Main achievements and further developments 2006 and beyond: Overcoming HIV/AIDS epidemic in Ukraine (programme (programme supported by the Global Fund) Overcoming HIV/AIDS epidemic in Ukraine (programme (programme supported by the Global Fund) 10 th Stakeholders’ meeting 15 th of March, th Stakeholders’ meeting 15 th of March, 2007 Andriy Klepikov Executive Director, International HIV/AIDS Alliance in Ukraine

Expenditure – Budget vs. Actual 2006 Activity description Budget (USD) Actual (USD) Spent (%)Variance Under/(over) spend (USD) 1Maintenance of PR Unit2,163,3821,887,86387%275,519 2Treatment, care and support (excl procurement of ARV and other medical supplies) 4,725,0624,715,650100%9, Procurement and delivery of ARV and other medical supplies 7,332,0137,226,27599%105,738 3Focused prevention3,489,1434,018,845115%-529,703 4Information, education and advocacy 2,099,3512,481,092118%-381,741 5Surveillance and evaluation700,848640,55591%60,294 6Alliance management fee500, %- TOTALS21,009,80021,470,280102%-460,480

Expenditure profile Alliance’s expenditure structure within Global Fund Project: from 1 January 2006 — 31 December 2006

2006 key results: people (3178 adults and 552 children) are receiving antiretroviral therapy;3730 people (3178 adults and 552 children) are receiving antiretroviral therapy; 1836 (4487 cumulatively since 2004) HIV-positive pregnant women received ARV to prevent mother-to-child transmission of HIV before and during labour during 2006;1836 (4487 cumulatively since 2004) HIV-positive pregnant women received ARV to prevent mother-to-child transmission of HIV before and during labour during 2006; 436 opiate-dependent people are receiving substitution maintenance therapy;436 opiate-dependent people are receiving substitution maintenance therapy; the groups most vulnerable to HIV have access to prevention and information services, including over 110,000 injecting drug users, over 15,000 women involved in commercial sex and over 29,000 of prisoners;the groups most vulnerable to HIV have access to prevention and information services, including over 110,000 injecting drug users, over 15,000 women involved in commercial sex and over 29,000 of prisoners; 406 medical institutions in all regions of Ukraine received medicines and other medical supplies406 medical institutions in all regions of Ukraine received medicines and other medical supplies

Key results:  Scaling up of ARV therapy has influenced declining in the AIDS mortality growth rate;  Introduction of the substitution maintenance treatment has demonstrated posive implications. The examples include: - a number of clients survived from death while being on SMT; - crime rate falls dramatically among SMT’s clients; - Illegal drug business loses significant money income from drug users reoriented on SMT;  In the area of HIV prevention several promising innovations were started (pharmacy initiative, peer driven interventions, VCT with rapid tests, community centres);  Round 6 process had very positive implications for the R1 grant (incl. progress with the methadone registration, substantial increase in the national AIDS budget for 2007 etc.)

Challenges:Challenges:  Several indicators were not met in 2006, particularly, the ones related to substitution maintenance treatment and prevention of mother-to-child transmission;  Lack of clear and consistent governmental policy in regard to sufficient rolling out of the substitution therapy maintenance treatment with methadone  In order to make an impact, HIV prevention efforts require more substantial funding over the next years  Over 2007 clear confidence should be built to pick up with governmental funding Round 1 activities related to ARV treatment and PMTCT

2007 targets 5,040 patients on ART (including 725 children) 3,500 IDUs on ST (850 of which also on ART); 7,325 pregnant women receive PMTCT (cumulative target starting 2004); 24,500 PLHA access non-clinical care & support (including 3,000 children) 128,000128,000 IDUs 12,50012,500 sex workers access prevention services 17,00017,000 prisoners 5,040 patients on ART (including 725 children) 3,500 IDUs on ST (850 of which also on ART); 7,325 pregnant women receive PMTCT (cumulative target starting 2004); 24,500 PLHA access non-clinical care & support (including 3,000 children) 128,000128,000 IDUs 12,50012,500 sex workers access prevention services 17,00017,000 prisoners

Next steps  Harmonization with Round 6 programme and with resumed World Bank loan project as well as with other major interventions including national and locally funded programmes  Addressing programme challenges e.g. ARV treatment dropouts, growing needs in substitution therapy, and coverage of most at risk populations and PLHA  Year 5 planning (October 2007 – September 2008) including incorporation of the savings to bridge Round 6 timetable  Recommendations from the external evaluation of the grant will be applied for the current and Round 6 grants as well as for the overall country response