On the eve of St. Valentine’s Day, Alliance for Public Health (Alliance) would like to remind you about the importance of “individual protection means” – condoms, which present a universal and effective way to prevent sexually transmitted infections (STI).

Condoms are an integral part of prevention services, which with support of Alliance are provided by non-governmental organizations to members of most vulnerable populations, including sex workers.

In 2015, 13.7 million male condoms and almost 41 thousand female condoms were distributed free of charge within Alliance programs. Over 285 thousand people were reached with HIV and STI prevention services, including almost 37 thousands of commercial sex workers. Over 203 thousand people got tested with rapid tests for HIV, and 67.6 thousand – for other sexually transmitted infections. As a result of screening among the members of vulnerable populations, 4.2% tested positive for Chlamydia, 2.6% – for hepB, and 2% – for gonorrhea and syphilis. Almost 2% of those tested for HIV received positive results.

According to the official statistics, 126.6 thousand people living with HIV were registered in Ukraine as of January 2016. If in the beginning of the century the main route of HIV transmission in Ukraine was through blood (up to 70%) and HIV was mostly spread among the members of vulnerable populations, since 2008 there has been a steady tendency towards the increase in the sexual route of transmission. According to the Ukrainian Center for Socially Dangerous Disease Control of the MoH of Ukraine, in 2015 only 22% of cases of HIV infection were related to drug use, with 60% being related to sexual contacts (with no account of data from the occupied Crimea and the Donbas areas temporarily not controlled by Ukraine).

It is an evidence of the significant change in HIV transmission trends and stable prevalence of the sexual route of transmission, which increases the thread of the infection going out of the concentrated circle of vulnerable groups to their sexual partners and more general population.

HIV is no longer the problem of vulnerable populations only. Today anyone who has unprotected sex is in the risk group!

Current situation in our country brings new risks. In the context of armed conflict in the Eastern Ukraine, humanitarian crisis and mass internal migration, the danger of the spread of HIV and other sexually transmitted infections becomes almost 50 higher. The most critical situation is observed in Donbas, which is becoming kind of a “black hole” in terms of uncontrolled spread of dangerous epidemics! Considering significant intensification of sex work in the areas of military operations on both sides of the conflict line, the issue of unprotected sex in the military settings deserves special attention. According to the results of a recent study by TNS conducted in cooperation with Alliance, 61% out of over 3.5 thousand respondents from among the military did not use condoms during the most recent sexual intercourse, while 18% had sex with casual partners. Currently, negotiations are underway between Alliance and the Ministry of Defense on transfer of several hundred thousand condoms in the places of troop disposition, rotation and training centers.

If you are in love, protect yourself and your loved ones, enjoy safely, remember about risks and try to avoid them!

Contact person – Natalija Kravchenko, (044) 490 54 85 (ext. 235), kravchenko@aph.org.ua

Web: www.aph.org.ua, Facebook: www.facebook.com/AlliancePublicHealth/

13 February

International Condom Day

ENPUD member, INPUD Board member, Global Fund Advocates Network Speakers Bureau member and Alliance for PublicHealth employee, Anton Basenko, has, with technical support of Regional Platform, successfully nominated by Alliance and ENPUD for participation in Stakeholder Task Force for the 2016 High Level Meeting and received an invitation from the head of UNAIDS Michel Sidibe to take part in preparation of High Level Meeting on AIDS/HIV 2016 as a representative ofStakeholder Task Force of UN General Assembly President.

Stakeholder Task Force mission is to provide guidance to UNAIDS and the OPGA in key decisions relating to the effective and meaningful participation of civil society and all relevant stakeholders in the High Level Meeting on AIDS to be held in New York in 2016.

The Goal of Task Force members is to provide guidance to the OPGA for, among other things:

● Designing the Civil Society Hearing (CSH), including format, topics, messages, speaker selection & preparation, and provide input to President’s CSH Summary Report.

● Devising selection criteria and the call for nominations for civil society and all relevant stakeholder speakers

● Identifying, recommending, preparing and briefing civil society and relevant stakeholder speakers for all CSH and HLM interventions

● Briefing civil society and relevant stakeholder participants during the High Level Meeting.

