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ICF “International HIV/AIDS Alliance in Ukraine”
ELECTRONIC NEWSLETTER
on implementation of the Programme Supported by the Global Fund to Fight AIDS,
Tuberculosis and Malaria
“Overcoming HIV/AIDS Epidemics in Ukraine”
Issue # 5–6, September – October 2004
CONTENTS
INTRODUCTION……………………..……………………………………………...……………….…………………………2
PROGRAMME COMPONENT ACTIVITIES:……….………………………………………………………………………..2
1. TREATMENT, CARE AND SUPPORT:
Procurement and supply management:
- ARV and other Medical Supplies and Equipment………………………………………………………………………..2
General component activities:
- Calls for Proposals Announced and Completed…………………………………….……………...…………………..2
- Provision of Technical Assistance………………………………………………………………………………………..3
- Advocating for Access to Substitution Therapy………………………………….……………………………………...3
- Monitoring Visits……..…………………………………………………...………………………………………………...4
- II Annual Conference of PLHA of Ukraine……………………………………………………………………………….4
- Stories from the Field………………………………………………………………………………………………………4
2. PREVENTION:
- Operating Projects …………………………………………………………………….…………………………………..6
- Calls for Proposals Announced……………………….…………………………………………………………………..6
- Grants Signed………………………………………………………………………………………………………………6
- Trainings……………………………….………………………………………………….………………………………...6
- Working Meetings...………………………………………………………………………………………………………..7
- Provision Technical Assistance...…………………………………………………………………………………………7
3. INFORMATION, EDUCATION AND ADVOCACY:
Education:
- Calls for Proposals Announced and Completed……………..…………………………………………………………7
- Cooperation with the Ministry of Education and Science of Ukraine (MoES): Joint Seminars…………………….8
- Trainings…………………………………………………………………………………………………………………….8
Information, Education and Communication (IEC) for Vulnerable Communities:
- Calls for Proposals for Periodical Publications………………..………………………………………………………...9
- IEC Working Group………………………………………………………………………………………………………...9
- On-line IEC Materials Database…………………………………………………………………………………………10
- Publications………………………………………………………………………………………………………………..10
Advocacy:
- Operating Projects………………………………………………………………………………………………………..10
- Trainings..………………………………………………………………………………………………………………….11
- Research…………………………………………………………………………………………………………………..11
- Publications………………………………………………………………………………………………………………..11
Sharing Lessons and Best Practices:
- Experience Exchange Programme for NGOs………………………………………………………………………….12
- Publications………………………………………………………………………………………………………………..12
Mass Media Work:
- Annual Concert ‘A Healthy Lifestyle is Trendy!’……………………………………………………………………….12
- Grants Signed……………………………………………………………………………………………………………..13
4. MONITORING AND EVALUATION:
- National M&E System: Enforcing National Capacity to Monitor and Evaluate HIV/AIDS Epidemic……..………13
- Announced and Completed Tenders …………………………………………..………………………………….…..14
- Operating Project…………………………………………………………………………………………………………14
- Trainings………………………………………………….…………..……………………………………………………14
- System and Plan of Monitoring and Evaluation……………………………………………………………………….15
THE 3RD STAKEHOLDERS MEETING……………………………………………………………………………….……15
TECHNICAL ASSISTANCE PROVIDED TO THE ALLIANCE IN UKRAINE……………………………………..…..15
Technical Assistance from the International HIV/AIDS Alliance…………………………………………………………15
External Technical Assistance……………………………………………………………………………………………….15
ENQUIRIES……………………………………………………………………………………………………………………16
Introduction
The fifth issue of the e-newsletter provides an update on implementation of the GFATM-supported programme ‘Overcoming HIV/AIDS Epidemics in Ukraine’ in September and October 2004. The programme is implemented by the International HIV/AIDS Alliance (the Alliance). Significant progress has been achieved in programme implementation during this period.
Based on the analysis of all grant recipients, which was recently conducted by the Global Fund Observer (GFO Newsletter, Issue # 33, 18th of October 2004), the Ukrainian programme, implemented by the International HIV/AIDS Alliance, was recognized within 10% of most successful projects supported by the Global Fund.
Among the main achievements of the programme are, first of all, starting of the large scale treatment programme and its progress, providing necessary medical supplies, work on advocating for access to substitution therapy for IDUs, information and education activities, publications, organizing public events, prevention work in vulnerable communities (IDUs, SWs, MSM), development of the unified system of monitoring and evaluation as well as conducting surveys.
TREATMENT, CARE AND SUPPORT
ARV and other Medical Supplies and Equipment
In September AZT for prevention of mother-to-child transmission and Combivir for post-exposure prophylaxis have been delivered. The Alliance has signed a supplementary agreement with UKRMEDPOSTACH on customs clearance, storage and delivery of these drugs. Contracts with suppliers of diagnostic equipment have been signed.
