staying at the HAB, people become very friendly with each other, start discussing very personal things that they would not say in public. We are all buddies here! After completing their habilitation and leaving the center, many residents continue participating in our activities, always calling and asking what events they can join. For example, recently it was a mountain hiking,” says Serhiy Titarenko.

According to the Ministry of Veterans Affairs, the projected number of veterans, their families and families of fallen soldiers after Ukraine’s victory in the war with Russia will be about 3 million people (10% of the total population of Ukraine). The first war veterans are already returning home, so the opening of habilitation centers in Ukraine is an extremely important initiative!

In Munich, Germany, the 25th International AIDS Conference (AIDS 2024) began—the largest global conference dedicated to the fight against HIV/AIDS. Over 10,000 people living with HIV, activists, scientists, and government representatives gathered to exchange experiences, develop new strategies, and celebrate achievements in combating HIV. The conference is taking place from July 22 to 26, 2024.

The opening of AIDS 2024 featured speeches by German Chancellor Olaf Scholz, Andriy Klepikov, Executive Director of the Alliance for Public Health, IAS President Sharon Lewin, Christoph Spinner, Executive Director of the Department of Medicine and Strategy and Chief Medical Officer at the Right Bank Isar University Hospital, Winnie Byanyima, Executive Director of UNAIDS, and Jay Mulucha, Executive Director of the Fem Alliance. The official ceremony was hosted by singer Vira Brezhneva and actress and presenter Annabelle Mandeng.

AIDS 2024, the 25th International AIDS Conference. Munich, Germany.rMonday, 22 July 2024rr OP01. Opening SessionrIn the photo: Left to Right: Android Klepikov, Chancellor Olaf Scholz, Sharon Lewin, Christopher Spinner.rr© Steve Forrest / IAS

Germany reaffirmed its unwavering support for the Global Fund.

In his speech, German Chancellor Olaf Scholz reaffirmed the German government’s commitment to the global fight against AIDS, emphasizing support for the Global Fund, and urged other world nations to do the same.

“Germany, as one of the largest donors to the Global Fund, is allocating 1.3 billion euros to fight HIV, tuberculosis, and malaria,” Scholz said.

“And we will continue to support it,” he added. Why is this so important? Because the programs funded by the Global Fund have saved the lives of fifty-nine million people. Fifty-nine million! That number speaks for itself.

“I would like to call on other donors for greater support,” the Chancellor added.

AIDS 2024, the 25th International AIDS Conference. Munich, Germany.rMonday, 22 July 2024rrOP01. Opening SessionrIn the photo: Chancellor Olaf Scholz of Germany speaking at the Opening Session.rr© Steve Forrest / IAS

AIDS 2024 is particularly focused on Eastern Europe and Central Asia—a region with one of the fastest-growing HIV epidemics in the world.

Beginning his speech, Andriy Klepikov noted that he wished air raid sirens could sound in the hall—a sound that has become an everyday reality for Ukrainians. These sirens have become a symbol of the resilience of the Ukrainian people and a reminder of the need for global solidarity in the fight against HIV.

“While in most regions of the world the HIV epidemic has been stabilized, in Eastern Europe and Central Asia it continues to spread rapidly,” emphasized Andriy Klepikov, regional co-chair of AIDS 2024 and Executive Director of the Alliance for Public Health.

“Only half of the people living in our region have access to antiretroviral therapy, which is far below the global target of 95%. The main reasons for the spread of HIV in the region are drug use, stigma, harmful policies, and unfortunately, the war.”

He reminded that in Ukraine, medical workers, social workers, and volunteers risk their lives daily to provide assistance to hundreds of thousands of Ukrainians amidst the constant risks of rocket attacks, air raid sirens, and power outages.

During Klepikov’s speech, conference participants expressed solidarity with Ukraine by lighting lanterns, playing the sounds of sirens, and raising Ukrainian flags. Andriy Klepikov concluded his speech with the phrase “Glory to Ukraine!” to which the delegates responded “Glory to the heroes!” and greeted Andriy Klepikov’s speech with prolonged standing ovations.