Participation of Anton Basenko in preparation of the meeting guarantees that voice and needs of people from PUDnetwork, OST clients and people living with HIV in the world and EECA region will be heard on Civil Society Hearing andconsidered on the High Level Meeting on AIDS to be held in New York in 2016.

Within the efforts aimed at expanding the access to hepatitis C (HCV) treatment in vulnerable populations, Alliance for Public Health holds a working meeting and a training for 70 healthcare professionals and representatives of NGOs from 15 oblasts of Ukraine, involved into implementation of the second phase of Alliance DAA-based HCV treatment program. In January 2016, a new phase of program implementation commenced, allowing 500 more patients to access effective HCV treatment.

On 3 February 2016, members of the working meeting in Kyiv, including representatives of the Ministry of Health, the Ukrainian Center for Socially Dangerous Diseases Control, chief doctors of healthcare institutions, NGO managers, doctors, civil society activists, and patients with HCV, discuss the ways to reinforce partnership and improve the efficiency of HCV treatment in Ukraine within the second phase of Alliance treatment program.

The training for healthcare professionals and social workers of NGOs on 4-5 February 2016 will include presentation of theoretical materials and development of medical and social support skills in HCV treatment in vulnerable populations using multidisciplinary approach, prevention of re-infections, use of innovative drugs in HCV treatment, and treatment monitoring.

Alliance expands access to hepatitis C treatment for vulnerable populations in Ukraine

Starting from January 2016, Alliance for Public Health launched the second phase of program for vulnerable populations, which stipulates treatment of hepatitis C virus (HCV) with innovative direct-acting antiviral agent, Sofosbuvir.

Thanks to the National Campaign “Demand Treatment!” initiated by Alliance and persistent advocacy activities in cooperation with partners from all regions of Ukraine, in October 2013, for the first time in Ukraine, Peginterferon and Ribavirin-based HCV treatment program was launched, and since2015, also for the first time in the country, Alliance initiated treatment with Sofosbuvir. As of 1 January 2016, there were 320 patients involved into the program, with 161 of them having already completed their treatment courses (mostly all of them demonstrated undetectable HCV at their final tests). Before the end of the year, at least 1,500 patients will have access to such treatment. Advocacy efforts of Alliance as well as confirmed treatment success of Sofosbuvir allowed including it to the State Register of Medicines and the Unified HCV Treatment Guidelines, opening the way for government procurement and inclusion of the drug into the state-funded treatment programs.

This year, HCV treatment will become available in five more regions of Ukraine (the total of 14 oblasts will be reached), with planned coverage of at least 500 patients. The list of healthcare facilities which offer treatment and NGOs providing support to patients is available here.

According to the updated criteria of patient selection, the treatment will be accessible not only to people with HIV/HCV co-infection, but also to members of other vulnerable populations, in particular opioid substitution treatment patients, people who inject drugs, commercial sex workers, etc. with no HIV.

Important notices for the patients who comply with selection criteria:

• In oblasts, which offer treatment only in AIDS centers, such treatment will be accessible only to people with HIV.

• Alliance, supporting I Speak Out Now! anti-corruption campaign of the Global Fund (http://www.ispeakoutnow.org/home-page-ru/), draws attention to the fact that one of the priorities of HCV treatment program is protection of the rights of patients from among vulnerable populations, in particular their right to free treatment. If any corruption situations occur when enrolling patients into the program or if there are any unreasonable proposals from the project staff to receive illegal rewards from patients, please write the details of such situations to Alliance e-mail porada@aph.org.ua.

Alliance does not rest on its oars, but continues its advocacy and treatment efforts to make an impact in response to the HCV epidemic in Ukraine.

