I recently visited Ukraine for the first time in my role as U.S. Global AIDS Coordinator. I was pleased to have the opportunity to return to Ukraine, a country where I have spent considerable time working to strengthen HIV prevention, care and treatment services.
Ukraine is currently experiencing the most severe HIV epidemic in Europe and the Commonwealth of Independent States. UNAIDS estimates that 1.1 percent of adults in Ukraine are living with HIV and an estimated 350,000 adults and children are currently infected — slightly over half of which are cases reported in women. The vast majority of reported HIV cases in Ukraine have occurred in most-at-risk populations, particularly people who inject drugs, and injecting drug use continues to be the main driver of the epidemic.
Under PEPFAR, the United States has supported Ukraine in making concrete progress in fighting HIV/AIDS and these efforts are saving lives. In fiscal year 2010, the U.S. supported HIV counseling and testing for approximately 43,300 individuals, and care and support for 13,900 people living with HIV/AIDS in Ukraine.
As with many concentrated epidemics, there is the need to engage in intensive prevention to ensure that the epidemic does not become more widespread. Doing so requires taking a comprehensive public health approach that is sensitive to the needs of at-risk populations. My recent trip afforded me the opportunity to get a sense of the progress Ukraine is making in this area.
There has recently been much promising activity around addressing this concentrated epidemic among often marginalized populations. On January 11, 2011, President Viktor Yanukovych signed a new law on HIV that supports important prevention activities and provides new authority to non-governmental organizations (NGOs) to expand coverage and ensure access to quality, comprehensive prevention, care and treatment services for people who inject drugs and others affected by HIV.
On February 15, 2011, in Washington, DC, I joined Foreign Minister Kostyantyn Gryshchenko in signing the U.S.-Ukraine Partnership Framework on HIV/AIDS. This is a five-year joint strategic framework that commits the Government of Ukraine and the U.S. to work together to reduce HIV transmission among injecting drug users and other most-at-risk populations and improve the quality and cost-effectiveness of HIV services. Through this Framework, we will also work together to strengthen national and local leadership, capacity, institutions, systems, policies and resources to support the national AIDS program in containing the epidemic.
During my visit, I was particularly struck by the active civil society that exists in Ukraine. Those seeking drug treatment, including medication assisted therapy, and the broader community that supports them, have been courageous and outspoken in providing support and standing up for the rights of all who need treatment. Their willingness to speak out about their experiences — including the challenges they have had accessing care — helps to fight against stigma. I admire their courage and would urge the Government to draw upon their thoughts and expertise as it works to implement its new law.
In particular, it will be important to address the needs of populations at risk in a way that protects their human rights. We anticipate the collective response of government, civil society and donors working together to expand access to quality, comprehensive prevention, care and treatment services for the people of Ukraine.