On February 6th-9th, delegations from Almaty (Kazakhstan), Batumi, Tbilisi (Georgia) and Kyiv (Ukraine) conducted a study and knowledge-sharing visit to Amsterdam (The Netherlands) to learn about the experience and best practices in building successful and sustainable city models of responses to HIV in key populations. The visit was organized by AFEW International and Alliance for Public Health.

The group of 16 people included Head of Republican AIDS Center from Kazakhstan, Deputy Chief Doctor of AIDS City Center of Almaty, Deputy Head of State Health Department of City of Almaty, Head of the Department of Health and Social Services of Tbilisi City Hall, Deputy Director General of NCDCPH, Minister of Health and Social Care, the Government of Autonomous Republic of Adjara, representatives of “Fast-Track TB/HIV responses for key populations in EECA cities” project implementing NGOs, and representatives of the key populations.

During the study tour different partners of AFEW International shared models, experiences and activities that demonstrate successes and challenges in increasing access to health for key populations. The participants had the opportunity to talk to civil servants and different health actors within the Netherlands and discussed initiatives to reach out to key populations to increase their quality of life. The participants met with representatives of municipality, police and NGOs working with these key populations and discussed different forms of collaboration. On February 6^th the High official meeting was organized with the participation of Eric van der Burg, the Deputy Mayor of Amsterdam and Lambert Grijns, the SRHR Ambassador of Ministry of Foreign Affairs.

“Fast-Track TB/HIV responses for key populations in EECA cities” project implementing NGOs will use the best practices of Amsterdam and the Netherlands responses in their HIV/TB programs.

An important aspect of patient-centered TB care is the focus on the individual needs of each patient, convenience and safety for him. Such care should take into account the personal and social conditions of human life, and not only the requirements of medical treatment. People-centered care considers the patient to be the central figure in the continuum of care.

In order to define the full range of MDR-TB patients’ needs Alliance for Public Health conducted the operational research. The research was carried out among the participants of the project “Strengthening the provision of quality outpatient care for MR-TB patients by providing medical, social, psychological services and forming treatment adherence”, implemented by the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2015-2017, in partnership with the Red Cross Society of Ukraine. Within the above project was proved that through a combination of medical, social and psychological support the cure rate was doubled up: over 80% of MDR-TB patients recovered (with an average cure rate in Ukraine about 40%).

A total of 427 respondents from among more than 7000 project patients from the most regions of Ukraine were selected to participate in the study.

67.2% of respondents were men; the average age of patients was 42 years. At the same time among women there is a greater patients’ proportion of in the age group of 18-29 years, and among men – 50-59. 14.6% of respondents have higher education, 11.3% – with incomplete secondary education. The vast majority of respondents (60.8%) are not married. The financial situation of the patients’ families is characterized mainly as an average for 50.9% of the respondents.

The vast majority of research participants (80.8%) emphasized that after diagnosis, they were informed by the phthisiologist about the possibility and conditions of outpatient treatment from the first day. 5,6 % of respondents promptly started the outpatient treatment, while in the oblast centers proportion of such patients – 11.3% of the total. Almost all participants of the program arrange the place for receiving drugs (89.2% received TB drugs at home, 11, 9% – in the clinic, in another place – 13, 1 %.)

Certainly, the disease affects patient’s contacts with the social environment. Thus, 11, 3% of respondents felt that they were turned away and avoided after they became aware of the diagnosis. However, 25, 0% of patients felt truly supported.

More than the third part of respondents said that they felt the need to communicate with other patients for mutual support. More than 12% of respondents, including mostly women, need to communicate with a psychologist. The most frequent of illness-related worries is disability (65.8%). Among others there are fears of infecting others, as well as the worries of not recovering from the disease.

Among the general patients’ wishes for the improvement of outpatient TB care the following were highlighted: availability of free medicines and vitamins; better quality and volume of product sets; material support to patients; the opportunity to undergo a comprehensive body check-up; solving legal issues; compensation of transport expenses; reduction of side effects of medicines and medication load during treatment; provision of sanitary and physiotherapy treatment.

We hope that further consideration of the research results and recommendations will be concurrently promote improvement of both the quality of MDR-TB treatment as well as lifestyle of thousands of people who are faced with these problems!

You can find the full report on the research results by the following link.

