Progress to date and Plans for Year 5 Overcoming HIV/AIDS epidemic in Ukraine Programme supported by the Global Fund 11 th Stakeholders’ meeting 22 nd of June, 2007 Andriy Klepikov Executive Director, International HIV/AIDS Alliance in Ukraine

Main achievements (as of April 01,2007)  persons (3 464 adults and 596 children) take the vitally important antiretroviral therapy (АRТ)  of HIV-positive pregnant women received ART to prevent the HIV-transmission from mother to child during birth (cumulatively since 2004)  522 injecting drug users access substitution maintenance treatment (SMT)  406 clinical facilities across Ukraine obtained medicines and other health products  The groups most vulnerable to HIV-infection received prevention services and information IDUs sex workers sex workers prisoners prisoners The coverage access prevention services

Implementation of the antiretroviral therapy in Ukraine by the sources of funding Global Fund State Budget Other sources

Major challenges at this stage and actions taken: Recall of Viracept  Immediate note of the Alliance to the Ukrainian authorities and quick communication to all essential stakeholders  Decision on replacing Viracept with Kaletra  Quick acting on placing the order with IDA  Ensuring that all necessary formalities are made Delay with rolling out substitution maintenance treatment (SMT) with methadone  Involvement in the MOH Order development, advocacy for signing the order  Support preparation of facilities where the therapy will be provided (48 sites)  Quick preparations of the documents and support of all other involved institutions in order to obtain the import quota for Ukraine  Quota procedure may delay actual rolling out of SMT

Ambitious 2008 targets  6,000 patients on ART  6,000 IDUs on ST (1250 of which also on ART);  12,200 pregnant women receive PMTCT;  26,300 PLHA access non-clinical care & support  150,000 IDUs  15,000 sex workers access prevention services  19,200 prisoners

Comparison budget table

Proposed Year 5 budget to Approved Year 5 budget Proposed Year 5 budget to Approved Year 5 budget Main Programme objectives Activity Description Approved Year 5 budget Proposed year 5 budget Variance as to approved budget Variance (%) 1Establishment and maintenance of PR Unit % 2 Treatment, care and support (including procurement of ARV and other medical supplies) % 3Focused prevention % 4Information, education and advocacy % 5Surveillance and evaluation % 6Alliance management fee % TOTAL % All costs presented in USD

Consolidated Budget - Revised Euro Budget, Prepared June Main Programme objectives Activity Description Year 3 Spend Proposed Year 4 Budget June 07 Proposed Year 5 Budget June 07 Total Year 3 – Year 5 1 Establishment and maintenance of PR Unit Treatment, care and support (including procurement of ARV and other medical supplies) Focused prevention Information, education and advocacy Surveillance and evaluation Alliance management fee TOTAL Amount of the agreement in EURO: Total Year 3 - Year 5 in EURO: Potentially available for no cost extension (EURO):

Round 1 to Round 6 complimentarity

No-cost extension priorities  Drugs for substitution therapy  Support programmes for the ST clients  Support for ARV Adherence  Administrative support

Key principles of the Y5 planning  Harmonization with Round 6 programme, addressing potential funding gap between October 2008 – June  Build confidence that all the patients that ill receive ARV treatment and PMTCT within the Round 1 framework will continue treatment after September 2008 with governmental funding.  Addressing programme challenges e.g. ARV treatment dropouts, growing needs in substitution therapy, and coverage of most at risk populations and PLHA  Recommendations from the external evaluation of the grant will be applied for the current and Round 6 grants as well as for the overall country response  Ensure meeting all the targets