In October ARVs for PMTCT/PEP were delivered. The second delivery of the bulk ARV order (for treatment) also started coming into the country. By the end of October, there were only two shipments still outstanding.
In the area of non-ARV procurement, a Humanitarian Aid Agreement was concluded between PATH and the National AIDS Centre, which allows delivery of drugs for opportunistic infections and diagnostic equipment to Ukraine as humanitarian aid, exempt from taxes and customs duties. The third Specification Review Committee meeting was held in October to approve technical specifications for additional laboratory equipment, refrigerators for AIDS Centres (as a follow up to treatment sites assessment conducted in July), and infant milk formula for children born of HIV-positive mothers. Appropriate procurement processes started immediately.
An order for additional ARV purchases for treating an additional 55 children with AIDS has been confirmed and placed with IDA.
Calls for Proposals Announced and Completed
In September a closed call for proposals on provision of medico-social and psychological support of ART in Kriviy Rig (Dnipropetrovsk oblast) was announced for two organisations:
v Charitable Organisation With Hope (Z Nadieyu);
v Charitable Organisation Centre of Rehabilitation and Personality Recovering EDEM.
The only project proposal submitted for this competition was ‘Organization of Highly Effective Medico-social Counselling Assistance to People Taking HAART on the Multi-disciplinary Basis in Kriviy Rig’ by the Charitable Organisation With Hope (Z Nadieyu). This project was supported by the expert committee on the closed CFP which met on 7 October.
The expert committee suggested finalising the project proposal according to the committee’s recommendations and sending Alliance experts to Kriviy Rig in order to conduct preliminary monitoring and provide technical assistance.
As a result, two programme officers from the Treatment, Care and Support Department visited Kriviy Rig on 28-29 October 2004. They studied the situation in the region, working conditions of the AIDS Centre and other medical institutions providing or planning to provide treatment to HIV-positive people. The TCS team has prepared recommendations according to which changes should be made in the project proposal.
Thanks to the technical assistance provided by the Alliance the budget and the project proposal of the project have been finalised, and the project is to start work on November 1.
Provision of Technical Assistance
ARV medicines became available for those requiring ART in six regions of Ukraine on August 16, 2004. Consequently, the Alliance has had to face new challenges: the absence of a national treatment monitoring and evaluation system, lack of experience and knowledge of medical and social workers in providing ARV treatment, problems in providing ARV treatment to intravenous drug users, and development of patients’ adherence to ARV treatment. Currently the Alliance is working on providing technical assistance to the National AIDS Centre for creating software for monitoring and quality control of ARV-treatment programmes, and building partnerships with national and international expert organisations on providing training for clinical doctors, nurses and social workers.
In order to provide high quality training programmes for medical staff and social workers, and national licensing of professionals finishing the training courses, the Alliance has signed an agreement with the American International Health Alliance (AIHA). AIHA is a highly skilled organisation that, with support of WHO and GTZ, is running the Regional Knowledge Hub for the Care and Treatment of HIV/AIDS in Eurasia, which has already gained much experience in providing training on a high level and has built partner relationships with the Kyiv Medical Academy of In-Service Medical Training and the Ministry of Health of Ukraine.
A detailed project proposal submitted by the American International Health Alliance (AIHA)/Knowledge Hub for comprehensive training for medical and other relevant professionals was agreed with the National AIDS Centre and MoH, and topics of the trainings prioritised according to essential needs and curricula were approved.
The AIHA training programme executed by the Knowledge Hub – its joint technical support project with WHO and GTZ – took place in October. The following trainings were conducted:
1. ART Adult & Adolescent Mentoring On-site
2. Pediatric ART Course
3. Pediatric Mentoring On-site
As a result 18 doctors, 8 paediatricians, 18 nurses and 16 social workers have been trained.
The curriculum of the rest of the trainings provided by the Knowledge Hub has been approved, and will include the following topics:
4. Advanced ART for Adults and Opportunistic Infections (OIs) Management
5. AIDS Care Administration and Management
6. Laboratory Testing and Monitoring of HIV-infection and Antiretroviral Therapy
7. ART During Pregnancy and Postpartum
The training programme is planned to continue in December.
Advocating for Access to Substitution Therapy
The arrival of ARV treatment advanced discussions about substitution therapy (ST), as the majority of PLHA in Ukraine are active or non-active injecting drug users (IDUs). Many HIV-positive drug users need ARV treatment, and their status as active IDUs must not preclude the provision of vital medical help for them. The Alliance is therefore advocating for the implementation of ST for IDUs on ARV-treatment. In order to support these advocacy efforts as well as facilitate the implementation of ST projects, the Alliance is participating in many conferences and workshops on ST, working closely with government representatives and preparing to sign an agreement with the International Renaissance Foundation, which already has some experience with substitution therapy projects.
