The Kryvy Rig TB hospital #2 gets GeneXpert Equipment for rapid TB testing through the USAID Strengthening TB Control Project.

THE CHALLENGE:

Through the President’s Emergency Plan for AIDS Relief (PEPFAR), USAID works to sustainably control the HIV/AIDS epidemic in Ukraine. USAID is helping Ukraine to follow the UNAIDS Fast Track Strategy to achieve an AIDS Free Generation by 2030 by reducing HIV transmission through an increase in the proportion of people living with HIV who receive treatment.

In Ukraine, an estimated 223,500 people over the age of 15 live with HIV. The Ukraine epidemic is concentrated in key populations: people who inject drugs (PWIDs) and their sexual partners, men who have sex with men, and female sex workers. HIV is also concentrated in specific regions of the country: 79% of all cases are found in 11 of Ukraine’s 24 regions.

To efficiently address the epidemic and achieve an AIDS Free Generation, USAID and PEPFAR partners have expanded outreach, care, and treatment to key populations in regions that have the highest HIV prevalence.

PEPFAR’s goal is for 72% of PWIDs to be on HIV treatment by 2017, putting Ukraine on the path to an AIDS Free Generation.

OVERVIEW:

USAID’s health program strengthens and sustains Ukraine’s health system, improving the availability and effectiveness of key health services, including reforms in the health care financing system. Ukraine has the highest burden of HIV/AIDS in Eastern Europe and one of the highest rates of multi-drug resistant TB (MDR-TB) in the world, and USAID is working with the government and local partners to control both diseases. 

OUR PROGRAMS:

HIV/AIDS

As an agency implementing the President’s Emergency Plan for AIDS Relief (PEPFAR) in Ukraine, USAID is committed to partnering with Ukraine’s Ministry of Health, regional health departments, healthcare facilities, and civil society organizations to eliminate HIV/AIDS as a public health threat. USAID provides technical assistance to develop a health system that improves the quality of HIV services, increases the proportion of Ukrainians aware of their HIV status, links people living with HIV/AIDS to treatment and care, and raises the capacity of Ukrainian organizations to deliver HIV and HIV/TB co-infection services. USAID also reduces the stigma of living with HIV/AIDS.

Tuberculosis (TB)

USAID’s TB control program supports Ukraine’s TB program to implement new treatment approaches, including the use of new drugs and shorter drug regiments for MDR-TB treatment.  USAID collaborates with the Ukrainian Center for Disease Control to transition to a more effective TB service provision with an increased use of ambulatory care.  USAID supported the development of a new case-based TB hospital payment system to enable reallocation of funding from long-term hospitalization to outpatient services.

PROGRAM HIGHLIGHTS:

HIV/AIDS:

• National Transition and Sustainability Strategy of Ukraine’s Response to TB/ MDR-TB, and HIV/AIDS developed and approved by the National HIV-TB Coordination Council at the Cabinet of Ministers of Ukraine.
• National Public Health Center established.
• Six regional HIV programs developed and approved, with government funding of UAH 2.5 million for 2016-2018
• A health systems reform and financing course for national health administrators and leading educational institutions faculty launched in partnership with Harvard University.
• Selected regional narcology facilities supported to implement an integrated HIV service model.
• National Strategic Information Portal for HIV/AIDS launched as an open source repository for national and regional HIV/AIDS data and strategic information.
• Quality Improvement (QI) teams established in over 100 HIV treatment sites in eight regions to improve HIV services and increase testing, care, and treatment.
• International and local evidence-based interventions implemented through over 50 sub-grants to local NGOs to strengthen the HIV care continuum for key populations.
• The National Essential Drug List developed to make government procurement functions more transparent.

Tuberculosis:

• A TB Training and Information Resource Center - the first large-scale Ukrainian technical resource on TB - created and transferred to Ukraine Center for Disease Control ownership.
• New outpatient care model with an emphasis on integrated TB and HIV ambulatory services successfully piloted in Kryvyi Rih.
• Medical and psychosocial support strategy for the treatment of MDR-TB ambulatory patients piloted in Poltava and Mykolayiv Oblasts.