Ukraine Losing HIV/AIDS Fight

KIEV, Ukraine -- Ukraine’s HIV/AIDS epidemic is a threat to Europe, according to UNAIDS, while international experts said the Ukrainian government is failing to curb the disease’s growth rate, which is the highest in Europe.

Ukrainian President Viktor Yushchenko demonstrates a chart revealing the increasing rate of citizens contracting HIV/AIDS at a December meeting to address the epidemic.

About 1.63 percent of Ukrainians, or about 756,300 citizens, were estimated to be living with HIV/AIDS in 2007, up from 1.46 percent of the population in 2005, or 685,600 citizens, according to UNAIDS. The statistics only reflect official cases, while those infected is likely higher, officials said.

“The current efforts of national and local authorities, the public and donors to stop the spread of HIV/AIDS have failed to have a due impact on the epidemic,” said UN Resident Coordinator in Ukraine Francis O’Donnell.

In particular, the government’s 2004-2008 program to combat HIV/AIDS had grave shortcomings and failing results, according to an audit sponsored by the National Coordination Council for HIV/AIDS (NCC), in cooperation with the UN, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the US government. Its report was released April 18.

“Although all the necessary elements were present in the 2004-2008 program, its scale was not large enough,” said Anna Shakarishvili, the coordinator of UNAIDS Ukraine.

“Statistics clearly show that even though really large sums of money were given by international sources for HIV/AIDS prevention, they were being used spottily.”

For example, the government program focused its efforts and resources on the Ukrainian regions known to have the highest HIV rates, including Odessa, Kherson, Mykolayiv, Donetsk, Kyiv and Crimea, while leaving other regions with few resources, said Olena Banash, the vice manager of the Chemical Dependence and AIDS Proficiency Fund.

In fact, as many as 36 projects were concentrated in these regions alone, using 30 percent of the total HIV/AIDS funding, Shakarishvili said.

“In the western regions, it often happens that there is just one dedicated expert for several oblasts,” Banash said.

Donations, from both government and non-government sources, totaled more than $255 million to fund HIV/AIDS programs between 2004 and 2008, Shakarishvili said.

In order for the government’s 2008-2013 program to combat HIV/AIDS to work effectively, it has to have a bigger scale, better quality HIV/AIDS treatment services and a system of quality monitoring, the audit said.

If the new program does not work out, those infected with HIV/AIDS will continue to increase and potentially cause anywhere between 43,400 to 95,000 deaths in 2010, Ukraine’s Ministry of Health Defense said.

In its turn, the World Bank offered a bleak prognosis in its year-end report released in December 2007, anticipating that 140 Ukrainians will die daily from HIV/AIDS in 2014, 75 percent of those infected will be between 20 and 34 years old, and half of them will be women.

Poor management of HIV/AIDS funds, and possible corruption, is a factor in Ukraine’s inability to control its HIV/AIDS epidemic.

In the past four years, several non-governmental organizations (NGOs) suspended major grants because of their dissatisfaction with government management of programs.

In April 2006, the World Bank suspended a four-year, $60 million project to stop the spread of HIV/AIDS and tuberculosis (TB) due to the government’s inability to properly distribute funds and implement programs.

The suspension was lifted in November 2006 under the condition that Ukraine improve project management and accelerate implementation of its programs.

The World Bank project will be re-evaluated at the year’s end.

Meanwhile in 2004, the Global Fund withdrew its two-year grant of $25 million from the government and transferred it to the management of the International HIV/AIDS Alliance in Ukraine (IHAU).

Despite the problems, international organizations remained patient with Ukrainian authorities and maintained financing.

In the same year after its grant withdrawal, the Global Fund gave the Ukrainian government’s 2004-2008 program about $150 million, the largest grant given to an Eastern European country.

Meanwhile, the government increased its own domestic funding for HIV/AIDS prevention to $20 million in 2007, Shakarishvili said.

With these funds, the government led HIV prevention campaigns among high risk groups (injecting drug users and sex workers) by offering them information, clean syringes, condoms, specialized therapy and prevention programs for children.

Among its other initiatives, the Ukrainian government is establishing Social Service Centers for Family, Children and Youth in HIV/AIDS Prevention, introducing prevention practices, distributing condoms and other supplies, and conducting lessons on HIV prevention in secondary school courses to increase awareness, Shakarishvili said.

The centers are situated in every oblast, with their own offices.

A network of call centers offer HIV/AIDS patients advice and counseling through a “trust phone” hotline established in June 2002.

The majority of callers are younger than 25 years old, said a call center operator who only identified himself as Rinat, stressing that each hotline operator uses a pseudonym.

“They may start asking very simple questions such as, ‘How long have I already been working,’ or ‘Until what time they can call,’ only later revealing that it has already been several years they have been living with HIV and are now experiencing serious psychological problems,” Rinat said, adding that a typical oblast call center gets 250 calls per month.

The call center can also provide a full database of AIDS centers throughout Ukraine and information on HIV drugs and treatments, such as anti-retroviral drugs, as well as a free consultation with a doctor on mornings.

While the Ukrainian government’s response to HIV/AIDS has made progress in addressing the epidemic, much more needs to be done to avoid devastating economic, health and demographic effects that are likely if no serious reforms are taken, said Olha Myrtsalo, public information advisor at USAID Regional Mission to Ukraine.

To this day, Ukrainians usually don’t take their own initiative to get tested for HIV, and women often only find out they are HIV-positive when they become pregnant.

Source: Kyiv Post

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Do you know if there is any chance to access the Ukrainian AIDS Council? I'm doing research on it...