The third module of the 4th cycle of Harm Reduction Academy that took place from 22 till 26 January, 2018 brought participants from 13 countries to Malaysia. This is the first time Alliance for Public Health is organising the training as a part of the course in this country. It became possible with the support from Malaysian AIDS Council whose staff members showed their hospitality taking care of field visits and organising sessions which made participants familiar with harm reduction programme in Malaysia.

The module on policy, advocacy, community empowerment and mobilisation was interesting and thoughts provoking, building leadership skills and deepen knowledge.

The lead facilitators of the module Gloria Lai from IDPC created a special atmosphere where participants were happy to learn and share their experience of policy-making and advocacy activities. Tetiana Deshko from Alliance for Public Health in addition to theory gave examples of effective advocacy activities from Ukraine and across the globe and made sure participants think about further actions after completion of the course. Professor Adeeba Kamarulzaman (University of Malaysia) lead participants through global policy issues and examples from Malaysia. Dr Anita Sulaiman from Ministry of Health told about support of Malaysian government to harm reduction programmes.  Edo Nasution from PKNI and Yati Jonet from MAC shared experience of developing leadership and empowering people who use drugs.

Zaki Arzmi from MAC and Audrey Edwards who is a journalist helped participants to develop skills on working with media around harm reduction issues.

Participants received certificates from the Deputy Head of Mission of the Embassy of Ukraine in Malaysia Kyrylo Kalyta who greeted participants and wished them all the best in their further work developing harm reduction programmes in their countries. This confirmed the importance of Harm Reduction Academy for promotion of Ukraine as a leader in public health approaches.

WHO leadership committed to the dialogue with civil society on TB

2018 year is the key time in fight against tuberculosis –UN High Level Meeting on TB with the participation of Heads of States is forthcoming. WHO Director-General Dr. Tedros Adhan Ghobreius and Dr. Teresa Kasayeva, Director of the WHO Global TB Program have shown high commitment and willingness to engage in dialogue with civil society.

Such a dialogue took place within the meeting in Geneva on January 15-16. The outcomes were  practical – based on the results of the work of a group of participants representing global and regional networks of activists and people with TB experience, formulated the key asks, namely:

1. The DG provides his vision of civil society engagement in TB programmes with all WHO offices globally
2. A letter from the DG to ensure:

1.1 WHO regional offices and country offices involve community representative in regional platforms, events such as NTP managers meeting, Regional Green Light Committee (rGLC), Regional Advisory Groups etc.

1.2 WHO National and Sub-national offices involve community representatives in TB programme reviews, missions, meetings etc.

1.3 Ensure that all Regional Offices and Country Offices create awareness and promote all WHO guidance and policies including WHO ethics guidance to implementing the End TB Strategy

1.4 Introduce various networks and coalitions working on TB such as GCTA, TBEC, ACT, TBAG UK, ACT AP, TB People etc.

3. WHO should demonstrate its commitment towards the meaningful engagement of civil society and communities through adequate investment and resource mobilisation to build their capacity
4. Provide sufficient resources for the core functions of the mechanism
5. Provide new guidance and indicators to all NTPs on meaningful engagement of civil society
6. Engage with relevant ministries and Head of States to emphasise civil society engagement, ensure country delegations have CS representatives in the country UN HLM TB delegation and provide resources for CS representation
7. Strengthen civil society engagement in the development of WHO guidelines on TB
8. Use the civil society engagement mechanism to consult on every TB policy, research, guideline, programme or process for input review on CRG
9. WHO to work with the GF and partners to encourage countries transiting out of GF to develop sustainable financially-sound transition plans
10. Ensure that the Essential Diagnostics List is completed as planned by April 2018
11. Guarantee participation of the civil society mechanism in all TB related research discussions
12. DG meets with the local civil society mechanisms during his visits

To learn more, please visit the link

http://mailchi.mp/e695e1b38c43/tbcivilsociety_meeting

THE YEAR 2017 WAS CRITICAL IN BUILDING SOLID GROUND FOR THE FUTURE UKRAINE –WE WOULD LIKE TO ACKNOWLEDGE STRONG LEADERSHIP OF THE MINISTER OF HEALTH ON HEALTH REFORM AND INCREASE IN DOMESTIC FUNDING FOR HIV AND TB. CIVIL SOCIETY ORGANIZATIONS INCLUDING ALLIANCE FOR PUBLIC HEALTH HAVE BEEN WORKING HARD TO ACHIEVE SIGNIFICANT RESULTS IN FIGHTING HIV, TUBERCULOSIS AND HEPATITIS.