SITUATION REPORT ON THE STATUS OF HIV/TB/HCV/OST PREVENTION AND TREATMENT PROGRAMS IN THE DONETSK AND LUHANSK OBLASTS (AS OF 27 JANUARY 2016)

ICF “Alliance for Public Health” in partnership with Contact Network (Switzerland) and AIDS Foundation-East-West (AFEW, the Netherlands) have conducted the second meeting for development of a regional program to the Global Fund on HIV and Tuberculosis responses among key populations in the Cities of Eastern Europe and Central Asia. This meeting took place on the 21-22 January 2016 in Kyiv, Ukraine.

 The goal of this program is the achievement of the UNAIDS model of ’90-90-90′ for key populations in cities of the EECA region as well as the to follow the End TB Strategy and the new Global Plan to Stop TBthrough the development of a Regional City Platform with the twinning and mentoring of cities in Western Europe. This platform provides for the sharing of experiences/best practices, development of political leadership among city policy makers, sustainable scale-up of services by developing an enabling environment and a conducive regulatory framework in cities, including sustainable funding to NGO service providers from municipal budgets. Key topics are: development of city service models, policies for key populations and HIV/TB/Hepatitis; political and financial engagement and collaboration between city authorities and NGOs.

NGO representatives from 10 countries, international stakeholders (UNAIDS, Global Fund), key population networks (SWAN, ENPUD, SCN, ECOM, ECUO), Stop TB Partnership and cities municipalities’ representatives took part in this meeting.

Participants discussed and endorsed the main objectives of the Concept Note as well as interventions and expected outputs of the programme. Also criteria for final cities’ selection were agreed.

The cities selected for the intervention in EECA are: Soligorsk (Belarus), Sarajevo (Bosnia and Herzegovina), Sofia (Bulgaria), Tbilisi (Georgia), Almaty (Kazakhstan), Bishkek, Osh (Kyrgyzstan), Beltsi (Moldova), St. Petersburg, (Russian Federation), Bucharest (Romania), Kyiv, Odesa (Ukraine).

On 18–23 January 2016, Odesa hosted Winter School 2016 «Public Health in Ukraine». Target audience of the School included medical doctors, epidemiologists, public health managers, researchers, educators, and representatives of civil society organizations. Among teachers there were speakers from the USA, the United Kingdom, and the Netherlands. During the week, public health professionals gained knowledge, shared their thoughts and professional experience.

School format — two parallel sections, with morning plenaries and afternoon discussions for all participants. Speakers representing ICF «Alliance for Public Health» – Tetyana Salyuk, Project Director: M&E-related Technical Assistance and Improved Data Application in HIV (METIDA), Liudmyla Shulga, Head of Technical Support at Alliance for Public Health, and Dr. George Rutherford, University of California, USA — worked in Section 1«Public Health and Basics of Epidemiology». In this section, the participants studied the basics of epidemiology of infectious and non-infectious diseases, principles of evidence base formation, terminology as well as basics of establishing dialogue among all public health players (European experience and lessons for Ukraine).

The Winter School was organized by the School of Public Health of the National University «Kyiv-Mohyla Academy» and UNICEF. The project was supported by M&E-related Technical Assistance and Improved Data Application in HIV (METIDA) Project, ICF «Alliance for Public Health», which provided grants to 30 applicants to participate in the School.

Besides, partners of the School included International Renaissance Foundation, USAID Project «Improving HIV/AIDS Services for Key Populations in Ukraine» (RESPOND) implemented by Pact, Inc. in partnership with Family Health International (FHI360), Maastricht University and the Ministry of Health of Ukraine.

Follow the link to see the Winter School’s booklet.

Alliance for Public Health is happy to greet our employee, Anton Basenko who successfully completed the selection process and became a member of the Community Delegation to the Board of the Global Fund.

The mission of the Communities Delegation is to ensure the voices and issues of people living with HIV, TB and affected by malaria influence the deliberations and decisions on investments and programmes of the Global Fund to achieve greater and sustained impact for communities. The goal of the Delegation is to ensure that our participation on the Global Fund Board results in Universal Access to quality prevention, treatment, care and support for communities living with and affected by the three diseases based on the principles of equity and human rights.

