October 09, 2017

With support of Alliance the Parliament Platform to Fight Tuberculosis Established at Ukraine

On October 3, 2017 in Verkhovna Rada of Ukraine, an interfactional platform of Parliamentarians was established to consolidate efforts to fight longstanding epidemic of tuberculosis (TB) in Ukraine. Members of Parliament representing different factions and committees willing to contribute to end the disease in our country joined the Parliament Platform to Fight Tuberculosis.

For over a year, the Alliance of Public Health, which is the focal point of the civil society organizations for working with the Global TB Caucus  in our country, and the international movement of parliamentarians Global TB Caucus, contributed to the development of the deputy initiative in Ukraine and its setting in the interfractional parliamentary association to fight against TB. As a result of this activity, on October 3, 2017, the Speaker of the Verkhovna Rada announced the official creation of the Parliament Platform to Fight Tuberculosis.

“We united regardless of party affiliation or political views. Within the framework of the Parliament Platform to Fight Tuberculosis, beside legislative resolution of issues concerning elimination of TB, our goal is to effectively cooperate with all related authorities, listen to the needs of the patients, ensure sustainable budget to fight the disease, collaborate with the civil society and parliaments of other countries. That is, to be the center of partnership and joint efforts. A special task of the Parliament Platform is to promote the rights of people affected by TB and overcome discrimination and stigma toward the patients and their families”” —noted during the Round Table on Establishing the Parliament Platform Mr. Serhiy Kiral, Member of Parliament of Ukraine, PACE Reporter on antimicrobial resistance and tuberculosis in Europe.

Participation in the event was attended by peoples’ deputies of Ukraine,, delegates of key international organizations, leaders of respective authorities, representatives of civic society, patients, and people affected by TB. At the beginning of the Round Table Olha Klimenko, a former patient and author of the book “The World in Me. Confessions of Tuberculosis Patient”, told the participants of the event about importance of supporting patients during treatment and considering their needs, based on her own experience: “A patient with any diagnosis is, first of all, a human being in need of help and support. It is important for people receiving treatment to be able to count on all the human and professional support to complete it successfully. We have a goal: to introduce outpatient treatment models in our country. For patients, provided medical indications are positive, to be able to choose whether they get treatment in the TB dispensary or at home, with regular visits and support provided by a social worker”.

Acting Minister of Health of Ukraine stated: “We have the money, we have the medicines, we have new treatment protocols. Our task now is to change the system to serve to the needs of the patients, and not its own needs. We have to make quality diagnostics and effective treatment accessible to people.”

Andriy Klepikov, Executive Director of International Charitable Foundation “Alliance for Public Health” informed regarding the need to switch to comprehensive people-centered systems of outpatient TB care that arises out of the critical situation in Ukraine and throughout Eastern Europe and Central Asia (EECA) region especially with the burden of multi-drug resistant tuberculosis (MDR-TB). He noted that our country is among the countries with the greatest burden of MRTB and that this form of the disease is diagnosed in every second patient with recurrent case of the disease, and in one of every four new cases. “Civil society organizations have proven to be key players in provision of quality and people-oriented TB care. In particular, combining medical, social and psychological support allowed doubling the success rate of MDR-TB treatment! About 80% of patients with MDR-TB were cured! This is a really impressive result, considering that on average in Ukraine, the success rate for such patients is as low as 42%.” — stated Andriy Klepikov – “In view of future switching from donor support to domestic budget sources, it is important to ensure sustainability of funding of effective approaches to detecting and treating tuberculosis. Availability of budget funds and mechanisms for social contracting of services is the foundation of the sustainability of Ukraine’s response to epidemic of tuberculosis.”

Congratulations of the initiative to create a Parliamentary Platform on behalf of the Global TB Caucus announced Rosanna Flury, EECA Regional Director of Global TB Caucus. She noticed that today Caucus has already united more than 2,400 parliamentarians from 132 countries of the world. Due to the political will and support that can be provided by members of the Parliament Platform to Fight Tuberculosis as representatives of the main legislature of the state will enable achieving sustainable outcomes, approving respective budgets and rendering significant public influence required to overcome stigma and raise the awareness of Ukrainians about the disease. Rosanna Flury also stated that “Global political actions are crucial to draw the attention to the problem of tuberculosis, a disease that kills more people than any other infection.  We are approaching an important moment in fighting TB — the 2018 UN High-Level Meeting on TB. Ukraine will play an important part in fighting TB in Eastern Europe and Central Asia, as well as on the global level.  Global TB Caucus welcomes establishing the Ukrainian Parliamentary Platform.”

