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IN THE EPICENTRE OF THE EPIDEMIC

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 EPIDEMIC. Closest to communities Sometimes – direct voice of communities Knowledge of real needs. SCALE. EFFECTIVENESS.

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IN THE EPICENTRE OF THE EPIDEMIC

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  1. What is the Strength of NGOs in Response to the HIV Epidemic?A. Klepikov, International HIV/AIDS Alliance in Ukraine

  2. IN THE EPICENTRE OF THE EPIDEMIC • Closest to communities • Sometimes – direct voice of communities • Knowledge of real needs

  3. SCALE

  4. 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: 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.

  5. 7448 7127 8000 90,0% 7084 7009 7015 6872 6516 6270 80,0% 7000 5778 70,0% 3964 6000 4815 4587 60,0% 4360 5000 3881 3771 50,0% 4000 40,0% 3000 30,0% 2000 1021 20,0% 1000 10,0% 3 0 0,0% 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 absolute number of new HIV cases among IDUs share of IDUs in overall number of new HIV cases EFFECTIVENESS • Officially Recorded HIV Cases among IDUs in Dynamics

  6. 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

  7. SUSTAINABILITY ART Programmes Transferred to the State Continue Developing

  8. FUNDRAISING • $230 million to fight AIDS • $100 million to fighttuberculosis • Sustainable support from US Government

  9. STANDARDS Purchase Prices for ARV Medications are Gradually Flattened out • 2009

  10. LEADERS OF BEST PRACTICE / WORLD INTEREST VAM, Insight, From Heart to Heart (Cherkasy)inLANCET The Way Home (Odesa)in SCIENCE magazine Convictus (Kyiv)inDie Zeit Eney, Vertical, Step by Step (Kyiv) in British Medical Journal

  11. 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

  12. THE POWER OF ADVOCACY Press conference: The doctors’ plot: criminal prosecution of doctors and their patients, 03.06.2010, UNIAN, Kyiv Punished for Fighting AIDSby Pavol Stracansky

  13. THE POWER OF ADVOCACY On September 25, 2010after120 days of incarceration by resolution of the Odesa Court of Appeal doctor Ilya Podolyan was released Though tough court proceedings are still awaiting him …

  14. 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.

  15. SUBSTITUTION TREATMENT IMPLEMENTATION: THREATS

  16. 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/AIDSis brought to a standstill: millions of syringes will stay in children’s playgrounds, at the stairs and next to residential houses.

  17. Thank you for 10 years of joint work

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