Overcoming HIV/AIDS Epidemic in Ukraine National programme supported by GFATM Presentation by Alvaro Bermejo and Andriy Klepikov at the Stakeholders Meeting on the GFATM Grant to Ukraine, Kyiv, April 8, 2004

Overcoming HIV/AIDS Epidemic in Ukraine Complex effort in support of Ukrainian response to HIV epidemic Designed taking into account other initiatives implemented or planned Success is conditioned on co-ordination and partnerships

What is Expected from International HIV/AIDS Alliance Quick completion of the start up phase and start of large scale implementation Concerted implementation of all components Implementation largely in accordance to the original programme design Articulated leadership and appropriate involvement of relevant stakeholders Compliance with international standards and good practice in programme management and implementation Transparency and accountability

Constituents of Success Renewal of the grant for years 3 to 5 Considerably improved access to treatment Significant coverage of focused prevention efforts in selected areas State public health system ready to take over the clinical care work Fully operational CCM resume programme oversight and strategic guidance

Components of the Programme Improving and Scaling Up Treatment, Care and Support for PLHA Focused Prevention in Vulnerable Communities Enabling Environment through Information, Education, and Advocacy Guiding Performance through Improved Surveillance and Evaluation System

Treatment, Care and Support ARV procurement and supply management Treatment planning, implementation and monitoring Fine-tuning the national treatment protocols Procurement and supply of non-ARV health products Capacity building through comprehensive training programmes Broad package of non-clinical care and support services Implementation of substitution therapy programmes for HIV-positive IDU

Focused Prevention HIV prevention scaled up programmes aimed at reaching substantial coverage of vulnerable communities (IDU and those involved in commercial sex) in 8 intensive focus regions Basic level of support for currently existing programmes targeting IDU and those involved in commercial sex in other regions Development of HIV prevention projects in penitentiary institutions Comprehensive technical assistance to organisations implementing the projects Strong co-ordination between prevention and care programmes

Information, Education, and Advocacy Coordination of all branches of national response to the epidemic through appropriate communication strategy Mainstreaming of HIV prevention on education system Working with and through media IEC work with vulnerable communities Database of Russian/Ukrainian language IEC resources National and local level advocacy work Best practice documentation and sharing of lessons

Surveillance and Evaluation Improvements of the national epidemiological surveillance system including introduction of regular and well-structured sentinel and behavioral surveillance Social research necessary to improve understanding of epidemiological trends and development of appropriate responses Development of the financial and managerial efficiency assessment system Development of national response evaluation system Project monitoring and evaluation system

Progress so Far Agreement with GFATM signed on 15 th March 2004 for 12 months for the amount of 15,737,000 USD Interruption of services on the ground avoided with bridging funding Budget breakdown by components, USD 1,396, ,000 10,725,000 2,869,000 and advocacy Treatment and support Focused prevention Information, education Surveillance and evaluation

Progress so Far (Cont’d) Whilst awaiting first disbursement: Project implementation unit established We have been assessed by the LFA International technical support provision intensified Workplans adjusted to the current situation A series of consultations were conducted with key stakeholders (government agencies, international organisations and donors, NGOs, PLHA) Established good working relations with the Ministry of Health of Ukraine -- key partner on the GFATM project Dr. Oleg Zalata is appointed as the project co-ordinator on behalf of the MOH Agreed to sign a Memorandum of Understanding and Co-operation between MoH and the Alliance under the Global Fund project Ukrainian AIDS Center is designated to be the recipient of ARV medications

Progress so Far (Cont’d) By the end of this week Alliance is planning to sign a contract with IDA to procure ARVs for Ukraine according to the list of drugs agreed with the MOH. ARV drugs borrowed from MSF to cover emergency gap will be reimbursed under this procurement Preparation for renewal of contracts with organisations that started their work at the first stage of the Project implementation and demonstrated the progress in the areas of care and support, and prevention New tenders for the project implementation in several areas are at the preparatory stage Concluding negotiations with PATH to assist with procurement of non-ARV health products and supply management Establishing geographic coverage concept including scaling up in the targeted oblasts as well as maintenance of a basic level of services in other oblasts External monitoring from the NGO and PLHA community was proposed by the NGO Coalition