The Global Fund is urging Ukraine's government to approve a resolution paving the way for emergency deliveries of critical medicines and other health commodities into the country's restive east, part of which is currently controlled by pro- Russian troops.
In a letter to Vice Prime Minister Vyacheslav Kyrylenko, dated 29 January, the Fund's manager for EECA, Nicolas Cantau, said that stocks of some of the medicines needed to help keep people who inject drugs enrolled in harm-reduction therapies would be depleted within a week.
“We are gravely concerned about the impending risk of treatment interruptions with regard to HIV, TB and opiate substitution therapy (OST) in the conflict-affected areas,” according to the letter, a copy of which was shared with Aidspan.
The letter was part of an intensive lobbying effort begun in late 2014 and spearheaded by Fund principal recipient International HIV/AIDS Alliance in Ukraine, alongside other civil society and technical stakeholders to organize a safe corridor to deliver medicines. The International Committee of the Red Cross (ICRC), Médècins Sans Frontières and other approved international humanitarian organizations would assume responsibility for the deliveries, should the resolution be passed.
A rapid assessment conducted by the Ministry of Health estimates that some 14,000 people living with HIV are residing in the area currently beyond government control. More than one-third have already begun ARV treatment; it is not known how many were preparing to enrol in treatment. There are also more than 2,000 people with active TB: one in four of them with MDR-TB.
While stocks of ARVs and TB drugs are forecast to last until end of March 2015, it is the OST that is of greatest concern. Stockouts of OST drugs (buprenorphine and methadone) have occurred since December 2014, forcing as many as 400 people off treatment. Another 450 more are at risk of discontinuation if stocks are not replenished before the end of February, according to the letter.
Ukraine is in the process of signing an agreement with the Fund for a joint HIV/TB grant worth nearly $134 million; activities under the grant include treatment and prevention interventions in the eastern region. Meanwhile, Alliance Ukraine has sent a separate request to the Global Fund to use cost savings to relocate patients from the conflict zone in order to continue their OST treatment, the group's executive director Andrey Klepikov told Aidspan.