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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
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
IN THE EPICENTRE OF THE EPIDEMIC
 Closest to communities
 Sometimes – direct voice of
communities
 Knowledge of real needs
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
SCALE
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
EFFECTIVENESS
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?
30
29.9
Decrease in HIV prevalence
among recent Injecting Drug
Users
25
20
Percent
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.
(median sentinel surveillance in 8
cities, Ukraine - International HIV/AIDS
Alliance, 2009)
17.7
15
11.2
10
5
0
2004
2006
2008
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
EFFECTIVENESS
4000
6872
7015
7009
7084
7127
6270
5778
90,0%
80,0%
70,0%
60,0%
3881
5000
3771
4360
6000
4815
3964
7000
4587
8000
6516
7448
Officially Recorded HIV Cases among IDUs in Dynamics
50,0%
40,0%
3000
1021
30,0%
2000
20,0%
1000
3
0
10,0%
1994
0,0%
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
absolute number of new HIV cases among IDUs
share of IDUs in overall number of new HIV cases
2005
2006
2007
2008
2009
2010
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
STABILITY
 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
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
SUSTAINABILITY
ART Programmes Transferred to the State Continue Developing
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
FUNDRAISING
 $230 million to fight AIDS
 $100 million to fight tuberculosis
 Sustainable support from US
Government
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
STANDARDS
Purchase Prices for ARV Medications are Gradually Flattened out
100.00
90.00
80.00
70.00
60.00
50.00
40.00
30.00
20.00
10.00
0.00
Price per pack, USD MoH
Price per pack, USD Alliance
2009
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
LEADERS OF BEST PRACTICE / WORLD INTEREST
VAM, Insight, From Heart
to Heart (Cherkasy) in
LANCET
The Way Home (Odesa)
in SCIENCE magazine
Eney, Vertical, Step by Step (Kyiv) in
British Medical Journal
Convictus (Kyiv)
Die Zeit
in
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
PARTNERSHIP
NGOs work in partnership. Programme implementation involves:
 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
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
THE POWER OF ADVOCACY
Press conference: The doctors’ plot:
criminal prosecution of doctors and their
patients, 03.06.2010, UNIAN, Kyiv
Punished for Fighting AIDS
by Pavol Stracansky
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
THE 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 …
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
ISSUES 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.
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
SUBSTITUTION TREATMENT IMPLEMENTATION: THREATS
70000
120,0%
60000
60000
100,0%
50000
80,0%
60,0%
%
40000
30000
33,3%
40,0%
20000
10000
0,7%
0,9%
20,0%
9,2%
3,7%
0
0,0%
2006
2007
# SMT patients
2008
2010 (july) 2013 (target)
% cov
SMT estimated need
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
AGAINST 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.
Міжнародний Альянс з ВІЛ/СНІД в Україні
www.aidsalliance.org.ua
10 years of joint work