in the epicentre of the epidemic

Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua

What is the Strength of NGOs in Response to the

HIV Epidemic?

A. Klepikov, International HIV/AIDS Alliance in Ukraine


IN THE EPICENTRE OF THE EPIDEMICIN THE EPICENTRE OF THE EPIDEMIC IN THE EPICENTRE OF THE EPIDEMICIN THE EPICENTRE OF THE EPIDEMIC

Closest to communities

Sometimes – direct voice of communities

Knowledge of real needs


SCALESCALESCALESCALE


EFFECTIVENESSEFFECTIVENESS EFFECTIVENESSEFFECTIVENESS

At the opening of the International AIDS Conference in Vienna in July 2010 the example of Ukraine was given in WHO report as a success story:

IDUs epidemic and response in Ukraine: a success story?

Decrease in HIV prevalence among recent Injecting Drug Users (median sentinel surveillance in 8 cities, Ukraine - International HIV/AIDS Alliance, 2009)

29.9

17.7

11.2

0

5

10

15

20

25

30

2004 2006 2008

Pe

rce

nt

The most encouraging as shown on the slide (on the right) is that these decreases have more than doubled among IDUs with a recent history of drug injections. Collaboration among the health sector, low enforcement against the IDU communities and NGO has been critical to success to date. The chart shows decrease of HIV infection prevalence among IDUs injecting drugs for less than 2 years.


EFFECTIVENESSEFFECTIVENESS EFFECTIVENESSEFFECTIVENESS

Officially Recorded HIV Cases among IDUs in Dynamics

7084

7009

7015

687271

27

6270

5778

4815

458739

64

3881

3771

651674

48

4360

1021

3

0

1000

2000

3000

4000

5000

6000

7000

8000

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20100,0%

10,0%

20,0%

30,0%

40,0%

50,0%

60,0%

70,0%

80,0%

90,0%

absolute number of new HIV cases among IDUs

share of IDUs in overall number of new HIV cases


STABILITYSTABILITYSTABILITYSTABILITY

Were the first to start harm reduction programmes and are still “in the forefront”

Assure sustainability on the back of new appointments in local and central authorities

Act as permanent advocates of programme interests


SUSTAINABILITYSUSTAINABILITYSUSTAINABILITYSUSTAINABILITY

ART Programmes Transferred to the State Continue Developing


FUNDRAISINGFUNDRAISINGFUNDRAISINGFUNDRAISING

$230 million to fight AIDS

$100 million to fight tuberculosis

Sustainable support from US Government


STANDARDSSTANDARDSSTANDARDSSTANDARDS

Purchase Prices for ARV Medications are Gradually Flattened out

2009


LEADERS OF BEST PRACTICELEADERS OF BEST PRACTICE / / WORLD INTERESTWORLD INTERESTLEADERS OF BEST PRACTICELEADERS OF BEST PRACTICE / / WORLD INTERESTWORLD INTEREST

The Way Home (Odesa) in SCIENCE magazine

VAM, Insight, From Heart to Heart

(Cherkasy) in LANCET

Eney, Vertical, Step by Step (Kyiv) in British Medical Journal

Convictus (Kyiv) in Die Zeit


PARTNERSHIPPARTNERSHIPPARTNERSHIPPARTNERSHIP

over 200 healthcare facilities (AIDS centers, drug, STI and TB treatment clinics, hospitals, etc.)

17 city and district centers of the Social Services for Family, Children and Youth

111 pharmacies 90 shelters and 25 centers of social

and psychological rehabilitation of children, subordinated to the Ministry of Ukraine for Family, Youth and Sport

NGOs work in partnership. Programme implementation involves:


Press conference: The doctors’ plot: criminal prosecution of doctors and their

patients, 03.06.2010, UNIAN, Kyiv

Punished for Fighting AIDSby Pavol Stracansky

THE POWER OF ADVOCACYTHE POWER OF ADVOCACYTHE POWER OF ADVOCACYTHE POWER OF ADVOCACY


On September 25, 2010 after 120 days of incarceration by resolution of the Odesa Court of Appeal doctor Ilya Podolyan

was released

Though tough court proceedings

are still awaiting him …

THE POWER OF ADVOCACYTHE POWER OF ADVOCACYTHE POWER OF ADVOCACYTHE POWER OF ADVOCACY


ISSUES ON THE AGENDAISSUES ON THE AGENDAISSUES ON THE AGENDAISSUES ON THE AGENDA

ART extension. HIV-positive injection drug users do not have proper access to treatment – their share among ART patients is less than 8%

Funding of prevention programmes. Not a penny has been disbursed from state budget for prevention activities among female sex workers, men who have sex with men.

Secret war of law enforcers against substitution treatment.

Treatment of hepatitis. TB treatment.


SUBSTITUTION TREATMENT IMPLEMENTATIONSUBSTITUTION TREATMENT IMPLEMENTATION: : THREATSTHREATSSUBSTITUTION TREATMENT IMPLEMENTATIONSUBSTITUTION TREATMENT IMPLEMENTATION: : THREATSTHREATS

0,7% 0,9% 3,7%9,2%

33,3%

60000

0

10000

20000

30000

40000

50000

60000

70000

2006 2007 2008 2010 (july) 2013 (target)

0,0%

20,0%

40,0%

60,0%

80,0%

100,0%

120,0%

%

# SMT patients % cov SMT estimated need


AGAINST CRIMINALIZATION AND REPRESSIONSAGAINST CRIMINALIZATION AND REPRESSIONSAGAINST CRIMINALIZATION AND REPRESSIONSAGAINST CRIMINALIZATION AND REPRESSIONS

As a result of recent enforcement of the Order of the MoH of Ukraine No.634, the level of criminalization of users of the most wide-spread illicit injection drugs has been increased 20-fold (!). Operation of prevention syringe exchange programmes implemented by NGOs and department of the State Social Service according to the National Programme on HIV/AIDS is brought to a standstill: millions of syringes will stay in children’s playgrounds, at the stairs and next to residential houses.


10 years of joint work

in the epicentre of the epidemic

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