AIDS 2024, the 25th International AIDS Conference. Munich, Germany.rMonday, 22 July 2024rrOP01. Opening SessionrIn the photo: Backstage at the Opening Session.rr© Steve Forrest / IAS

AIDS 2024, the 25th International AIDS Conference. Munich, Germany.rMonday, 22 July 2024rrOP01. Opening Session.rIn the photo: Ukraine demonstration at the Opening Session.rr© Steve Forrest / IAS

Ahead of the 25th International AIDS Conference, which will be held in Munich in late July, the regional information campaign “Walls are not the answer! #PutPeopleFirstEECA” is launched. Сampaign is coordinated by the VirusOFF media platform and the Alliance for Public Health, with the support of UNAIDS EECA. The campaign and activities are carried out with the participation of regional networks and organizations.

The campaign aims to amplify the voices of the Eastern Europe and Central Asia (EECA) region and give communities, activists, public and international organizations, and human rights defenders working to end the AIDS epidemic a platform to speak out about what hinders the region from stopping the epidemic and why it is important to put people first.

“The #PutPeopleFirstEECA campaign is an important cooperation of regional organizations and community networks of EECA region in the information field ahead of the International #AIDS2024 Conference. #SoS_project 2.0 always supports such initiatives of the region. We believe that only through the joint efforts of all stakeholders and sustained international support we can overcome barriers such as restrictive laws, criminalization and stigmatization, and, make a significant progress in access to treatment and sustainability of HIV services. I encourage experts from the region to share their views and experiences on best approaches, support the campaign,” said Inna Gavrylova, Alliance for Public Health.

The EECA region faces significant barriers such as restrictive laws, criminalization, and stigmatization, which hinder the fight against HIV. To combat these challenges and prevent the building of new “walls” in the region, the concerted efforts of all stakeholders and sustained international support are needed.

According to UNAIDS, the HIV epidemic in Eastern Europe and Central Asia is the fastest-growing in the world. Since 2010, the number of new cases in the region has increased by 49%, and the number of deaths has risen by 46% over the same period. Additionally, only half of the patients with HIV-positive status are receiving therapy.

Ineffective laws, criminalization, gender inequality, and the consequences of the war in Ukraine are just a few of the reasons why countries in Eastern Europe and Central Asia may not meet the goal of ending the epidemic by 2030.

What needs to be done to stop the spread of the infection? How can governments be convinced to fully fund prevention and support programs? And why should people be put first in the fight against HIV? These questions will be discussed at the AIDS 2024 International Conference, where the Eastern Europe and Central Asia region will be one of the priority topics. The information campaign is part of the #PutPeopleFirst initiative launched by the organizers of the 25th International AIDS Conference.

If you want to join, record your short video message answering the question “Why should people be put first in the fight against the HIV epidemic?” and post it on social media with the hashtag: #PutPeopleFirstEECA and #PutPeopleFirst. Your opinion could lead the way!

The #PutPeopleFirstEECA campaign is coordinated by the VirusOFF media platform and the Alliance for Public Health, with the support of UNAIDS EECA. The campaign and activities are carried out with the participation of regional networks and organizations: ECOM, ITPC EECA, EHRA, Teenergizer, EWNA, ENPUD, REG, EKPC, AFEW, HAC, 100% Life, Alliance Consultancy, Life4me+, Eurasian Movement for the Rights to Health in Prisons, SoS_project 2.0, #BaltHUB and others.

Follow the pages of the VirusOFF media platform and its partners on social media to not miss updates within the campaign and the launch of the special EECA page for AIDS 2024.

Learn more about Eastern Europe and Central Asia at AIDS 2024 by visiting aids2024.virusoff.info, a special web page dedicated to EECA and AIDS 2024 on the online regional platform Virus OFF. 