The Alliance is confident that the Parliamentary Platform is waited for the fruitful cooperation with the executive authorities, international organizations and civil society. It is very important today to combine all the efforts and key components of the response to the TB problem, in particular, within the framework of the regional TB-REP project, which Ukraine is a participate in.

 

Follow the official Facebook page at www.facebook.com/platformaborotbiTB  for specific steps of the Parliament Platform to Fight Tuberculosis.

Video recording of the Round Table can be viewed at http://newsvideo.su/video/7664241

Video recording of the press briefing on the establishment of the Parliament Platform to Fight Tuberculosis can be found at http://newsvideo.su/video/7664241

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September 29, 2017

This week Ukraine hosted 4th Cycle of Harm Reduction Academy

21 participant from 13 countries visited Kyiv, Ukraine, on September 25-29, to start Harm Reduction Academy course which is developing global leadership in harm reduction. Ukraine has been purposefully chosen as one of the world’s biggest and efficient harm reduction programs that allowed to reverse the pace of HIV epidemic in injecting users and the country as a whole.

HIV epidemics is growing among PWID in the world – 10% of new infections in 2015 were through dirty needles when injecting drugs. Although there are effective and proven practices to respond to drug use driven HIV and HCV epidemics recommended WHO – clean needles, substitution therapy and ART for HIV-plosive persons – these services are available to only 10% of the estimated global population of people who are injecting drugs. Harm Reduction Academy appeared as response to the critical lack of access to key services  with ambition to generate leadership, technical knowledge and action to mainstream the interventions for people using drugs and end epidemics of HIV, HCV and TB.

The Academy started in 2016 and since then it has reopened doors to 4th group of participants this week. The students and alumni are public health professionals, national and local government workers, civil society, community, police – totally from 18 countries of the world. In the course of 3 weekly Modules they get exposed the themes of harm reduction services and interventions, data and research, drug policy and community mobilization. Combination of learning an practical exposure to programs in 3 of the hosting countries – Ukraine, Kenya and India/Malaysia – allow to receive international understanding of harm reduction and equip students for action in their home countries.

Thanks to the  participation in the academy, some significant progress has been made in developing city responses in Kyiv and Odesa, conducting international police dialogues on TB and harm reduction, initiating interventions on HIV response among people injecting drugs in Kenya.

We are really grateful for our supporters and donors, Stop TB Partnership and EQUIP project, Centre of Public Health and NGOs that kindly welcomed our visitors in Kyiv. Next module will take place in November in Mombasa, Kenya

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September 18, 2017

CITY health international conference held in Basel

On September 13-14th, the 6th International City Health International (CHI) Conference was held in Basel, Switzerland. City Health international is an annual international conference, which examines current policy and practice in relation to public health and health behaviours in cities.

The main theme of the CHI 2017 was ‘Empowerment, Engagement and Partnership: participating to develop healthy cities’. This reflects the belief that measures and actions for health promotion and urban development are more effective if the affected populations play an active and co-decisive role in the process of design, development and delivery. Evidence demonstrates that such engagement and participation contributes to sustainable solutions, to a greater identification with urban public space and increased intergenerational communication. These measures should lead to better improving health of city residents, increase life expectancy and social security of the population.

The conference was attended by about 130 delegates, including partners from the “Fast-track TB/HIV responses for key populations in EECA cities” project from Ukraine, Moldova, Georgia, Bulgaria, Kazakhstan, Switzerland and the Netherlands. Representatives from NGOs that implement the project in cities, municipalities, key populations, city AIDS Centres held a separate meeting to discuss the progress, achievements and challenges of the project, as well as the forthcoming visits of city delegations to the municipalities of Bern and Amsterdam, and exchange visits between project cities.

The conference covered broad public health topics, including sessions on homeless people, alcohol, nicotine and cannabis use, physical culture, sports, life expectancy, ecology and environmental protection, etc.

The conference ended with the announcement of City Health International 2018 Conference, which will be held on September 13-14, 2018 in Odessa, Ukraine. This will be the first City Health Conference in the Eastern European region.

