Concerns are growing over the disruption in treatment for people living with HIV and tuberculosis in Eastern Ukraine where fighting in the rebel-controlled territories of Donetsk and Luhansk has interrupted crucial medical supplies.
Following a decision by the Ukrainian government to halt supplies to these areas, and with the border now blocked, major stockouts of antiretroviral drugs, opioid substitution therapy (OST) and other life-saving treatments are anticipated by the end of February. More than 300 OST patients in Donetsk and Luhansk have lost access to treatment since the conflict began. A further 550 patients on methadone will run out of drugs imminently if emergency supplies cannot be delivered.
Eastern Ukraine has the highest prevalence rates of HIV and TB in the country. One in five new infections are registered in Donetsk and Luhansk oblasts (regions) which are home to nearly a quarter of Ukrainians living with HIV. HIV prevention commodities such as condoms and clean syringes are now much more expensive and hard to come by. HIV testing rates have also fallen and, with more than a million people displaced and the risk of severe treatment interruption, the International HIV/AIDS Alliance in Ukraine is alarmed at the implications both for the country's HIV response and prevention efforts and for the future of harm reduction programmes for injecting drug users in the country.
According to Andrey Klepikov, Executive Director of Alliance Ukraine: "Unless centralized supplies of vital medicines are sanctioned by the Government of Ukraine through international humanitarian organisations within the next one or two weeks, we are facing a humanitarian catastrophe in the East.
"Several OST sites have been forced to close and we are extremely concerned that patients receiving substitution treatment are just being abandoned to a grim fate which is what happened in Crimea last year where dozens died when the opioid substitution treatment programme was shut down following annexation."
Alliance Ukraine and other stakeholders have been calling on the Ukrainian government to organize a safe corridor for delivery of life-saving medicines with the support of the International Committee of the Red Cross (ICRC) and have stressed the need to take urgent action to ensure that treatment regimens are not interrupted. The Ukrainian government's resolution regarding this new humanitarian procedure has been agreed by the key government agencies, technical partners and principal recipients of the Global Fund to Fight AIDS, Tuberculosis and Malaria grant, and is now awaiting final approval.
Alliance Ukraine has provided emergency support - such as housing, basic living support, help with medical services and finding employment - to some 200 OST patients who have had to move from Crimea and Eastern Ukraine in order to continue their treatment.
Klepikov continued: "Due to limited funding, we've had to reduce the number of patients receiving emergency support to 100, and have only been able to help a fraction of OST patients from the affected areas. We need international assistance and we need it now."