Instagram – Virus off

Facebook – Virus Off

X Social Network – UNAIDS EECA 

Linkedin – Alliance for Public Health 

Kyiv, Ukraine – 19/06/2024 

ICF “Alliance for Public Health” in partnership with the Alliance Consultancy is pleased to announce the opening of the Help24 TeleHealth telemedicine platform and online clinic. This unique platform, based on the Help24 website, provides free online medical services to vulnerable populations in Ukraine. In particular:

• Virtual consultations with doctors.
• Remote referral for laboratory tests.
• Online prescription and treatment monitoring.
• Access to HIV and other sexually transmitted infections prevention.
• Mental health counseling.
• Testing and counseling for infectious diseases.

“Help24 TeleHealth is not just a new platform. This is a strategic direction of the Alliance’s work and another step towards the introduction of modern IT solutions in Ukrainian medicine, which means a significant leap forward in ensuring the availability and quality of medical care for key and vulnerable populations, especially in wartime and the destruction of the healthcare system. In 2023, 13,267 medical consultations were provided through the platform. The Help24 TeleHealth platform is an innovation that saves lives!“ – emphasizes Andriy Klepikov, Executive Director, ICF “Alliance for Public Health”.   

Help24 TeleHealth is:

• • A unique Ukrainian platform that offers online clinic and telemedicine services specially created for people living with HIV and other vulnerable groups.
  • A comprehensive solution that allows you to:
    • Receive preventive and treatment services for HIV, mental disorders, and viral hepatitis even in the context of military operations and the destruction of the healthcare system.

• Access diagnostic tools and PrEP remotely.

• Take advantage of psychological assistance.
• Read information and educational materials.
• A team of more than 15 experienced medical professionals who guarantee openness, expertise, and confidentiality of consultations, regardless of your location.
• Absolute data security and confidentiality, as information protection is one of the platform’s top priorities.

“Help24 TeleHealth is a new stage in providing affordable and high-quality online medical services,” – says Vlasta Brodska, Director, Alliance Consultancy. “With this platform, we are breaking down barriers and ensuring equal access to healthcare for all groups of people. Our goal is to provide the necessary support to those who are most vulnerable to HIV and other infections, so all Help24 TeleHealth services are free of charge. We believe this innovative platform will become a key tool for improving the health and well-being of our citizens.”

The initiative is supported by the Public Health Center of the Ministry of Health of Ukraine, as well as Frontline AIDS and Gilead. 

Andriy Bilets, an infectious disease specialist at the Department of HIV Management and Control, Public Health Center of the Ministry of Health of Ukraine, emphasizes the importance of telemedicine and Help24 TeleHealth in the fight against HIV in the context of active hostilities in Ukraine: “Given the current situation in Ukraine, telemedicine is becoming extremely important as it helps to ensure timely diagnosis, treatment and prevention of HIV infection, especially in conditions of limited human resources and lack of access to healthcare facilities due to damage or destruction of infrastructure. This not only saves time and money for patients, but also allows them to receive prompt, qualified assistance regardless of their location, which is especially important during military aggression and active hostilities.”

“We support this initiative because it provides patients with access to HIV diagnosis, treatment and prevention, helping to overcome existing barriers and provide quality and comprehensive medical care even in the most difficult times. Through the implementation of such interventions, we not only ensure the implementation of the State Strategy for the Development of Telemedicine in Ukraine, but also strengthen the implementation of the necessary response to HIV for different populations, including vulnerable groups, and hope that such projects will form the basis of a modern, effective medical system in our country.“ – says Andriy Bilets.

In 2023, the Cabinet of Ministers of Ukraine approved the Telemedicine Development Strategy, identifying this area as a priority tool for developing eHealth and digital transformation. Help24 TeleHealth was created to implement this strategy and ensure equal access to quality healthcare services for key populations, including HIV, mental health, and related areas. 