The Community Delegation has one vote in the Board of the Global Fund and is one of the 3 Delegations, comprising the advisory bodies to the Board of the Global Fund.

Anton Basenko as a representative of the international and regional PUD networks, OST clients and people living with HIV will bring his strong voice and support to the solving of problems connected to access to Global Fund programs for these communities.

The year 2015 was challenging both for the state and for non-governmental organizations providing
humanitarian aid and social support in Ukraine, nevertheless significant results have been achieved.

President of Ukraine Petro Poroshenko, speaking at the UN Sustainable Development Summit, noted
that the country was able to reduce HIV/AIDS incidence rates and make progress in combating tuberculosis.
To a great extent, those results were obtained through the coordinated efforts of government
and civil society, and Alliance for Public Health is proud that it has made its contribution into achieving
these results.

Here are our five highlights of the outgoing year which have formed a solid ground for 2016:

/1

New program ‘Investing for impact against tuberculosis and HIV’ helped to achieve major
country targets and avoid TB and HIV treatment interruption. In 2015 the prevention services
were provided to 192,000 people who inject drugs, 32,000 sex workers and 29,000 men who
have sex with men. This is 8% or 17,600 more than in 2014. The Global Fund awarded
Alliance the highest performance rating A1.

/2

Alliance has directed the largest part of its 2015 funding to stopping TB. Procured by Alliance
molecular genetic tests allowed to identify 80% of all new TB cases in Ukraine in 2015. Every
second MDR-TB patient receiving treatment in Ukraine is treated with drugs that were
procured, donated and delivered by the Alliance.

/3

We have made DAA Hepatitis C treatment a reality in Ukraine! Alliance procured Sofosbuvir
at the lowest price in the region, making the treatment available for the most vulnerable – over
300 HIV/HCV co-infected people who inject drugs. Based on this experience the Ukrainian
Ministry of Health has changed the treatment guidelines and re-oriented state procurement
prioritizing up-to-date DAA treatment.

/4

Thanks to Alliance support and dedicated efforts of social workers and physicians, prevention
and treatment projects are still operating in the areas temporarily not under control of the
Ukrainian Government. Humanitarian aid procured and delivered by Alliance to Donbas
during 2015 contained over 8.3 million pieces of tests, condoms, syringes and other
commodities, as well as 48,182 packs of TB drugs which made possible to maintain
uninterrupted MDR-TB treatment for 773 patients.

/5

Ukraine became a model for other countries requesting to learn from us. By the end of
2015 Alliance has provided technical support to 40 countries. In addressing a great demand
from different continents the Alliance Centre of Practice for HIV, Hepatitis C and Drug Use was
established in Kyiv combining Ukrainian and international expertize.

It was a year of transformation for Alliance: following 15 years of experience we evolved to become the
Alliance for Public Health to be in a stronger position to address the AIDS, Tuberculosis and Hepatitis
epidemics. As the Alliance for Public Health we will bring into 2016 our broader public health
commitment and our expertise in driving innovations and taking programs to scale to impact
the epidemics and to ensure sustainability. By working in partnership with you all, we will work hard
to change Ukraine and the world for the better!

On the World AIDS Day, Alliance for Public Health in collaboration with the State Administration of Railroad Transport of Ukraine, the Trade Union of Railway Workers and Transport Constructors of Ukraine, Convictus Ukraine, Eney Club Charitable Foundation and other civil society organizations conducted HIV testing on the main railway stations: in Kyiv, Dnipropetrovsk, Kharkiv, Vinnytsia, and Kryvyi Rih. According to preliminary estimates by 3.30 p.m. among 544 individuals tested over 3% were found to be HIV positive.

Media coverage of event:

Kyiv:

http://24tv.ua/kiyan_bilya_vokzalu_pereviryali_na_snid_n636…

Dnipropetrovsk: http://www.dnepr.com/…/20621-na-vokzal-bazhayuch-mogli-proy…

Kryvyj Rih: https://www.youtube.com/watch?v=9OWhZao2hA0

Vinnytsia: http://www.myvin.com.ua/ua/news/health/38614.html