Component Overview
Overcoming HIV/AIDS Epidemic in Ukraine
National programme supported by GFATM
Presentation by I. Borushek, L. Shurpach, L. Hyde and P. Smyrnov at the
Stakeholders’ Meeting on the GFATM Grant to Ukraine, Kyiv, April 8, 2004
Components of the Programme
1. Improving and Scaling Up Treatment,
Care and Support for PLHA
2. Focused Prevention in Vulnerable
3. Enabling Environment through
Information, Education, and Advocacy
4. Guiding Performance through
Improved Surveillance and Evaluation
1. Treatment, care and support
• ARV procurement and supply
• Treatment planning, implementation and
• Fine-tuning of treatment protocols
• Building capacity of treatment facilities
through comprehensive training
Treatment, care and support
• Procurement and delivery of medical
equipment and medications for OI
management, post exposure prophylaxis,
PMTCT, substitution therapy
• Broad package of non-medical care and
support services
• Implementation of substitution therapy
programs for HIV+ IDUs
ARV drugs procurement and
• Treatment, care and support component will be
implemented in collaboration with MoH
• Memorandum of Understanding between MoH and
International HIV/AIDS Alliance is to be signed soon
• Oleg Zalata is appointed to coordinate the GF project on
behalf of the Ministry
• Ukrainian AIDS Center has been appointed the recipient
of ARV medications
• MoH has approved the list of medications to be procured
for treatment of 2100 people
• Negotiations with IDA regarding the procurement are
completed, conditions agreed, the contract is in progress
Procurement and delivery of nonARVs and medical equipment
• To be implemented with the help of
PATH (Program for Appropriate
Technologies in Health)
• Procurement based on international
• Terms of reference developed jointly
with MoH
Treatment planning, implementation
and monitoring
Implementer: Ukrainian AIDS Center
• Methodical support of the treatment
• Building capacity of AIDS centers / treatment
• Introduction of a treatment and monitoring
• Development of national treatment protocols
for pregnant and breastfeeding women,
protocols of non-medical and palliative care
• Monitoring the use of diagnostic equipment
• Research on introduction of HIV drug
resistance testing
Technical assistance in treatment planning,
implementation and monitoring
Selection criteria for TA providers:
1. Extensive treatment implementation experience
(including in resource limited settings).
2. Experience of TA provision, building
partnerships and introduction of treatment in
other countries.
3. Training program.
4. Comprehensive disease management system.
5. Willingness to contribute to the Program
Building capacity of treatment facilities
through comprehensive training program
Selection criteria for training providers:
1. Experience of work in HIV/AIDS
2. Extensive partnerships with various
agencies (national, international,
governmental, non-governmental, MoH, and
academic sector)
3. Solid capacity to implement a
comprehensive national training program
4. Ability and right to certify trainees
Non-medical care and support
Continued work with NGOs that started their work at the first
stage of the project implementation and demonstrated
progress in the following directions:
development of self-help groups, psychosocial care
and support, non-medical home-based care (All-Ukrainian
Network of PLHA + 26 local partner organizations),
rehabilitation of HIV+ drug users (Rehabilitation center
national hotline (Substance Abuse and AIDS
Prevention Foundation),
medical and social aspects of treatment provision,
treatment adherence support (Time for Life + Kiev, Life +
Treatment, care and support
Development of new directions of work (tender based approach):
medical and social aspects of treatment provision, treatment
adherence support (NGOs together with AIDS centers) in
Donetsk, Dnipropetrovsk, Nickolayev, AR Crimea, and Kiev.
care, psychosocial support for pregnant and breast feeding
women and their children and building their ARV treatment
adherence skills;
development of drug rehabilitation and substitution therapy
programs for HIV+ IDU receiving ARV treatment and developing
their ARV treatment adherence (NGOs jointly with narcological
dispensaries or AIDS centers);
development of the hospice care and creating specialized
unit at the Institute of Pulmonary Disease in Kiev to be postponed
until the next phase of the project implementation.
2. Focused prevention
(What has been done)
• Situation assessment in 23 cities and towns of 8
• 23 HIV prevention projects among vulnerable groups
• Project activities extended to small and medium
• 8 trainings for local implementing partners conducted
• Regular monitoring and technical assistance
Focused prevention
(Planned Activities)
• 25 HIV prevention projects among vulnerable groups
to be supported in 8 priority regions
• Cherkassy oblast is determined as a new priority
• HIV prevention projects among vulnerable groups to
be supported in 13 non-priority regions. Preparation
for the “second wave” of expansion
• 3 HIV prevention projects among prisoners to be
• Technical assistance and monitoring
• 15 trainings and seminars for local implementing
Focused prevention
(Existing Partners)
International Renaissance Foundation – main partner in HIV
prevention program among vulnerable group (project support in 4
priority and 13 non-priority regions; training program and monitoring —
through the British Council)
State Penitentiary Department of Ukraine – prevention programs in
penitentiary facilities
International HIV/AIDS Alliance
Focused prevention
(Call for Partnership)
• Expert group on procurement of prevention
• Stakeholders’ participation. Expansion of
• Development of quality standards for HIV
prevention programs among vulnerable
3. Creating an Enabling Environment
for HIV/AIDS work in Ukraine
Harmonised IEA campaign on a national and
regional level:
through schools, regional resource centres,
media, public events, specific activities with key
organisations and institutions (e.g militia, local
authorities), targeted publications.