“Telemedicine is an effective form of access to basic healthcare services and an integral component of a comprehensive healthcare system. Telemedicine services must be a necessary and effective tool to overcome barriers to access to basic standard medical services, which is especially important given the challenges to the healthcare system caused by the war. Thus, telemedicine is not an additional but a basic need for key populations, including people living with HIV, internally displaced persons, and those who are forcibly staying abroad. That is why the purpose of creating telemedicine offices and the telemedicine module of the Help24 Telehealth platform is to standardize the telemedicine method itself, to develop and implement standard operating procedures and algorithms to meet the needs of key populations, including people living with HIV,” adds Sergii Antoniak, infectious disease Doctor, Project coordinator, Help24 TeleHealth. “In general, telemedicine should be considered one of the priority elements of comprehensive eHealth in Ukraine, which provides access to quality health care, promotes health restoration, rehabilitation of Ukrainians and prevention of HIV and other socially significant diseases.” 

Help24 TeleHealth offers comprehensive healthcare solutions right on your screen, wherever you are!

To sign up for a consultation, please follow the link: 

https://h24.org.ua/  

https://help24.org.ua/uk/doctor-consultation-info 

Kyiv, Ukraine, June 12, 2024 – Alliance for Public Health in partnership with the MAINline International, within the framework of the SoS 2.0 project, has adapted and launched a training course “Interventions for the Mental Health of People Who Use Amphetamine Stimulants (ATS)”. This course is designed to help service providers better understand the link between mental health and ATS use, as well as to provide them with the knowledge and skills to work effectively with this category of people.

“Community-based interventions are crucial in areas where access to healthcare is affected by stigma and availability. Today we took the first step in offering important interventions to people who use methamphetamine, by gaining insight into what mental wellbeing is. What a fun session!” said Simon Williams, Learning lead & Project lead Asia, MAINline International 

The course has an adaptive structure that allows participants to study topics independently and consolidate their knowledge through online sessions with a moderator. It consists of 10 theoretical topics and 4 online modules.

The course modules include the following topics: 

-Recognizing mental health problems among people who use ATS

-Screening for mental health problems among people who use ATS

-Basic community mental health interventions for people who use ATS

-Establishment of mental health-based referral networks for people who use ATS

“We were pleasantly surprised by the high level of interest in the new training course,” shares her impressions Nadia Yanhol, Project Manager, Alliance for Public Health. “In three days after the announcement of its launch, 120 participants from all over Ukraine registered. The first online session, which took place today, gave us the opportunity to meet an incredible group of participants who have mastered the topic of mental health of people who use methamphetamine.”

Advantages of the course:

Flexibility: Participants can take the course at their own pace and time.

Interactivity: Online sessions with a moderator provide an opportunity to ask questions and get clarification.

Accessibility: The course is available in Ukrainian and English.

“As part of the further development of the project, we plan to translate the course into Russian and distribute it in the countries of the Eastern European and Central Asian region,” emphasized Nadia Yanhol, Project Manager, Alliance for Public Health. “We are convinced that this course will be a valuable tool for professionals working with people who use amphetamine-type stimulants (ATS) and will help improve the quality and effectiveness of their primary care.”

Get access to the course

Over the past 7 years, one of the country’s largest projects, HealthLink, was being implemented, providing Ukrainians with the opportunity to get tested for HIV and start treatment free of charge, quickly and safely.

Overcoming numerous challenges, such as the Covid-19 pandemic and the beginning of the full-scale invasion, the Alliance for Public Health and CO “100% of Life”, in partnership with 29 non-governmental organizations and more than 700 health care facilities, worked tirelessly to ensure that as many Ukrainians as possible would have access to HIV prevention, testing and treatment. Before the war, the project was being implemented in 12 regions with the highest HIV prevalence (Dnipropetrovs’k, Kirovohrad, Zaporizhzhia, Donetsk, Odesa, Chernihiv, Poltava, Cherkasy, Kherson, Mykolaiv and Kyiv oblasts (regions) and the city of Kyiv). After the outbreak of the war, activities in Kherson region were suspended, and Zhytomyr, Zakarpattia, Lviv, and Ivano-Frankivsk regions were added to the project. The results of the project are really impressive, as we have managed to:

• test over one million people;
• detect around 26,000 new HIV+ cases;
• 90% of newly detected patients started taking ART.

