1. www.aids2014.org Update on epidemic in Ukraine: civil society perspective Andriy Klepikov International HIV/AIDS alliance in Ukraine klepikov@aidsalliance.org.ua

2. www.aids2014.org Key Results Reduction of HIV new cases (per 100 000 tests made) Stabilization of the epidemic among general population Reduction of AIDS Mortality Key factors Large-scale prevention program among PWID Scaling up of ART

3. www.aids2014.org Effectiveness of HIV prevention programs among PWID has an impact on the overall epidemic

4. www.aids2014.org Effectiveness of HIV prevention programs All data sources confirm inverse correlation between increasing coverage of prevention programs and number of new cases among PWID. The annual coverage exceeds 200000 PWID

5. www.aids2014.org Scaling up of OST Crimea annexation

6. www.aids2014.org Implications of NFM for Ukraine

7. www.aids2014.org KPs WILL SUFFER THE MOST

8. Services 2014 (R10)2015 (NFM) HIV risk reduction communication (Social worker counseling) Screening for HIV and counseling (VCT) provided by medical staff Screening for HIV and counseling (VCT) with assistance of social/outreach worker Distribution of syringes and needles, spirit wipes, condoms IOM Lubricants Screening for HCV TB questionnaire (screening) with nurse involvementScreening for TB ( questionnaire) Testing and counseling for STI Screening for HBV Vaccination against hepatitis B Overdose prevention Narcologist support Psychological support Social support Holding self-help groups, informational classes Legal advice Needles/syringes exchange and utilization Project administration Cost per client - $30,66 Cost per client - $18,73 ($16,47 + $2,26 above allocation)

9. www.aids2014.org UNEXPETED DOMESTIC FUNDING DECREASE As the comparison made in USD it takes into account devaluation of national currency, happened between planning and actual budget allocation

10. www.aids2014.org Ideology vs. Science Example from Ukraine: Russian authorities cut over 800 OST patients from vital medical services. As of today it has led to closure of OST in Crimea. Such cut is classified as tortures. It has resulted in dozen deaths!

11. www.aids2014.org Next steps Negotiations with the Global Fund, with in-country and external stakeholders in order not to allow decreasing coverage or limiting the service package for PWID Maintaining emergency projects such as the one for patients of OST moved from Crimea or war zones in Eastern Ukraine which currently provides services to 120 patients. Stronger positioning of Ukraine in the region, building on the evidence based interventions and innovations have been constituting taking the epidemic under control Piloting innovations such outreach testing; engaging more in Hepatitis C and TB, including treatment