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August 16, 2017

Odessa hosted mobilization meeting of the sex workers

On August 10-11 2017, Alliance of Public Health together with the All-Ukrainian Liga Legalife conducted meeting with representatives of the sex-workers community for strengthening the advocacy potential and mobilize community members.
The meeting participants, including community representatives and non-governmental organizations. Community members got knowledge about:
– Implementation of prevention, harm reduction and access to treatment during the transition period regarding new financing model;
– Advocacy at the regional and national level;
– Argumentation of the abolishing of the administrative responsibility, stipulated in art. 181-1 of the Code of Administrative Offences of Ukraine
Participants practiced on:
– Initiative group leader’s work
– Delegation of the interests and requests of the community to the CCM representative:
– An algorithm for actions in case of violation of their rights
According to the positive feed-back from community representatives, the meeting was very useful and informative. Some of the participants became new members of the All-Ukrainian Liga Legalife. Alliance continue to support and develop communities, which play the key role in HIV,viral hepatitis and TB elimination in Ukraine.

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August 14, 2017

Alliance continues trainings for National Police staff

On August 10, 2017 in Dnipro the training for managers of Temporary Detention Centers from Dnipropetrovsk, Zaporizhzhya, Donetsk, Luhansk and Kharkiv regions was organized by Human Rights Office of the National Police of Ukraine in cooperation with Alliance for Public Health.  The questions of cooperation with the police within the framework of harm reduction projects, prevention and treatment of socially dangerous diseases were included into the training program. These issues were highlighted by Pavlo Skala, Associate Director: Policy and Partnership of, who also represents The Law Enforcement And HIV Network (LEAHN) in Ukraine.

 

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August 09, 2017

New Prospects of Cooperation in Response to Socially Dangerous Diseases Set Forth with the Sumy Regional State Administration

On 9 August 2017, an official ceremony was held to sign the Memorandum of Understanding and Cooperation between the Sumy Regional State Administration and the International Charitable Foundation “Alliance for Public Health” (hereinafter – Alliance) within implementation of relevant state programs in response to HIV/AIDS, tuberculosis and viral hepatitis. By signing this memorandum, the regional administration demonstrated its deep interest in the implementation of programs to fight HIV/AIDS, tuberculosis and other socially significant diseases and in further cooperation of local authorities and civil society organizations.

As one of the official co-implementers of the activities stipulated in the National Targeted Social Program in Response to HIV/AIDS in 2014–2018, Alliance makes a significant contribution to overcoming the epidemics in Sumy region, in particular within the program “Investing for Impact Against Tuberculosis and HIV” supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. In particular, in 2016 technical support and financial resources were provided for the implementation of integrated interventions in response to the spread of such diseases in the region in the total amount of over UAH 13 million 697 thousand. The programs implemented in the region to prevent socially dangerous diseases among key affected populations bring positive results – over 11 thousand people are covered with prevention services, and there is a clear dynamics towards reducing the level of risky behavior among the key populations. Long-term implementation of the prevention programs in Sumy region (since 2001) allowed achieving high safe behavior indicators back in 2011 and maintaining the achieved indicators within the next years. Retention of programs, which include activities in such areas, and their adequate financing are the basis of stabilization of the epidemic in the region. An important factor is allocation of funds from the regional budget to provide social support to the OST patients. Such support is provided by the Club Shans NGO though the social contracting mechanism.

In the region, a program of medical and social support of patients with multidrug-resistant tuberculosis is implemented, with a cure rate higher than the average rate in Ukraine (87% success rate as compared to the average treatment success rate in Ukraine of 47.7%). Within the project to expand access to efficient hepatitis C treatment, 81 members of the key populations received treatment with direct-acting antivirals. Treatment success rate of such new antivirals is over 90%, which is almost twice as high as of the old regimens.

However, taking into account reduction in the scope of international donor funding, on the one hand, budget restrictions and further commitments of the state, in particular towards the Global Fund to Fight AIDS, Tuberculosis and Malaria, on the other hand, effective cooperation and understanding with local authorities is of great importance to ensure further implementation of the integrated programs in response to HIV/AIDS, tuberculosis and other socially dangerous diseases.

That is why support from the side of Sumy Regional State Administration and personal leadership of its head – Mykola Klochko, who realizes that the effective response to the epidemics should be grounded on the productive cooperation of governmental authorities and civil society organizations, which have a valuable long-term experience in prevention activities aimed at the key populations, present real prospects of countering the dangerous epidemics.

Mykola Klochko, head of the Sumy Regional State Administration, started the ceremony with the following statement: “I am confident that only effective changes at the local level can enable sectoral reforms at the national level, in particular, the healthcare reform. At the same time, the health of the nation depends on the efforts focused on key populations. I realize that the document that we signed today with the Alliance for Public Health will not resolve the issue completely, but I am sure that its provisions will ensure better access of such people to qualified medical, social and psychological support and will bring down risks of the spread of socially dangerous diseases.”