HERE ARE OUR SEVEN HIGHLIGHTS OF THE OUTGOINGYEAR WHICH HAVE FORMED A SOLID GROUND FOR 2018:

1 With all its partners Alliance makes great contribution in achieving 90-90-90-90 in Ukraine. In 2017 HIV prevention services were provided to 218 829 people who inject drugs, 37 571 sex workers and 40 406 men who have sex with men. Alliance has made significant input in HIV case finding at the national level. 237 000 representatives of key affected populations were tested. Moreover, in 2016 and in the first half of 2017 85% of all officially registered cases among PWID were confirmed as a result of successful referral from harm reduction projects.

2 Scaling up Opioid Substitution Therapy to over 10 000 patients – making it the largest program in Eastern Europe and Central Asia. Being able to nurture this program over from a seed level of less than 100 patients to 10034 patients in 178 sites all over the country, Alliance started transitioning this program to the Ministry of Health. The transition has transferred the first 8% of the OST patients as of 1st of December 2017 with the clear road map and further scale up plans.

Transition of the Ukrainian OST program from Alliance to the Government

3 Alliance has directed half of its 2017 funding to stopping TB. During 2015-2017 every second MDR-TB patient receiving treatment in Ukraine was treated with drugs that were procured, donated and delivered by the Alliance. Starting from 2018 the government will be in charge of treating all MDR-TB patients with governmental resources. As for the treatment model we are proud that patient-oriented approach implemented by civil society organizations allowed for a nearly twofold increase in treatment success rate – 46% to 79%! Policy support is provided by the recently established in Ukraine Parliamentary TB Platform with 47 MPs joioned!

4 We have made DAA Hepatitis C treatment a reality in Ukraine! Over 2000 patients representing key populations got access to treatment using Sofosbuvir and Harvoni. Those who completed treatment and were tested (1679 patients) showed incredible results – in 95% virus was not detected! The treatment was focused on patients from key populations with or without HIV co-infection, among them 83% of patients were people who inject drugs. Treatment was also provided to 50 military veterans. This year Alliance supplied 1000 HCV rapid
tests to the prison population allowing diagnosis and treatment for 50 prisoners.

5 Ukraine became a model for other countries requesting to learn from us. During 2017 Alliance has been supporting ongoing projects in 15 countries, mostly in Eastern Europe and Central Asia. In 2017 in partnership with Alliance Consultancy technical support was provided to 24 countries:
Armenia, Azerbaijan, Afghanistan, Belarus, Bulgaria, Georgia, Ethiopia, Iran, Kazakhstan, Kenya, Kyrgyzstan, Kosovo, Malawi, Malaysia, Moldova, Nigeria, Pakistan, Russian Federation, Seychelles, Sudan, Tajikistan, Tanzania and Zanzibar, Uganda and Uzbekistan.

6 Exploring new areas and bringing innovations was another feature of 2017 – PrEP, self-testing, starting new program with transgender population, working with Ukrainian military personnel and in conflict areas in the East of Ukraine, boosting TB/HIV fast-track cities response. Alliance was the key advocate to scale up work with transgender people, including allocation of special resources from the Global Fund. We supported transgender movement in the region, conducted a unique assessment with over 600 transgenders in 3
EECA countries. Jointly with PLWH Network the Alliance launched campaign on HIV testing, focusing on self-testing with the visuals and referral to the web-site selftest.org.ua. New oral HIV tests were demonstrated during WAD and piloted in key populations programs.
7 Alliance, PLWH Network and Public Health Center by joining efforts with all key stakeholders together mobilized over USD 150 million for Ukraine’s HIV, TB and Hepatitis response for 2018-2020. The major external funding sources for the country are the Global Fund and PEPFAR. During the year Alliance has managed to attract new funding from 7 other donors.

THE YEAR OF 2018 WILL BE A YEAR OF ENSURING SUSTAINABILITY AND TRANSITION OF ESSENTIAL PREVENTION AND TREATMENT PROGRAMS, AND IT IS OUR JOINT RESPONSIBILITY TO MAKE IT SUCCESSFUL. FOCUS ON COMMUNITIES AND KEY POPULATIONS IS THE MAJOR PRIORITY IN ALLIANCE WORK.