IEA support for prevention and for care and
• IEC materials, best practice, media support,
experience exchange, series of advocacy
IEA support for research and evaluation:
• National indicators on media monitoring,
coverage in education establishments.
Coordination and harmonisation:
• A joint communication strategy for Ukraine.
Five sub-components:
1. Mainstreaming of HIV prevention in the
education system
2. Working with and through media
3. IEC work with vulnerable communities
4. National and local level advocacy
5. Coordination, documentation, sharing
HIV prevention in the education system
• New curricula (materials, teacher training).
• Peer-education system (through eight
regional resource centres).
Collaboration and partners:
• Ukrainian Scientific Methodical Centre of
Practical Psychology and Social Work of
MoES (existing partner).
• regional resource centres (open tender for
NGO/government coalitions).
• Partners for materials and training
Working with and through media
• Support for journalists and editors.
• National public awareness campaign.
Collaboration and partners:
• Training on basis of regional resource centres
• Training programme developed by working
• Bulletin for journalists, media monitoring.
• Open tender for media agencies to develop
National public awareness campaign.
• Public events.
IEC work with vulnerable communities
• Assessment, reprint of existing IEC materials.
• Online database of Russian/Ukrainian
language resources.
• New materials produced centrally and locally.
Collaboration and partners:
• Working group for assessment (building on
existing work with BC, IRF).
• shared ownership of resource database.
• Grants to NGOs for new materials.
Advocacy for an enabling environment
• National level advocacy around PLHA rights
• Local advocacy around vulnerable groups
(uniformed services, prisons administration,
local authorities)
Collaboration and partners:
• National advocacy grant for 2 national or
international NGOs (to work on PLHA rights)
• Training on basis of regional resource centres
• Open tender for small grants to local NGOs
Coordination, documentation, sharing
Best practice publications for all components
Exchange visits.
Keeping the ‘AIDS community’ informed.
A joint national communication strategy?
Collaboration and partners:
• Bursaries for exchange visits.
• Existing coordination structures (e.g UN
theme groups).
• Working group to develop a joint strategy?
4. Surveillance and Evaluation (goals
and objectives)
• Supporting necessary improvements of the national
epidemiological surveillance system including introduction
of regular and well-structured sentinel and behavioral
• Supporting social research necessary to improve
understanding of epidemiological trends and development
of appropriate responses
• Supporting the development of the financial and
managerial efficiency assessment system
• Supporting development of national response evaluation
•Monitoring and evaluation of the project performance
Existing situation
• At the beginning of the 2003 there was an increasing
need in monitoring and evaluation of country
response to HIV/AIDS expressed as by National
bodies as well as by international donors
• Existing information on financial, administrative,
behavior, and epidemiologic aspects of HIV/AIDS in
the country appeared to be rather sporadic and
Actions already taken
To address this issue the following actions were taken
by HIV/AIDS community:
• National indicators were developed in series of
• Assessment of the current M&E system and practices
on HIV/AIDS in Ukraine
• The plan of the National M&E System was drafted
with involvement of all key players
Next steps
• GF project is called to support the National
M&E system
• To implement this goal the following steps will
be taken:
– To follow up on draft of the National ME
– To create an expert group, coordinated and
on the base of UNAIDS technical group on
strategic planning, to formulate
recommendations on sampling,
methodology and tools for research on
Next steps (cont.)
• To actively involve key Government bodies in
the process in order to build their capacity for
the future
• Developed methodology will be discussed on
UN technical group on strategic planning and
made available to public
• Open tenders will be conducted for each
research and survey
• After research will be performed, data will be
analyzed and results will be distributed
Topics for research
• The following research activities are
included in the plan:
- BSS on groups vulnerable to HIV (IDU and
CSW) parallel with testing on biomarkers
(second generation epidemiologic surveillance)
- BSS on youth
- Research project on stigma and discrimination
among general population
Other areas of interest
• Other potential research topics within the
1st year:
- Research or BSS on MSM issues
- Research or BSS on persons in uniformed
- Research to provide information on composite
policy index and amount of national funds
spent on HIV/AIDS
- Research on prison population
Expected results
• Unified methodology for assessing country is
developed and made available to public
• Conducted research and activities provides
information on about 18 indicators
• Other indicators could be possibly covered by
other donors (WB, EC, UN agencies, etc.) or
by data collection which is already in place
(for PMTCT or blood transfusion indicators)
Other work within GF Research
and Evaluation component
• Technical support to AIDS centers for
enhancing of routine epidemiologic
• Assessment of financial and managerial
• Monitoring of GF project activities

Overcoming HIV Epidemic in Ukraine