“Despite the very ambitious goals of the project, we were constantly trying to introduce something new. We used a lot of non-standard approaches and innovations that yielded tremendous results, making HIV testing commonplace for all people,” – says Maryna Varban, HealthLink project manager, the Alliance.

“Safe Boxes” Innovation. During Covid and the war, online services became extremely popular. Given that people in the modern world are increasingly striving to maintain their privacy, we have developed the website oraltest.org.ua, which is popular among members of the LGBT community. Here you can order a safe box that contains a rapid HIV test, contraceptives, lubricants, informational materials and stylish souvenirs. This initiative has helped to reach people living in small towns and villages, the most isolated group of men over 35, and the broader MSM community. A total of 15,000 safe boxes have been distributed during the project’s implementation.

“Prevention videos at health care facilities” Innovation. People waiting to see a doctor in the corridor of a health care facility are mostly sitting around doing nothing, so we decided to use this time to good effect. We distributed 180 plasma TV sets among partner medical institutions and created a series of videos on health, hygiene, debunking myths about HIV, pregnancy, etc. Each video ended with a call to get tested, and people who saw this information could immediately ask their doctor about an HIV test. After watching the videos, about 6,000 people sought testing.

“Video Doctor” Innovation program aimed to improve the index testing rate. Doctors were provided with tablets on which they showed videos with information about HIV to the patients during counseling and explained further steps in case of HIV detection. A series of videos with instructions on how to involve partners in testing was also developed. During the intervention, more than 2,000 patients watched the videos and 1,400 of them then referred their partners for testing. About 500 of them were found to be HIV+.

“The Testomats (Test Vending Machines)” Innovation has made free HIV testing even more accessible by allowing people to get an oral HIV test-kit and self-test kits in a place convenient to them. To do this, one needed to visit the respective website, answer the questions, generate 2 QR codes, bring them to the scanner, and receive their HIV test-kit and a box of condoms at the Testomat. In total, 3,700 tests were distributed through these Test Vending Machines.

“Supervisor Support” Innovation. Throughout the project, it provided the professional support and motivation of the staff: health care workers and NGO representatives. The number of face-to-face supervisions was significantly reduced due to the war, but despite the difficulties, supervisors managed to conduct more than 500 supervision visits to NGOs and health care facilities for 5,000 participants. The need in individual supervision led to the creation of the website supervision.org.ua, which provided more than 7,000 supervisions online.

“Online Support Groups” Innovation – combined 2 approaches: peer-to-peer mentoring and an online platform for communication, thereby creating a safe place where people with the same experience could gather. Professional psychologists-moderators of support groups held thematic meetings on living with HIV, provided psychological support and stress management and motivational counseling services to build adherence to ART, and other services. This approach made it possible to support PLHIV at risk of dropping out of treatment and help them to adjust to their new status. In total, the project organized more than 100 support groups for PLHIV, MSM and social workers.

Here is the story of HIV detection efforts from the NGO “Alternative”, Chornomorsk.

“I received a call from a client who is now defending Ukraine in the Armed Forces and who asked me to send him ARV drugs to the front. His wife was supposed to pick up the medication. While talking to her, I found out that she did not know anything and did not want to know about her husband’s HIV status. But I couldn’t just give her the medication and let her go, so I told her about all the risks and why it was important for her to know her HIV status as well and, if necessary, start treatment. I was very much afraid that when she left the office, I would never see her again, so I decided not to wait, but to take an HIV test right away. I had oral test-kits, which came in handy because the result was positive. I wouldn’t say I was surprised, but the main task now was to get the woman to the clinic for further examination and make sure she started her ARV therapy.

The woman refused to see a doctor. She asked to take a few days to think about it and, after receiving therapy for her husband, went home. A few days later, she called me and told me that she had been thinking about the test results and what we had discussed during the meeting. She said she agreed to additional examinations and treatment. Now she is taking ART, and we keep in touch. After a while, I talked to her husband, who was very grateful for the work that was done for his wife”.

