Injection Drug Use in Ukraine
The Challenges of Providing HIV Prevention and Care
Ukraine has been experiencing what has now become Europe’s most severe HIV epidemic. As of 2009, people who inject drugs (PWID) represented about 60 percent of all HIV-infected people in Ukraine, and nearly 50 percent of new HIV infections registered in 2010 were among PWID. Despite this predominance of PWID among the country’s HIV infected population, fewer than 8 percent of all patients receiving antiretroviral treatment for AIDS in Ukraine in 2010 were PWID.
Movement toward comprehensive care and treatment and prevention programs for PWID has been stymied by a number of technical, administrative, financial, and structural obstacles. A recently awarded grant to Ukraine from Round 10 of the Global Fund to Fight AIDS, Tuberculosis, and Malaria has the potential to help address a number of these obstacles over the next several years. In addition, although the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has not been a major source of HIV/AIDS funding in Ukraine to date, an increasing PEPFAR presence in Ukraine and the signing in 2011 of a formal bilateral Partnership Framework on HIV/AIDS between the governments of Ukraine and the United States provide the U.S. government with additional leverage to ensure that the 2012–2016 Global Fund grant has maximum impact in advancing HIV prevention and other services for PWID.
Ukraine is poised for progress. If the outstanding major administrative and structural challenges can be addressed and the political will mobilized and sustained, the availability and eventual full implementation of Ukraine’s Round 10 Global Fund grant will provide the country and its institutions with both adequate resources and with an excellent opportunity over the next several years to use new policies, new laws and regulations, new practices, and new resources to provide comprehensive and evidence-based AIDS care and PWID care and treatment to all of its affected citizens and to dramatically reduce the spread of HIV among its population. The U.S. government, through its political leadership and through the effective implementation of the bilateral Partnership Framework agreement, can play a critical role in keeping this process on track.