On the New Year eve we are expressing huge thanks and wishing all the best to our partners – over 300 NGOs and medical facilities we are implementing the programs with in and outside of Ukraine, PLWH Network 100% Life, Public Health Center, Ministries we are working with – Health, Youth and Sports, Social Policy, Internal Affairs, Defense, Education
and Science, Justice , Foreign Affairs and other governmental institutions, Members of Parliament, to The Global Fund, PEPFAR, CDC, USAID, French Agency for International Technical Expertise, Elton John AIDS Foundation, Robert Carr civil society Networks Fund, Open Society Foundation, Levi Strauss Foundation, Gilead Sciences Inc., PAS Center, Right to Care, The Swiss Confederation, The Dutch Government, Aidsfonds, International Renaissance Foundation, Yale University, National Development and Research Institutes, Management Sciences for Health and all other donors, to UNAIDS, WHO, UNICEF, UNFPA, UNDP and all other UN agencies, International HIV/AIDS Alliance, TB Europe Coalition,
Stop TB Partnership, AFEW International, licit, Global TB Caucus, Eurasian Key Populations Health Network (EKHN), ECOM, ENPUD, SWAN, TB People, ECUO, EHRA and many many other partners, stakeholders, community groups and leaders! Together we will achieve more in ending AIDS, Tuberculosis and Hepatitis epidemics and saving more lives!

Merry Christmas and Happy New Year!

Alliance of Public Health in partnership with AFEW International (Netherlands), Odesa City Council and Knowledge Action Change (UK) is organizing City Health International 2018. The Conference will be held in the city of Odessa (Ukraine) on September 13-14, 2018.

Founded in 2012, Сity Health International is focuses on health and well-being of people and looks at the following issues such as the use of alcohol, drugs, healthy eating, safe sexual behavior and prevention of violence, as well as factors affecting the health of urban residents. The conference considers a wide range of topics. Representatives from non-governmental organizations, public projects, advocacy groups, as well as scientists and policy makers were invited to participate. You can find additional information about the conference at https://cityhealthinternational.org/2018/

The key theme of City Health International in 2018 – Developing healthy responses in a time of change’. This includes changes in political and societal norms, as well as changes in perceptions and expectations within communities. It also provides scope to tackle the important principle of inclusion, with regard to marginalised individuals and groups.The conference will be held for two days with a planned number of participants of up to 250 people. For the first time a conference of this format will be held in Eastern Europe. Participation of Ukraine in such event opens new opportunities, aimed at resolving public health issues at the city level. It is planned to invite the mayors of Kyiv, Istanbul, Athens and others to strengthen the role of local authorities in strengthening the health of city residents.

Organizers are waiting for abstracts for oral presentations and posters. The deadline for abstracts submission https://cityhealthinternational.org/go2018/ is April 1, 2018. The registration fee for participation in the conference is $ 150 per delegate. A reduced registration fee of $ 100 is provided to participants from Ukraine and low-income and middle-income countries according to the World Bank classification. If you have any questions regarding participation or support of the conference, please contact Maryna Braga, Alliance for Public Health at braga@aph.org.ua

On 20 December 2017, a press briefing and field visit to a substitution maintenance therapy (SMT) site took place on the occasion of state’s undertaking the responsibility for funding the program which has for 12 years been funded exclusively by international donors. The visitors had a unique opportunity to learn about the activities of the first SMT site in Ukraine, talk to doctors, social workers, and patients, and see with their own eyes how the patients receive SMT drugs are medical and social support. They could also hear opinions of representatives of the Ministry of Health of Ukraine and civil society organizations with regard to the future of development of this important program as a component of HIV prevention for people who inject drugs.

In 2018, the SMT program that will be funded largely from the state budget will remain the largest program of the kind in Eastern Europe and Central Asia. While at the beginning, in 2005, it reached less than 100 patients, next year it will be covering over 10 thousand patients at 178 healthcare facilities throughout Ukraine. The dry numbers belie more than 12 years of hard work of international and domestic NGOs, the Ministry of Health of Ukraine and healthcare facilities: awareness raising, training staff, engaging patients, procurement, distribution and delivery of the medications to the regions, and protection of the rights of patients.  First patients have recently begun receiving medications paid for by the state, which is a good precondition for the transition to state funding to be gradual and smooth.

Michel Kazatchkine, the UN Special Envoy for HIV/AIDS in Eastern Europe and Central Asia, welcomes the move: “Today’s announcement is great and, certainly, has an important political meaning for the whole of Eastern Europe where HIV epidemic has been and remains connected will illegal drug use. With the support of the Global Fund, the Alliance have for many years supported the largest substitution therapy program in the region. The Government of Ukraine is now taking the leadership in the program acknowledging that no-one must be denied access to healthcare”

“The Government understands its responsibility before patients and assumed the responsibility to purchase medications for opioid substitution therapy in order to ensure its sustainability and further development”, – said Iryna Chybisova chief specialist of the State Institution “Ukrainian Center for Social Disease Control of the Ministry of Healthcare of Ukraine during the briefing.

