Stop TB Partnership

Addressing TB and drug-resistant TB in the Eastern Ukrainian region

27 January 2015 - The challenges in addressing the implementation of comprehensive HIV, TB and viral hepatitis prevention and treatment activities in the Eastern Ukraine affected by the warfare is complicated and escalating every week. With damaged transport routes between the settlements and a critical humanitarian situation, the International HIV/AIDS Alliance in Ukraine (Alliance-Ukraine) continues to support the operations of HIV prevention projects on behalf of 13 regional NGOs. Alliance-Ukraine also provide lifesaving TB and MDR-TB drugs to support the National TB program.

According to data by the Ukrainian Ministry of Health, there are about 14,000 of patients living with HIV, and among them 5,600 are on the antiretroviral therapy (ART), while 2,434 people have active TB, including more than 500 people with drug-resistant TB.

TB prevention and treatment in the rebel controlled territories

There are currently 1652 active TB patients in the Donetsk region and 782 in the Luhansk region which includes 535 patients with drug-resistant TB at risk of interruption or lack of treatment in 2015, according to the Ukrainian Center for AIDS Prevention of the Ministry of Health of Ukraine.

In the Donestsk region in Ukraine, rapid TB diagnostics is provided via GeneXpert systems which is procured and supplied by Alliance-Ukraine at the expense of the Global Fund. The GeneXpert system procured and supplied by the Alliance at the expense of the Global Fund remained in Donetsk. It is not possible to supply consumables for this system now due to aggravated security risk. The situation in Luhansk is even more severe. The only GeneXpert system procured and supplied by Alliance Ukraine at the expense of the Global Fund remained in Luhansk.

To prevent interruption of treatment of the patients with drug-resistant TB who were treated at the expense of the government's budget, Alliance Ukraine made an emergency procurement of second line TB drugs funded from the Global Fund grant/ The Global Fund supported medicines will approximately be sufficient to treat about 550 patients with drug-resistant TB.

Main challenges

Some of the main challenges include a delay in delivery of health products procured to the Donetsk and Luhansk areas and the absence of an exchange mechanism between the Ukrainian and rebel-controlled territories. It is also impossible to provide treatment for patients in rebel-controlled territories, further hindered by the absence of control mechanisms on usage and storage of health products in these regions.

Expecting an appropriate response from the government

In order to find a solution to the overall supply problem in the rebel controlled territories, the working group of principal recipients of the Global Fund grants and authorized state bodies recently developed and agreed the draft Resolution of the Cabinet of Ministers aimed mostly at preventing further interruption of HIV/TB prevention and treatment programs on temporarily uncontrolled territories of the Eastern Ukraine. The International Committee of the Red Cross and other international humanitarian organizations will be engaged in the delivery of supplies.

On January 15, 2015 the government representatives and non-governmental and international organizations met in the World Health Organization Country Office in Ukraine to discuss possible solutions to the most urgent issues of ensuring continuity of HIV/TB/OST and prevention of further humanitarian crisis in the rebel controlled territories. First Deputy Minister of Health Care O. Pavlenko assured the attendees that the recently drafted Resolution of the Government will allow for the organization of humanitarian medicines supply to uncontrolled territories that will in turn save lives of thousands of Ukrainian citizens.