Results of the 3rd year of implementation Global Fund Grant

Pavlo Smyrnov

Director: Field Programmes, Alliance-Ukraine

Alla Scherbinska

Director, National AIDS Centre

IX Stakeholders meeting, 7th November, 2006

Expenditure – Budget vs. Actual

Activity description

Budget

(USD)

Actualinc commitments

(USD)

Variance

Under/(over) spend(USD)

1 Establishment and maintenance of PR Unit

2,350,504 1,770,982 579,612

2 Treatment, care and support (excl procurement of ARV and other medical supplies)

5,219,033 4,590,767 628,267

2.3 Procurement and delivery of ARV and other medical supplies

6,759,156 6,153,888 605,267

3 Focused prevention 3,665,405 3,693,810 (28,406)

4 Information, education and advocacy 2,172,585 2,127,252 45,334

5 Surveillance and evaluation 632,275 582,350 49,925

6 Alliance management fee 500,000 500,000 -

TOTALS 21,298,958 19,418,960 1,879,998

Note: Budget of Second Primary Recipient in the amount of USD697 086 was not used according to recommendations of Global Fund to fight AIDS, Tuberculosis and Malaria

Expenditure profile

Alliance’s expenditure structure within Global Fund supported project:Alliance’s expenditure structure within Global Fund supported project:from from 1 1 October October 2005 2005 —— 30 30 September September 20062006

4. Information, education and

advocacy ; $2 127 252;

11%

5. Surveillance and evaluation; $582 350;

3%

6. Alliance Management Fee; $500 000;

3%

1. Establishment and maintenance of PR Unit;

$1 770 892; 9%

2. Treatment, care and support (excuding

procurement of ARV and other medical

supplies) ; $4 590 767;

24%

3. Focused prevention ; $3 693 810;

19%

2.3 Procurement and delivery of ARV and

other medical supplies ; $6 153 888;

31%

Expenditure summary

Chart of budget and expenditure for the period from Chart of budget and expenditure for the period from October 01, 2005 to September 30, 2006October 01, 2005 to September 30, 2006

0

5 000 000

10 000 000

15 000 000

20 000 000

25 000 000

Q1 Q2 Q3 Q4

Quarter

$

Budgeted expenditure (cumulative) Actual expenditure (cumulative)

Partnership in numbers

397 health care facilities397 health care facilities supplied with medicines and supplied with medicines and other health products other health products

140 140 organizationsorganizations have participated in the program have participated in the program implementation during 3implementation during 3rdrd year year

155155 grants/contracts/agreements grants/contracts/agreements were signed during were signed during 12 month period12 month period

Geographical distribution of efforts

Distribution of funding across the regions of UkraineDistribution of funding across the regions of Ukraine(1(1stst April April 2005 2005 toto 30 30thth September September 2006) 2006)

0,00

1000000,00

2000000,00

3000000,00

4000000,00

5000000,00

6000000,00

Розширення АРТ в Українісерпень 2004 - серпень 2006 року

Regions which began ART during phase 2

Other regions

Regions which began ART during phase 1

Regions which began ART during phase 3

ART scale-up in Ukraine August 2004 – September 2006

ART implementation in Ukraine from October 2005 to September 2006 Based on sources of financing

2601

106159

2714

185157

2857

36058

3082

5093

3431

7033

0

500

1000

1500

2000

2500

3000

3500

4000

4500

For October2005

October -December

January -March

April - June July -September

GF State Budget Other Sources

Clinical preceptorship and training of specialists

DuringDuring 3 3rdrd year of the Programme in the Regional Knowledge Hub were year of the Programme in the Regional Knowledge Hub were trainedtrained: : – 68 adult ART specialists (among them 45 doctors)– 79 pediatric ART specialists (among them 35 doctors)– 27 adult ART specialists in prisons (among them 17 doctors)

• Joint trainings were conducted for infectiologists Joint trainings were conducted for infectiologists with phthisiatricians and infectiologists with narcologists ( 21 phthisiatricians, 6 narcologists, 27 infectiologists)

• 7 7 national trainers were trained, national trainers were trained, who then conducted trainings for 56 regional infectiologists

• Programme of clinical preceptorship and training of specialists Programme of clinical preceptorship and training of specialists is implemented on the basis of Institute of epidemiology and infectious diseases of L.V. Gromashevsky (implemented by NGO “Time of Life Plus”)

Improvement of diagnostics

Provided access to evaluation on CD4 lymphocytes, viral loadProvided access to evaluation on CD4 lymphocytes, viral load evaluation for ARV patients from all regions of Ukraineevaluation for ARV patients from all regions of Ukraine (from September 2005 to October 2006 – 12 557 patients were tested for immune status; from September to October 2006 – 1 108 tests of virus load were performed)