We were able to achieve such outstanding results thanks to fruitful and well-coordinated teamwork and support of each other in these difficult times. We would like to express our sincere gratitude to all our partners who have been standing side by side and working purposefully on the result.

The project was implemented with the financial support from the CO “100% of LIFE” and the ICF “Alliance for Public Health” as part of the HealthLink project: “Accelerating Ukraine’s Efforts to End HIV” project implemented with the support from the United States Agency for International Development (USAID).

A program to introduce an innovative method of pre-exposure prophylaxis for HIV infection has been launched in Ukraine – long-acting injectable cabotegravir, which, if used in accordance with medical recommendations, protects against HIV infection through sexual contact by 99%. 

The supply of long-acting cabotegravir was made possible through a partnership between the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and ViiV Healthcare. Implementation of the project in Ukraine was organized by the Public Health Center of the Ministry of Health of Ukraine in partnership with the PEPFAR Coordination Office, CDC, USAID, WHO, ICF “Alliance for Public Health”, and NGO “ALLIANCE.GLOBAL”. 

After a systematic review of the evidence and results of the studies WHO recommends the use of CAB-LA for PrEP.   The availability of the medication in Ukraine will allow expanding the access and coverage of pre-exposure prophylaxis services, as well as HIV prevention in general, which is especially important in a time of war. The offer of injectable cabotegravir along with tablet forms of PrEP (TDF/FTC) provides a possibility of choice: regular oral medication or an injectable, extended-release version. 

“Pre-exposure prophylaxis is one of the evidence-based methods of controlling the HIV epidemic in the world. Over the past 3 years, the number of people receiving pre-exposure prophylaxis in Ukraine has tripled. Ukraine has been selected as one of 5 countries among the PEPFAR partner countries prioritized for expanding access to the injectable form of pre-exposure prophylaxis – long-acting cabotegravir. This is a modern innovative drug that will be available in medical institutions of the two cities after the registration is completed,” said Ihor Kuzin, Deputy Minister, Chief State Sanitary Doctor of Ukraine, during a joint press conference in Kyiv. 

According to Mykhailo Rosada, Director General of the Public Health Center of MOH Ukraine, the introduction of the newest pre-exposure prophylaxis medication in Ukraine was made possible by the strong cooperation of the Public Health Center, the PEPFAR team, the ICF Alliance for Public Health, the NGO ALLIANCE.GLOBAL, and WHO. 

The PHC, together with partners, created a Working Group on the organization of the introduction of injectable drugs for HIV prevention, selected specialists for implementation teams, and developed operational manuals and clinical pathways. PEPFAR has centrally procured CAB-LA in the amount of 1,350 vials, which corresponds to almost 200 annual courses, and transferred them to the PHC as the project implementer.

“Until recently, HIV was called the ‘plague of the 21st century’. Today, we can –  not only to control the disease, but also prevent it by 99%. This is the efficacy rate of Cabotegravir, an innovative sustained-release drug for pre-exposure prophylaxis of HIV. I am grateful to our international partners for their strong support and cooperation, which helps to save and preserve the lives of Ukrainians,” said Mykhailo Rosada, Director General of Public Health Center of MOH.

Ukraine became one of the few PEPFAR partner countries to be the first to implement the CAB-LA program. A roadmap for the introduction of long-acting cabotegravir as pre-exposure prophylaxis for HIV in Ukraine was developed and approved, and negotiations were held with representatives of health care institutions in Lviv and Kyiv to implement CAB-LA. 

“We are very pleased that Ukraine has applied to participate in the first wave of CAB-LA rollout. Given the risks associated with the war and the constant displacement of the population, we are confident that this highly effective and innovative drug will be a convenient alternative in Ukraine. Thanks to the commitment and professionalism of our government and civil society partners in Ukraine, I am confident that together we can end the HIV epidemic,” said Brendan T. Garvin, Director of Management and Budget at U.S. PEPFAR.

CAB-LA implementation is planned to start in Kyiv (Kyiv City Clinical Hospital #5) and Lviv (Lviv Regional Phthisiopulmonary Clinical Treatment and Diagnostic Center of the Lviv Regional Council) for the MSM group (men who have sex with men). 