At the ceremony, the Executive Director of Alliance for Public Health, Andriy Klepikov, said: “Alliance makes a significant contribution to the response to the epidemics of AIDS, tuberculosis and hepatitis in the region in 2017 it is almost UAH 12 million. Sumy region is an example both in terms of controlling the epidemics thanks to the effective prevention efforts and in financing the social support services provided by civil society organizations. The Memorandum signed today marks the results of cooperation and defines further priority areas of our activities increasing HIV case finding, bringing up the number of patients who receive ART and OST services and expanding the innovative treatment of hepatitis.

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July 31, 2017

Hepatitis C: Learn Now & Treat on Time!

On 28 July 2017, Alliance for Public Health (Alliance) together with 28 partner organizations held a traditional all-Ukrainian awareness-raising campaign dedicated to the World Hepatitis Day, which is marked on this day all over the world. In Kyiv, the event was held in the Shevchenko Park. All participants had a chance to get tested for Hepatitis C for free, get qualified consultations of doctors and social workers, and receive information materials. Though today we live in an information-oriented society, the level of public awareness concerning this dangerous diseases remains extremely low. As estimated by WHO, 95% of people are not aware of their status, which is to a great extent related to the fact that the disease may be asymptomatic. Annual campaigns organized by Alliance on this day show: it is time to open our eyes as this challenge knocks on the door of almost every family. Since 2012, Alliance has already run over 252 thousands tests among the members of key affected populations. Besides, almost 18 thousand people from among general population have been tested, the rate of positive testing results being within the range of 8-12%.

This year, the main task of the campaign was not so much to provide testing, but to communicate to the public the importance of knowledge on the routes of hepatitis C transmission, timely testing and treatment, which becomes more and more accessible.

Participants of the press briefing underlined that, though the WHO classifies Ukraine as one of the 17 countries responsible for 70% of the viral hepatitis burden in the world – WHO estimates show that one to two million of Ukrainians have hepatitis C – the official statistics contains only about 49 thousand registered cases. This is a sign demonstrating that the epidemic remains hidden – people do not want to open their eyes and see it, and symptoms develop not at once, but over the time. Public officials often prefer not to talk about it.

Since long ago, hepatitis is not considered an incurable disease. New direct-acting antivirals appeared, which have up to 95% treatment success rate (old regimens – 30-40%). 

“Today for the first time ever we have confidence to say that Ukriane has got a real chance to overcome the challenges of hepatitis C, – said Larysa Hetman, Deputy Director of the Public Health Center of the Ministry of Health of Ukraine. – The government together with civil society organizations was able to achieve the reduction of prices for modern effective antivirals and is now making further steps to develop the system of hepatitis prevention services and ensure that they are accessible to all people who need them”.

“Joint efforts of the Ministry of Health of Ukraine and non-governmental organizations allowed to create the conditions for providing patients with highly effective drugs in the country – up-to-date treatment guidelines were approved and direct-acting antivirals were registered, the price for which has been decreased both for public procurement and pharmacy networks. That is why access to treatment will be growing every year, – said Olga Golubovska, Head of Infection Disease Department of the National Medical University named after O. Bogomolets. – Due to budget restrictions, within the national program we can treat only those patients who are approaching the stage of irreversible liver damage, which may lead to lethal consequences. This is an international practice. The government should ensure a proper level of financing for prevention and treatment to stop the spread of hepatitis C epidemic. Doctors should not be the buffer between dying patients and inadequate health care system”.   

Alliance was one of the first to draw attention to the issue of hepatitis C in Ukraine, initiating voluntary testing back in 2009 and launching “We Demand Treatment!” advocacy campaign in 2012.  For the first time in Ukraine, Alliance implements a program of treatment with innovative new-generation drugs at the lowest price per course in the world, in 25 health care institutions.  Each of almost 1,900 saved lives is the source of pride for the Alliance team as well as all involved doctors, medical and social workers, but we do not stop focusing on comprehensive response to the hepatitis epidemic in Ukraine. Taking into account successful results of the treatment project and persistent efforts in cooperation with international partner organizations, the Ministry of Health revised Hepatitis C treatment guidelines, including to those guidelines as well as to the list of medical drugs to be procured within national and regional budgets direct-acting antivirals, and procures such drugs with national budget funds for the second year already.

