Over 400 stakeholders in Ukraine’s response to HIV/AIDS gathered for the ‘2nd National Conference on Harm Reduction’ in Kiev. The attendees included government officials, health and social care practitioners, drug users, law enforcement and public security personnel, and media figures. Together, participants shared experiences and listened to expert speakers on areas such as best practice and advocacy, financial and political support for harm reduction, and the implementation of programmes in Ukraine.
Opening the conference, Vladimir Zhovtyak (a Chair of the Coordination Council of the All-Ukrainian Network of People Living with HIV) emphasised the urgency of scaling-up access to harm reduction in Ukraine. For example, although 110,000 people accessed harm reduction services in Ukraine in 2006, only about 500 people currently have access to substitution therapy in a country with an estimated 397,000 injecting drug users. Mr Zhovtyak reminded delegates that funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Ukraine’s primary donor towards the AIDS response) is largely dependent on Ukraine meeting its target of 3000 injecting drug users accessing substitution therapy by the end of 2007. If this target is not met, Mr Zhovtyak warned that future Global fund money might be discontinued. This would have severe implications for a country with one of the fastest growing HIV epidemics in the world.
The overwhelming message from the conference – from the grassroots level to policy makers – was that substitution therapy is an essential part of the HIV prevention effort in Ukraine, and an urgent scale-up is needed in order to have an impact on the HIV epidemic there. The Head of the Ukrainian AIDS Centre announced that scaling-up towards universal access for HIV prevention, treatment and care (including substitution therapy and harm reduction interventions) was now their national goal. In Ukraine, the small numbers on substitution therapy are receiving buprenorphine. The World Health Organization, amongst others, have urged the Ukraine Government to begin distributing methadone (a cheaper and effective alternative to buprenorphine). Methadone prescribing remains a contentious and unresolved issue in Ukraine.
As well as the commitments from stakeholders to scale-up harm reduction, the conference also led to the establishment of a working group to devise an action plan on harm reduction measures in prisons. The Central and Eastern European Harm Reduction Network (CEEHRN) reported that two needle and syringe pilot projects will start in penal institutions in Ukraine by September 2007. The World Health Organization will be helping to monitor these projects, with the Canadian HIV/AIDS Legal Networkproviding additional technical assistance.
