Overcoming the HIV/AIDS epidemic in Ukraine Looking ahead: Programme supported by the Global Fund Stakeholders meeting February, 2006 Stakeholders meeting February, 2006 Andriy Klepikov Executive Director, International HIV/AIDS Alliance in Ukraine

Major developments so far  Meeting all major 2005 targets  Rolling out substitution therapy  Being substantial part of national response  Catalyzing improvements in national response  Strengthening coordination at the local level  Linking prevention and care through community based services and information (CBSI)  Meeting the contractual conditions

Recent milestones  Extension of 126 grant agreements with 89 subrecipients for a total amount of over 35 million UAH  Expanding ARV treatment to 5 new oblasts (20 in total)  Provision of substitution therapy to over 160 patients  Starting introducing ART for 30 patients in the penitentiary system (Daryivska penitentiary institution № 10 in Kherson oblast) and launching pilot needle exchange projects in Lviv and Mykolaiv  Scaling up harm reduction services to all oblasts of Ukraine (except Ternopil)

Overcoming the HIV/AIDS epidemic in Ukraine Budget to actual for 2005, USD Total for 2005 BudgetExpenditureVariance USD Management / PR Implementation Unit/international Technical Assistance Treatment, Care & Support (excluding ARV and other health products) ( ) ARV and other health products procurement Focused Prevention Information, Education & Advocacy ( ) Surveillance & Evaluation ( ) Alliance management fee Total

Challenges:Challenges:  Lack of support in rolling out substitution therapy and constraints in registration and setting up projects with methadone  Absence of national HIV/AIDS strategy ensuring treatment and prevention continuum  Growing gap in funding for focused prevention, i.e. due to the failure with the World Bank project implementation  Continuous changes in the Ukrainian government

2006 targets 3,700 patients on ART (including 600 children) 700 IDUs on ST (400 of which also on ART); 5,700 pregnant women receive PMTCT; 15,500 PLHA access non-clinical care & support (including 2,000 children) 98,00098,000 IDUs 10,00010,000 sex workers access prevention services 14,00014,000 prisoners 3,700 patients on ART (including 600 children) 700 IDUs on ST (400 of which also on ART); 5,700 pregnant women receive PMTCT; 15,500 PLHA access non-clinical care & support (including 2,000 children) 98,00098,000 IDUs 10,00010,000 sex workers access prevention services 14,00014,000 prisoners