Andriy Klepikov, Executive Director of the Alliance for Public Health, shared his experience of advocating for this opportunity for Ukraine:

“This is a truly remarkable day: Ukraine was the first country in the Eastern Europe and Central Asia region to receive the most modern drug for pre-exposure prophylaxis of HIV infection. For 3 years, we had been negotiating and arguing the need for CAB-LA, but often heard that it was not the right time. However, we did not lose our motivation and kept moving forward. Ukraine won this right through successful negotiations and the trust of its partners. This program is being launched thanks to the support of the US Government under the PEPFAR program. Despite the challenges of war, Ukraine is a leader in the implementation of innovative technologies in HIV prevention.”

Andrii Bogoslavets, Head of the Pre-Exposure Prophylaxis and Information Campaigns Project at ALLIANCE.GLOBAL, said: “The organization has been working with the support of international donors and the ICF Alliance for Public Health to distribute PrEP among the community since 2018, and we  understand how important PrEP is in overcoming the HIV epidemic. PrEP tablets are an effective solution to protect against HIV infection. When taken daily, it protects against HIV by up to 99% and has become a know-how in overcoming the HIV epidemic.  Today, we presented an injectable form of PrEP, which will be a great solution for those members of the community who may miss taking pills on a daily basis. And the fact that cabotegravir needs to be injected every two months is a great solution for the community, which will protect 99%. Knowing the feedback from, the community is looking forward to when this drug will be available and hopes that after this pilot project there will be an expansion when this medication will be available in all cities of Ukraine”. 

Background: 

Long-acting cabotegravir (CAB-LA) is a long-acting injectable drug that belongs to the class of integrase chain transfer inhibitors (a class of antiretroviral drugs). CAB-LA is indicated for pre-exposure prophylaxis of HIV infection for adults weighing at least 35 kg and is used to reduce the risk of sexual transmission of HIV-1. The use of CAB-LA involves the intramuscular injection of 2 doses of the drug with an interval of 4 weeks, then one injection every 8 weeks. In July 2022, the WHO included Cabotegravir in its recommendations for pre-exposure prophylaxis of HIV infection, which was approved by the US Food and Drug Administration (FDA) on December 20, 2021. 

To date, CAB-LA is the only sustained-release injectable that has demonstrated high efficacy in randomized clinical trials (HPTN 083 in cisgender men and transgender women who have sex with men; HPTN 084 in cisgender women in sub-Saharan Africa). 

Expanding HIV prevention choices is an important element of the public health approach to reducing new HIV infections. Offering additional PrEP options has the potential to increase PrEP coverage and effective use, as well as HIV prevention in general, by allowing people to choose the method they prefer.

Recording of the press conference:
https://www.youtube.com/live/OEs_y92A3Rs?si=nSDm7MkHO05Z6Yu9

Alliance for Public Health and CoAct are pleased to be technical partners for the Unitaid-funded Hepatitis C project for the period 2023-2026. This project is part of a consortium led by Frontline AIDS and aims to implement innovative research on community-based hepatitis C treatment models and care and support services in Nigeria.

The UNITAID project, which will be implemented in Gombe State with the participation of the NGO DAPHO, aims to improve the health status and ensure access to quality health services for people who inject drugs. According to the plan, in July 2024, 625 people will receive low-dead-volume syringes for 18 months, and from January 2025, 2800 people will be tested for hepatitis C virus. HCV treatment services with direct-acting antiviral drugs are planned for 250 people, with the goal of completing treatment by October 2025.

The project seems to be very timely, as there is a general concern about the development of the HIV epidemic among PWID in Nigeria, the prevalence of HIV infection among which has increased from 3.4% to 11% over the past 6 years. This is due to the practice of needle sharing (only 36% of respondents reported always or almost always using a clean needle during injections in the past month), as well as low coverage of PWID with key interventions recommended by the World Health Organization, such as substitution maintenance therapy.