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Results of the 3 rd year of implementation Global Fund Grant Pavlo Smyrnov

IX Stakeholders meeting, 7 th November, 200 6. Results of the 3 rd year of implementation Global Fund Grant Pavlo Smyrnov Director: Field Programmes, Alliance-Ukraine Alla Scherbinska Director, National AIDS Centre. Expenditure – Budget vs. Actual. Expenditure profile.

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Results of the 3 rd year of implementation Global Fund Grant Pavlo Smyrnov

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  1. IX Stakeholders meeting, 7th November, 2006 Results of the 3rd year of implementation Global Fund Grant Pavlo Smyrnov Director: Field Programmes, Alliance-Ukraine Alla Scherbinska Director, National AIDS Centre

  2. Expenditure – Budget vs. Actual

  3. Expenditure profile Alliance’s expenditure structure within Global Fund supported project:from 1 October 2005 — 30 September 2006

  4. Expenditure summary Chart of budget and expenditure for the period from October 01, 2005 to September 30, 2006

  5. Partnership in numbers • 397 health care facilitiessupplied with medicines and other health products • 140 organizations have participated in the program implementation during 3rd year • 155 grants/contracts/agreementswere signed during 12 month period

  6. Geographical distribution of efforts Distribution of funding across the regions of Ukraine (1st April 2005 to 30th September 2006)

  7. Розширення АРТ в Українісерпень 2004 - серпень 2006 року ART scale-up in UkraineAugust 2004 – September 2006 Regions which began ART during phase 1 Regions which began ART during phase 2 Regions which began ART during phase 3 Other regions

  8. ART implementation in Ukraine from October 2005 to September 2006Based on sources of financing

  9. Clinical preceptorshipand training of specialists During 3rd year of the Programme in the Regional Knowledge Hub were trained: • 68 adult ART specialists (among them 45 doctors) • 79 pediatric ART specialists(among them 35 doctors) • 27 adult ART specialists in prisons (among them 17 doctors) • Joint trainings were conducted for infectiologists with phthisiatricians and infectiologists with narcologists ( 21 phthisiatricians, 6 narcologists, 27 infectiologists) • 7 national trainers were trained, who then conducted trainings for 56 regional infectiologists • Programme of clinical preceptorship and training of specialists is implemented on the basis of Institute of epidemiology and infectious diseases of L.V. Gromashevsky (implemented by NGO “Time of Life Plus”)

  10. Improvement of diagnostics Provided access to evaluation on CD4 lymphocytes, viral loadevaluation for ARV patients from all regions of Ukraine(from September 2005 to October 2006 – 12 557 patients were tested for immune status; from September to October 2006 – 1 108 tests of virus load were performed) Provision of testing for early HIV diagnostic for childrenof HIV-positive mothers (from December, 2005 to October, 2006 – 1 832 tests were performed) Testing for ARV drug resistance has been started

  11. ART IMPACT ON AIDS MORTALITY AND LETHALITY * Data for 12 months of 2006 were estimated based on available data for 9 months of 2006

  12. Providing care and support for PLHA • Over 17500adult PLHA and about2500 children, affected by the epidemicaccessed services of non-medical care and support all over Ukraine • 86% ofpeople, who receive ARV therapy in the country are covered by services of forming adherence to treatment in the frame of the programmes of care and support for PLHA • Main components of the programme ofnon-medical care and support: • Adherence to ARV treatment in children and adults • Support for programmes of prevention of mother to child transmission • Centers of comprehensive care (NGO’s community centers and daycare centers for children) • Care and support in prisons • Home based care (medical and non-medical) • The component is implemented byAll-Ukrainian Network of PLWH

  13. Comprehensive HIV prevention • Over 100 000 IDUs, 14 000 SWs, 5500 MSM, and about26 000 prisoners accessed prevention and information services throughout Ukraine • Supporting comprehensive prevention programmes providinglegal, social and medical support and counselling, IEC materials, community mobilisation activities (self-help groups etc), provision of prevention commodities • Supporting introduction of additional services: scaling up access to VCT with quick test use (5468 IDUs, 1039 SWs, 18 MSM, 463 young people with risky sex behavior), substitution therapy, rehabilitation, community centers and employment support for representatives of vulnerable groups • Significant scaling-up of prevention services coverage for prisoners (29 prisons)

  14. Substitution Maintenance Therapy for IDUs • By October, 1st,2006 substitution maintenance therapy was provided for 220 people with opioiddependence (169 among them was HIV-infected, 59 received ARV therapy simultaneously) in Ukraine • Basis forimplementation of substitution therapy (ST) in Ukraine was developed: • 9 health care facilitiesreceived technical support • 9 multidisciplinary teams were trained, experience sharing is provided for the teams in order to improve qualification and provide quality psychological and social help to clients • Methodical recommendation on Substitution Therapy were developed and disseminated for medical workers and other members of multidisciplinary teams • ST projects were implemented in 7 sites: Simferopol, Dnipropetrovsk, Donetsk, Mykovaiv, Odesa, Kherson, Kyiv

  15. Prevention programmes based on life skills approach through educational system of Ukraine • Among secondary and high school students and technical schools students • Basic information – 1 500 directors and teachers of educational institutions • Training based on life skill approach – 4 232 teachers, 36 165 pupils and 55 000 parents • Education based on life skill approach – 210 000 pupils of 5-6 grade (within the project a chapter on HIV prevention for a textbook on “Basics of Health” subject was developed ) • Among students of primary school • Basic information – 28 000 parents • Training based on life skill approach – 15 020 pupils,514 teachers • Ministry of Education and Science, central and regional institutes of postgraduate pedagogical education, education administration and regional Resource Centers:direct participation in training for teachers and conducting lessons in educational institutions

  16. Treatment and care & support services for PLHAs: targets and actuals(% of actual compared to target)

  17. Prevention among vulnerable groups: targets and actuals(% of actual compared to target)

  18. Issues, which have to be addressed in the year 4 • Contribute to developing of clear state policy regarding substitution therapy implementation and integrating substitution therapy projects in system of narcological treatment provision • Improve access and quality of VCT for vulnerable groups, also with the purpose of provision of full course of PMTCT • Improve work coordination between AIDS Center and Network of PLWH in order to reduce level of ARV discontinuation due to non-medical reasons • Coordinate activities with State Social Service for families, children and youth regarding prevention among vulnerable groups • Contribute to creation of national multisectoral Center for Monitoring & Evaluation of HIV/AIDS response

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