USA HIV/AIDS coordinator visits Alliance Ukraine and pledges continued support for scale-up of methadone-based treatment
30 October 2008
On 15 October, Ambassador Mark Dybul, United States Global HIV/AIDS Coordinator, visited the International HIV/AIDS Alliance in Ukraine and affirmed US support for the scale-up of methadone-based treatment programmes in the fight against HIV. He also emphasised the importance of partnership between government and civil society to strengthen the national HIV response in Ukraine.
The HIV epidemic in Ukraine is particularly concentrated amongst injecting drug users. Methadone-based Medication-Assisted Treatment (MAT) – more widely known as Opiate Substitution Treatment (OST) – was first rolled out there in May 2008 after a long campaign led by Alliance Ukraine. Substitution treatment enables injecting drug users to regain control of their lives by reducing unsafe injecting, and by supporting the process of starting – and adhering to – life-saving antiretroviral treatment.
During his stay, Dybul visited a MAT unit and Kyiv City AIDS Centre which receives USAID support through the Alliance. He gained insights into the medical and social services provided there, particularly prevention of mother to child transmission, and support and rehabilitation services for patients on MAT and antiretroviral treatment.
Methadone is considerably cheaper than other drugs used in opiate substitution treatment such as buprenorphine. This means that treatment can now be provided to a far greater number of injecting drug users. USAID has been a major donor supporting Ukrainian HIV efforts since 2001. Building on significant support provided through the Global Fund to Fight AIDS, Tuberculosis and Malaria, USAID is now working in close cooperation with the Ukrainian government to support the delivery of methadone-based MAT on a much larger scale.
The SUNRISE project, funded by USAID and implemented by Alliance Ukraine, currently provides information and prevention services to 170,000 Ukrainians who are at high-risk of HIV infection. The project is now seeking to expand access to MAT for HIV-positive injecting drug users and reduce waiting time for treatment.
At a press conference Dybul commended the Ukrainian government for its leadership in supporting methadone-based MAT. He praised the services he had seen during his visit and stressed the value of cooperation between state medical workers and NGOs for comprehensive service provision.
During the press conference – attended by top-level officials from the Ukrainian Ministry of Health, representatives from the Global Fund, Kyiv city AIDS Centre and Alliance Ukraine – a joint statement of partnership was issued and signed. The joint statement signifies continued cooperation between the Ukrainian and US governments in the effort to contain HIV transmission, particularly by scaling up services to injecting drug users and other vulnerable groups in the country.
The priorities and challenges associated with the rolling out of MAT services were discussed at a subsequent high-level meeting held at Alliance Ukraine. The meeting was attended by representatives from UN agencies, the Global Fund, the French Red Cross country delegation as well as Ukrainian and international civil society organisations. Dybul also had the opportunity during his visit to meet with representatives from self-help injecting drug user groups like ‘Club Eney’ to discuss the challenges their communities face as people who often have urgent needs for treatment – both HIV treatment and drug dependency treatment – but who also experience high levels of discrimination.
The scale-up of methadone-based treatment services in Ukraine is part of an ongoing effort by the Alliance to address the particular prevention needs of the epidemic in Ukraine. According to Andriy Klepikov, executive director of Alliance Ukraine, about 60,000 injecting drug users need treatment. “Currently more than 1,500 drug-dependent patients receive effective treatment in 52 health care establishments in Ukraine. We plan to increase this number to 3,000 patients by the end of the year and to 5,000 patients next year. This would be impossible to do if it were not for the financial support of the Global Fund and USAID,” he said.
