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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 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
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
SCALESCALESCALESCALE
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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.
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
SUSTAINABILITYSUSTAINABILITYSUSTAINABILITYSUSTAINABILITY
ART Programmes Transferred to the State Continue Developing
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
FUNDRAISINGFUNDRAISINGFUNDRAISINGFUNDRAISING
$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
STANDARDSSTANDARDSSTANDARDSSTANDARDS
Purchase Prices for ARV Medications are Gradually Flattened out
2009
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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:
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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.
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
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.
Міжнародний Альянс з ВІЛ/СНІД в Україні www.aidsalliance.org.ua
10 years of joint work