Provision of testing for early HIV diagnostic for childrenProvision of testing for early HIV diagnostic for children of HIV-positive mothers (from December, 2005 to October, 2006 – 1 832 tests were performed)

Testing for ARV drug resistance has been startedTesting for ARV drug resistance has been started

ART IMPACT ON AIDS MORTALITY AND LETHALITY

* Data for 12 months of 2006 were estimated based on available data for 9 months of 2006

Providing care and support for PLHA

• OverOver 17 17 550000 adult PLHA and aboutadult PLHA and about 22 5500 00 childrenchildren, , affected by affected by the epidemicthe epidemic accessed services of non-medical care and support all over Ukraine

• 86%86% of of peoplepeople, , who receive ARV therapy who receive ARV therapy in the country are covered by services of forming adherence to treatment in the frame of the programmes of care and support for PLHA

• Main components of the programme ofMain components of the programme of non-medical care and support:– Adherence to ARV treatment in children and adults

– Support for programmes of prevention of mother to child transmission

– Centers of comprehensive care (NGO’s community centers and daycare centers for children)

– Care and support in prisons

– Home based care (medical and non-medical)

• The component is implemented byThe component is implemented by All-Ukrainian Network of PLWH

Comprehensive HIV prevention

• OverOver 100 100 000 000 IDUsIDUs, , 1414 000 000 SWsSWs, , 55 5500 00 MSMMSM, , and aboutand about 2626 000 000 prisoners prisoners accessed prevention and information services throughout Ukraine

• Supporting comprehensive prevention programmes providingSupporting comprehensive prevention programmes providing legal, social and medical support and counselling, IEC materials, community mobilisation activities (self-help groups etc), provision of prevention commodities

• Supporting introduction of additional servicesSupporting introduction of additional services: scaling up access to VCT with quick test use (5 468 IDUs, 1 039 SWs, 18 MSM, 463 young people with risky sex behavior), substitution therapy, rehabilitation, community centers and employment support for representatives of vulnerable groups

• Significant scaling-up Significant scaling-up of prevention services coverage for prisoners (29 prisons)

Substitution Maintenance Therapy for IDUs

• By October, 1st, 2006 substitution maintenance therapy was provided for 220 220 people with people with opioidopioid dependence (169 dependence (169 among among them was HIV-infected, 5them was HIV-infected, 59 9 received ARV therapy received ARV therapy simultaneously) in Ukrainesimultaneously) in Ukraine

• Basis forBasis for implementation of substitution therapyimplementation of substitution therapy (ST) in Ukraine was developed: 9 health care facilities received technical support 9 multidisciplinary teams were trained, experience sharing is provided

for the teams in order to improve qualification and provide quality psychological and social help to clients

Methodical recommendation on Substitution Therapy were developed and disseminated for medical workers and other members of multidisciplinary teams

• ST projects were implemented in 7 sitesST projects were implemented in 7 sites: Simferopol, Dnipropetrovsk, Donetsk, Mykovaiv, Odesa, Kherson, Kyiv

Prevention programmes based on life skills approach through educational system of Ukraine

• Among secondary and high school students Among secondary and high school students and technical schools students– Basic information – 1 500 directors and teachers of educational institutions – Training based on life skill approach – 4 232 teachers,, 36 165 pupils and

55 000 parents – Education based on life skill approach – 210 000 pupils of 5-6 grade

(within the project a chapter on HIV prevention for a textbook on “Basics of Health” subject was developed )

• Among students of Among students of primary schoolprimary school– Basic information – 28 000 parents– Training based on life skill approach – 15 020 pupils, 514 teachers

• Ministry of Education and ScienceMinistry of Education and Science, , central and regional institutes central and regional institutes of postgraduate pedagogical education, education administration of postgraduate pedagogical education, education administration and regional Resource Centersand regional Resource Centers:: direct participation in training for teachers and conducting lessons in educational institutions

Treatment and care & support services for PLHAs: targets and actuals (% of actual compared to target)

Prevention among vulnerable groups: targets and actuals (% of actual compared to target)

Issues, which have to be addressed in the year 4

• Contribute to developing of clear state policy regarding substitution therapy implementation and integrating substitution therapy projects in system of narcological treatment provision

• Improve access and quality of VCT for vulnerable groups, also with the purpose of provision of full course of PMTCT

• Improve work coordination between AIDS Center and Network of PLWH in order to reduce level of ARV discontinuation due to non-medical reasons

• Coordinate activities with State Social Service for families, children and youth regarding prevention among vulnerable groups

• Contribute to creation of national multisectoral Center for Monitoring & Evaluation of HIV/AIDS response