"We started the program back in 2000," recalls Josje Reinartz, operational director of MSF. "With prevention of the transmission of the HIV virus from mother to her child. From there we slowly expanded the programme to all the other components of the programme."
"Ukraine has one of the highest rates of HIV/Aids in Europe and only a small amount of people is aware of their status. To break through the stigmas that still surround the disease is the only way to offer the patients good treatment and a dignified way of living," says Zahedul Islam, the departing head of the MSF programmes.
Six years ago projects were set up in Southern Ukrainian cities like Odessa, Simferopol and Mikolaev. One of the main priorities was to set up a programme that combated the disease from the moment of the very first diagnosis of the disease to daily lifelong medication for the patients.
The programmes specifically targeted those groups like sex workers and drug addicts, people at the lower end of the society that at the same time had to confront a fierce stigma and discrimination that up until today surround the disease.
According to Zahedul Islam: "An HIV/Aids programme can be only really successful, if the stigma that still surround the disease is broken through. Only then the patient can be offered good treatment and a dignified way of living."
In order to achieve this MSF set up a 'continuum of care' model. This was done in close cooperation with the Ukrainian Ministry of Health and several Ukrainian organizations. This model provides HIV/Aids patients with affordable antiretroviral treatment, diagnostic facilities and innovative psycho-social support for the patients and their direct relatives.
"We started the program back in 2000', recalls Josje Reinartz, operational director of MSF, 'with prevention of the transmission of the HIV virus from mother to her child. From there we slowly expanded the programme to all the other components of the programme."
MSF enrolled 1,239 mother and child pairs in the programme, reducing the transmission rate from around 30% to 12,9%.
Availability of antiretroviral treatment for these mothers and their children was essential. As of mid 2002 MSF started to treat children and as of November 2003 also adults with antiretrovirals. Despite the HIV epidemic these drugs were in the Ukraine only available for a small group of patients that participated in research programmes.
In total 138 adults and 32 children received the drugs. The Ministry of Health took over this programme element and was treating by September 2005 almost 2,700 people with the same medication.
Overall in the past six years the programmes of MSF in the cities of Odessa, Mikolaev and Simferopol focused on:
Reducing the transmission of HIV from pregnant women to their babies: Transmission rates dropped from over 30% to around 12.9% by providing treatment. Infant formula is also provided to prevent transmission through breastfeeding
Providing treatment and care to people living with HIV/Aids: Offering life saving antiretroviral treatment, treatment of HIV related infections and clinical follow up
Establishing psycho-social programmes: To make sure that patients would adhere to their treatment; provide voluntary counselling and testing for HIV infections in regional AIDS centres, maternity houses for pregnant women and their partners and to give psycho-social support for all patients and their families
Training staff from the Ukrainian Ministry of Health and national NGOs: From January 2004 to August 2005 MSF organized 141 trainings attended by 2,227 participants to ensure ongoing care when the Ministry of Health and the national NGOs take over the programme
Raising awareness: Together with the Ministry of Health and the national NGOs MSF participated in a national campaign to raise awareness about HIV/Aids, empowering those who live with the virus or the disease and reduce stigma and discrimination.
A lot has changed over the past six years in fighting HIV/Aids. Ukraine has received significant funding from the Global Fund for the next five years. Programmes can be expanded and more people will receive treatment. Ukrainian organizations like LifePlus, Alternativa, UNITAS and Time to Live as well as the Ministry of Health are now ready to take up the fight against HIV/Aids.
MSF hands over all its activities to them in the confidence that they will continue the fight against stigma and discrimination of those who are affected, to ensure the life-long care that every patient deserves.