“Alliance is transferring to the Government the OST program currently providing services to over 10 000 patients. This program has been implemented according to the highest international standards ensuring high treatment adherence. 10 years ago Alliance had transferred to the Government responsibility another program – antiretroviral treatment. Since that time ART coverage increased by several times, and we expect that it will be the same with OST program as the real need in Ukraine exceeds 50 000”, – highlighted Andriy Klepikov, Executive Director of Alliance for Public Health.

The event took place at the Kyiv City Narcological Hospital “Sociotherapy”, one of the 178 healthcare facilities, serving 775 patients as of 01.11.2017. This is a facility with the highest number of SMT patients in Ukraine! Behind each patient is his or her own story, problems, path to socialization and overcoming dependency from illegal drugs. Anton Basenko, a patient, tells about his experience on the program: “Just saying that SMT has changed my life is saying nothing. SMT has saved my life and returned me to my family, I have married my girlfriend and we are planning to have children; finally, SMT has made me what I am, an employee of an international organization, public activist and representative of the community of people who inject drugs and SMT patients at the National Council to Fight Tuberculosis and HIV/AIDS. And trust me, every one of more than 10,000 patients can tell his own positive story.

Yet we sometimes forget that all these lives were saved only through financial support of international donors that cannot be provided forever and would simply end one day. And without a state support, all these people are doomed.  Today, we are really happy that the government have finally turned their attention to the drug-dependent people and for the first time provided funds to procure SMT medications, but we are still worried about whether this is a final decision and whether they are ready to ensure secure and stable procurement of medications as well as provision of the complex of necessary psychosocial support of the patients”.

Effective response to HIV/AIDS epidemic, which includes SMT program as an efficient component, demands united efforts of government agencies and non-government organizations. And it is very good that this process is characterized by mutual understanding and cooperation.

Substitution maintenance therapy is a globally recognized method of treatment of people who inject drugs (PWID) aiming at prevention of spreading of HIV/AIDS among PWID. It also facilitates re-socialization of PWID, returning them to living full life in the society. In Ukraine, implementation of the SMT program started in 2005, and legislative support for the program was provided in 2008. SMT is implemented at healthcare facilities (narcological dispensaries, AIDS centers, TB dispensaries, city and rayon hospitals, primary healthcare facilities). Overall, there are about 180 HCFs in Ukraine providing services to about 10 thousand patients of whom 42% are HIV-positive. All patients receive integrated services of medical (diagnostics and treatment of HIV/AIDS, TB, hepatitis, or other somatic diseases) and psychosocial support (employment, restoring interpersonal relations, creating families, having children, reintegration to the social life). In 2017, for the first time SMT medications for the amount of UAH 13 mln were procured using state budget funding, the medications are being delivered to HCFs and issued to the patients. Bidding procedures to procure the next batch of SMT medications with the funds of the State Budget of Ukraine for 2018 are going on.

Growing coverage of SMT program in Ukraine and growing share of public funding (2005-2018):

The Alliance of Public Health in collaboration with the Stop TB Partnership have implemented project “Tools for Evaluation of Communities, Rights and Gender Aspects in TB Context in Ukraine”. The project involved a study involving a broad circle of stakeholders.

This study is based on tools developed by the Stop TB Partnership, namely: HIV/TB Gender Assessment Tool (Stop TB Partnership, UNAIDS) and Data for Action Framework on Key, Vulnerable and Underserved Populations (Stop TB Partnership). The results of the study provided useful information to strengthen national TB and TB/HIV response.

Socio-cultural norms in many countries may lead to different levels of stigma, discrimination and gender inequalities. Therefore, gender has a critical impact on health seeking and treatment behavior, determining how men, women, transgender people, boys and girls seek health services and bear different kind of barriers. Using gender-based approach to evaluate TB program helped to identify barriers, which will facilitate development of corresponding interventions considering certain risks for men and women, boys and girls, as well as people with other gender identities under TB programs.

Beside desktop review, two focus groups with men and women affected by TB were conducted. Also, the study included in-depth interviews in four regions of Ukraine involving different groups and stakeholders to collect quality information for further analysis and preparation of recommendations on strengthening the national TB response.