“In the first six months of 2017, 51,688 hepatitis C tests were provided within the Alliance programs, with 8,925 positive results, – told Andriy Klepikov, Executive Director of the Alliance for Public Health at the press briefing. – At the same time, hepatitis is a curable disease – over 94% of patients, who received treatment with modern antivirals delivered by Alliance to health care institutions of Ukraine – Sofosbuvir or Harvoni – recovered and got free from hepatitis! We not only cooperate with the Public Health Center and the Ministry of Health of Ukraine within the current program, but we also work together for Ukraine to approve the Hepatitis Elimination Strategy”.

Alliance for Public Health and its partners call Ukrainians to learn more about hepatitis C, get tested and practice safe behaviors! We also address the MInistry of Health and public officials responsible for the national and local budgets, calling them to stop the epidemic of hepatitis C at the national level!  On the streets of Ukrainian cities our new hero, Petrovych, urges people who pass by not to postpone the question of hepatitis, but to get information, test and get timely treatment.

 

Over 150 million people in the world are infected with hepatitis C, with over 2 million of such people living in Ukraine. According to the WHO estimates, over 1.3 million people in the world died of hepatitis in 2015, among them over 400 thousand – of liver diseases caused by hepatitis C. Most people are not aware of their disease as in 80% of cases the acute phase of the disease is asymptomatic. One of the priorities in the activities of the Alliance for Public Health is response to the spread of viral hepatitis C in Ukraine and provision of hepatitis C diagnostics and treatment for most affected populations. In 2012, Alliance initiated an all-Ukrainian advocacy campaign “We Demand Treatment!” with the main goal of scaling up access to hepatitis C diagnostics and treatment in Ukraine.

We would like to thank Norton Ukraine pharmaceutical company and Pharmasco LLC for the tests provided to conduct testing among general population in Kyiv, Kharkiv, and Dnipro.

 http://www.aph.org.ua/hepc/

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July 27, 2017

Hepatitis B and C in Eastern Europe and Central Asia: response to the epidemics

Alliance for Public Health in collaboration with 11 partner organizations in Eastern Europe and Central Asia (EECA) presents the report “Hepatitis B and C in Eastern Europe and Central Asia: response to the epidemics”.
The purpose of this report is to provide an overview of key aspects of the hepatitis  B (HBV)  and C (HCV) epidemics and response in 11 EECA countries (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Ukraine and Uzbekistan).

It also includes tools and activities for civil society organizations (CSOs) and community-based groups working on expanding access to treatment of viral hepatitis in the region. Right now, there is a strong global movement towards elimination of the viral hepatitis hepatitis It is essential that this analysis is available to ensure that the EECA region is not left out of global strategies being developed to provide universal access to innovative curative treatment regimens currently in the pipeline.

The overview summarizes data with scesial focus on availability of HCV medicines, HCV treatment guidelines, national/donor HCV treatment programs, and civil society involvement in the HCV response. It also offers possible approaches and steps that could be taken by CSOs to improve access to HCV treatment in their countries.

You may find the updated report here

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July 25, 2017

New Prospects of Cooperation in Response to Socially Dangerous Diseases Set Forth with the Mykolaiv Regional State Administration

On 25 July 2017, an official ceremony was held to sign the Memorandum of Understanding and Cooperation between the Mykolaiv Regional State Administration and the International Charitable Foundation “Alliance for Public Health” (hereinafter – Alliance) within implementation of relevant state programs in response to HIV/AIDS, tuberculosis and viral hepatitis. Mykolaiv region became the first in the list of signatories, demonstrating leadership of the regional administration in forming the commitment of local authorities and civil society organizations to the sustainable implementation of programs to fight HIV/AIDS, tuberculosis and other socially significant diseases.