After the series of negotiations in September-October 2004 the Ministry of Health of Ukraine, the International HIV/AIDS Alliance in Ukraine and PATH have reached an agreement about implementation of substitution therapy in Ukraine. On October 15 Alterations and Addenda to the Memorandum of Understanding on Cooperation between the Ministry of Health of Ukraine and the International HIV/AIDS Alliance (Great Britain) concerning substitution therapy issues were signed. It is hard to underestimate this step forward that was made towards implementation of the ST in Ukraine.
Monitoring Visits
To strengthen services on development of ART adherence, a number of Alliance programme officers have conducted monitoring (site) visits to familiarise themselves with the local situation and with project implementation. Visits also provided supervision, monitoring and technical assistance to organisations implementing projects on development of ART adherence.
In September the first round of monitoring visits covered projects in Donetsk and Odesa oblasts, while during the second round in the framework of the Knowledge Hub project visits were made to Donetsk, Dnipropetrovsk, Odesa, Mykolaiv and Simferopol. Experts of the TCS Department also visited several projects in Kyiv. In October monitoring visits to projects in Donetsk, Dnepropetrovsk, Odesa, Mykolaiv, Simferopol and Kyiv were conducted as well.
During the visits a lot of important information was gathered on new developments at regional AIDS Centres: new challenges and new successes resulting from the scale-up of ART. Different issues were discussed and dealt with while the success stories were publicised so that other ART adherence projects and AIDS Centres could use their example. Copies of successful patients’ adherence diaries were shared with other specialists, innovative ideas on how to attract new patients and improve their adherence to ART were shared. The visits were also important as they provided an opportunity for project staff to clarify all questions they have accumulated in the previous months of work.
II Annual Conference of PLHA of Ukraine
On 25-29 September 2004 the Annual Conference of PLHA of Ukraine, established in 2003 by the All-Ukrainian Network of PLHA, was held in Foros (Crimea). About 170 PLHA from 27 cities and towns of Ukraine took part in the conference. The main objectives of the Conference are:
- To develop the self-help movement;
- To mobilise the PLHA community throughout Ukraine;
- To provide training for those PLHA involved in provision of services for PLHA at the local level;
- To share best practices of the PLHA Network with other projects and organisations.
In the framework of the Conference the following training sessions were conducted: Legal Issues, Conflict Resolution, Best Practices of Work in the realm of HIV/AIDS, Group Work, Self-help Groups. In the course of the conference participants also had a unique opportunity to exchange experiences, strengthen partnership ties between NGOs, initiative groups, and projects, discuss issues of concern and develop joint strategies to overcome difficulties. A representative of the Alliance TCS Department participated in the conference to monitor PLHA Network projects and provide technical assistance.
Stories from the Field
The following success stories come directly from the local organizations that implement projects in the framework of the GFATM-supported programme - organisations that are using funds to change the situation in regions and communities. The stories demonstrate both organisational successes and benefits that make an impact on the lives of ordinary people touched by HIV/AIDS in Ukraine.
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Charitable Foundation Alternative, Gorlivka. The project “Organisation of Medical, Psychological, and Social Care and Support for HIV-positive Women and Their Children”
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In 2003 an HIV-positive woman gave birth, but because of unfavourable personal circumstances she decided to leave the child at the hospital - she could not give it proper care. Later on she found herself in a situation that forced her to officially put the child into care in an orphanage in Kramatorsk, while she became a client of the project staff from NGO Alternative. Over time the woman found a job and as she became more self-confident she wanted to get her child back.
Ukrainian bureaucracy and stereotypes about socially vulnerable people made getting the child back a very complicated task. The project staff did all they could to help. With guidance and support from the NGO, the AIDS Centre and the Social Services for Youth, the parental relationship was finally reconfirmed and the mother could finally take her child home from the orphanage.
Very soon, after parental rights were re-established, the child was diagnosed with TB that had to be treated, and a kindergarten had to be found. Project staff again provided help and support and the child now attends kindergarten and is receiving TB treatment.
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CF Povernennya do Zhittya (Return to Life). Project “Life Long Remission”
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One of the most challenging tasks for NGOs operating in Ukraine is to build productive cooperation with the institutions representing the state and government. Nevertheless, organisations are succeeding in establishing strong links with the government. The project “Life Long Remission” is a very good example of such cooperation, not only gaining the understanding of local government structures but also receiving very important support. As a result a rehabilitation centre for IDUs became possible, and a total of 45.000 UAH (almost $ 8.500) was given by the government for the development of the centre.