Among key findings of qualitative data collection were specific needs of women, men and transgender people with regard to TB diagnostics and treatment. For example, participants of the focus groups stressed the need of separation of “gender flows”, i. e. separation of queues of patients wishing to do sputum tests, providing wards for separated stay of people with transgender identity receiving inpatient treatment; providing gender-sensitive physiological and hygienic conditions at healthcare facilities, including having separate toilet and shower rooms for men and women or equipping such rooms with soundproof partitions; creating psychologically comfortable conditions for diagnostics, for example, setting up a screen behind which women may comfortably strip to the waist, etc.  Considering the significant number of gender-related needs of patients, outpatient mode of treatment appears to be the best prepared to satisfy them without placing a substantial additional financial and administrative burden on the healthcare system.

The second tool was applied with the focus on the key, vulnerable and underserved populations that face an increased risk of development of TB because of biologic and behavioural factors. Such populations differ in different countries, but they are always people that are likely not reached with health services and suffer severely from TB. The project reflected existing approaches to key populations, which will ensure healthcare system’s taking account of all populations facing increased risk. Carefully selected factors influencing the risk of disease in different key populations allowed preparing an exhaustive list of such populations. It is suggested to revise the tool on the annual basis and update it on the national and regional levels as required. It may also be used by NGOs as a strong advocacy tool. The Alliance for Public Health will, in turn, recommend to approve it on the national level, and a representative of the Public Health Center of the MoH of Ukraine noted that the Center fully agreed with the conclusions of the study and would take them into consideration and advocate the changes together with the civil society.

During implementation of the project, two stakeholder meetings were conducted to introduce the evaluation tools and enable public consultations. The broad circle of stakeholders invited to the meetings contributed to the evaluation through sharing their experience and expertise and participation in development and implementation of measures based on recommendations of the study.

Strategic insights and results of the study on gender barriers and key populations in the context of TB conducted in Ukraine by Alliance for Public Health in collaboration with Stop TB Partnership will be incorporated in the national TB regulations.  Presentation of a detailed study report is scheduled for January 2018.

World Health Organisation (WHO) headquarters requested a study tour to Ukraine for representatives of Ministry of Health, WHO and civil society of Pakistan to learn about HIV prevention, diagnosis and treatment services for people most at risk of HIV. WHO sees this as an excellent opportunity to show case Ukraine achievements and provide much needed assistance to other countries struggling with similar epidemics.

Dr Marthe Everard, WHO Representative and Head of WHO Country Office Ukraine is saying: ‘WHO congratulates Ukraine for its efforts in responding to one of the largest HIV epidemics in the European region. We recognize the critical role of civil society organizations in reaching those key populations most at risk of and affected by HIV. We are delighted to facilitate and support the sharing of the Ukrainian experience in delivering evidenced-based HIV prevention, testing and treatment services with countries in other regions such as Pakistan’.

The tour is being received in Ukraine 11-14 December, 2017, in Kyiv. During the visit Alliance for Public Health, PLHA Network and other NGOs, Centre of Public Health of the Ministry of Health of Ukraine, AIDS and Narcology hospitals are visited and their experience shared with Pakistani specialists.

Special focus of the study tour is the technology to increase access to HIV treatment for people most at risk which is a global challenge. This technology was developed by Ukraine civil society organisations under the leadership of Alliance for Public Health and received international recognition. It is based on case management approach focusing on individual client’s treatment path. Alliance shared this learning during multiple international dialogues as well as supported introduction of these approaches in Indonesia, Kazakhstan, and Kenya.

‘Current HIV treatment coverage in Pakistan is 7% and we are struggling to increase it, – says Dr Safdar Kamal Pasha of WHO Pakistan while in Kyiv. – It is really exciting what Ukrainians did to link people with HIV to care. We very much appreciate exchange with colleagues and will adapt this technology in Pakistan. Look forward to continuous collaboration’.

On December 14th 2017 the street action dedicated to International Day to End Violence Against Sex Workers was held on Maidan Nezalezhnosti in Kyiv. During the action the sex-workers, human rights activists, representative of non-governmental organizations in the form of street performance demonstrated the current situation with the observance of the rights of one of the most marginalized categories of population in Ukraine, which have no less than 80 thousand people.

The action was organized by All-Ukrainian League ‘Legalife’ and Alliance for Public Health.