As one of the official co-implementers of the activities stipulated in the National Targeted Social Program in Response to HIV/AIDS in 2014–2018, Alliance makes a significant contribution to overcoming the epidemics, in particular within the program “Investing for Impact Against Tuberculosis and HIV” supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria. In particular, in 2016 technical support and financial resources were provided for the implementation of integrated interventions in response to the spread of such diseases in Mykolaiv region in the total amount of over UAH 24.2 million. The prevention programs implemented in the region, which was one of the first to start providing services to prevent socially dangerous diseases among key affected populations, brought positive results – over 12 thousand people are covered with prevention services, and there is a clear dynamics towards reducing the level of risky behavior among the key populations. In turn, such dynamics reduces the risks of further spread of HIV among the general population. Despite the fact that the region ranks third in Ukraine in terms of HIV rate (699.7 per 100 thousand people), and in 2016 it became the “leading” region in terms of new HIV cases detected, HIV prevalence is growing alongside with reduced morbidity levels and stabilization of the incidence. It proves the impact of prevention programs in terms of reduction in the number of new HIV cases as well as efficiency of care and support programs. Retention of programs, which include activities in such areas, and their adequate financing are the basis of stabilization of the epidemic in the region. An important trend is reduced HIV prevalence among people who inject drugs (27% in 2015 as compared to 40% in Ukraine).

Mykolaiv region is one of the leaders in terms of efficiency of treatment of patients with multidrug-resistant tuberculosis – thanks to the case management programs supported by Alliance, cure rate here is higher than the average rate in Ukraine (59.3% treatment success rate (2014 cohort) as compared to the average treatment success rate in Ukraine of 45.9%). An important role in increasing treatment success belongs to the project of Alliance and the Ukrainian Red Cross Society, which stipulates support of patients with MDR-TB at the ambulatory stage of treatment. Thus, out of 120 patients (2013), who received such support, 98 (82.3%) were cured. Alliance was the first to initiate an innovative program of hepatitis C treatment with direct-acting antivirals, which demonstrates the best outcomes, with over 94% of patients being cured.

However, taking into account reduction in the scope of international donor funding, on the one hand, budget restrictions and further commitments of the state, in particular towards the Global Fund to Fight AIDS, Tuberculosis and Malaria, on the other hand, effective cooperation and understanding with local authorities is of great importance to ensure further implementation of the integrated programs in response to HIV/AIDS, tuberculosis and other socially dangerous diseases. That is why support from the side of Mykolaiv Regional State Administration and personal leadership of its head – Oleksii Savchenko, who realizes that the future achievements should be grounded on the productive cooperation of governmental authorities and civil society organizations, which have a valuable long-term experience in prevention activities aimed at the key populations, present real prospects of countering the dangerous epidemics.

At the ceremony, the Executive Director of Alliance for Public Health, Andriy Klepikov, said: “We hope that, combining the resources from the local budget, Alliance and the national funding, Mykolaiv region will be one of the first regions in Ukraine to achieve the 90-90-90 targets – international commitments, which our country has to meet by 2020. The Memorandum signed today is an evidence of the strategic partnership in response to the epidemics of HIV, tuberculosis and hepatitis. This year, we are going to invest over UAH 18 million to the region. You can count on us in our future joint efforts”.

Information about event from Mykolaiv Regional State Administration: http://www.mk.gov.ua/ua/news/?id=38413

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July 21, 2017

For the first time, Ukrainian and international experiences of implementing different MAT models/approaches were synthesized and described in a single publication called “Analysis and description of MAT models/approaches”

The publication “Analysis and description of MAT models/approaches” was developed within the project “Improved quality and sustainability of medication assisted treatment in Ukraine” with support of U.S President’s Emergency Plan for AIDS Relief (PEPFAR) in collaboration with U.S. Centers for Disease Control and Prevention (CDC). It includes detailed description of six models/approaches on provision of MAT services, studying and implementing of which is significantly perspective for Ukraine in the context of ensuring the violability of the program.

As of shortage in the government budget, there is a need to find the alternative plan for implementing the most cost-effective models/approaches to MAT provision. The issue of ensuring the violability of the program is a serious challenge for the country and the only way to solve it is the rational reinterpretation of further program development, optimization of expenses and introduction of efficient approaches to service provision of national level.

The aim of this publication is going to be fulfilled through the implementation of the following objectives:

  • To analyze the experience of MAT services from 35 countries (Pacific Rim, Near East, North Africa, Latin America, Europe, Caucasia) stressing out the countries with similar social and political background.
  • To collect experts` opinion on the implementation of different models of MAT sustainability (it was questioned 11 national and 9 regional experts: medical personnel, government representatives, representatives of international organizations/projects, NGOs representatives that work on policy making in the area of MAT).
  • To choose long-term MAT models/approaches for Ukraine in terms of program funding and service provision for supporting the sustainability, using the international experience and the results of expert questioning.
  • To study and describe chosen models/approaches and develop the strategy in order to create conditions for further practical executing (it was involved experts with experience of practical implementation)

The full text of the publication and Annexes you may find by clicking the link.

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