1. PROGRAM UPDATE OVERCOMING HIV/AIDS EPIDEMICS IN UKRAINE NATIONAL PROGRAM SUPPORTED BY GFATM COMPONENT: TREATMENT, CARE AND SUPPORT Presentation by Treatment, Care and Support Department at the 3rd Steakholders Meeting on the GFATM Grant to Ukraine September 2, 2004, Kiev, Ukraine

2. TREATMENT, CARE AND SUPPORT Clinical component Monitoring of treatment, adherence, procurement, etc. Technical support of National AIDS center in developing capacity for programme implementation Component on training doctors, nurses and social workers Development of national protocols. Creation of the unified system of procurement management and monitoring Process of procurement (ARV medicines, non-ARV medicines, equipment, consumables) Procurement management Non-medical care and support

3. Partnership that facilitates successful project implementation  Ministry of Health of Ukraine  Ukrainian center for AIDS prevention  Institute of epidemiology and infectious diseases of the AMS of Ukraine  PATH  MSF  Ukrmedpostach  Employees and consultants of the International HIV/AIDS Alliance (Brighton, GB)  National and international consultants  Creation of new department in the Alliance

4. Procurement of ART medicines was the most complicated task for Alliance Absence of experience Recruitment of consultants on procurement, logistics, brokers, lawyers, and other professionals Despite the difficulties the Alliance has successfully managed achievement of its objectives. As a result, the cargo has obtained the status of humanitarian aid Issuance of the Edict of the Ministry of Health of Ukraine has approved the Schedule of the supply and implementation of ART on the regional and local levels On August 16, 2004 the medicines have been supplied to all regional AIDS centers Procurement of ARV medicines

5. Procurement of non-ARV supplies Ratification of the specifications on procurement of diagnostic equipment: three flow cytometers, viral load analyzers and drugs for opportunistic infections, and also buprenorphine for implementation of substitution therapy On August 31, 2004 the tender has been conducted on three flow cytometers, viral load analyzers and drugs for opportunistic infections

6. Training of medical staff and social workers In June 2004 the series of trainings have been conducted on Providing ART to Adults and Adolescents (by Knowledge Hub and the Ministry of Health of Ukraine at the premises of the Lavra Clinic) On September 1, 2004 we have started preparation on providing trainings listed below:  Pediatric ART Course  Pediatric Mentoring On-site  ART Adult and Adolescent Mentoring On-site Currently we negotiate with AHF-Global Immunity on providing system of treatment monitoring and training of medical staff on its use

7. Non-medical care and support Providing rehabilitation services for HIV- positive intravenous drug users (IDU) – 5 projects Medical-social and psychological support of ART – 7 projects Medical-social and psychological support of HIV-positive pregnant, recently confined women and children born to HIV- positive mothers” – 4 projects

8. Ukrainian center for AIDS prevention – project „Organization of medical support for HIV/AIDS infected people and improvement of epidemiological monitoring in the country for realistic estimation of the scale of HIV/AIDS epidemic” Charitable Fund „Substance Abuse and AIDS Prevention Foundation” – project „National hotline on the issues of HIV/AIDS”. All Ukrainian Network of PLHA – project „Development of care and support for people living with HIV/AIDS” which includes 34 projects. Megaprojects:

9. Non-medical care and support Megaproject: ACO „All Ukrainian Network of PLHA” Trend: Development of non-medical care and support for people living with HIV/AIDS – 5 projects Trend: Care and support for people living with HIV/AIDS in prisons – 3 projects Trend: Development of Community Center model for HIV- positive people – 5 projects Trend: Development of self-help movement – 12 projects Trend: HIV/AIDS self-help (summer camps) – 3 projects Trend: Care and support for children with HIV/AIDS – 4 projects Trend: Comprehensive care and support – 2 projects

10. Making ART accessible to intravenous drug users (IDUs) Currently, the Alliance has been unable to proceed with only one project – substitution therapy. Preparatory work on the purchase of buprenorphine has been successfully performed. It can now be purchased at any time. The project has not been started for a number of reasons. However, the new adequate schemes to offer substitution therapy for IDUs on ART are constantly being searched for.