Over the past several years, Ukraine has been battling the second largest HIV epidemic in Eastern Europe and Central Asia. As of 2018, approximately estimates determined that 240,000 people were living with HIV in Ukraine out of the nearly 45 million citizens.

Causes of Ukraine’s HIV Epidemic

In origin, Ukraine’s HIV epidemic stems from transmission through the injection of drugs, predominantly among the male population. However, as of 2008, the catalytic force driving the outbreak has shifted to the transmission through sexual contact. According to the Joint United Nations Programme on HIV and AIDS (UNAIDS), up to 73.8 percent of the HIV cases in Ukraine during 2018 spread through sexual contact.

Complicating treatment initiatives is the fact that only 71 percent of the people living with HIV in Ukraine are aware of their condition and only 52 percent are receiving treatment. Further, the war in Donbass between the Ukrainian government and pro-Russian separatists has spurred the spread of the virus as national unrest grows. Both war conflict and HIV are predominant in the Ukrainian provinces of Donetsk and Luhansk. Initially, the government made attempts to supply the areas with antiretrovirals for HIV treatment but security reasons and separatist control throughout the region obstructed the efforts.

Efforts to Treat and Prevent HIV

Following the report of 12,000 new HIV cases among citizens in 2018, the Ukrainian government designated $16 million to fund and expand HIV prevention methods and treatment services for the 2019-2020 year. This budget is a part of Ukraine’s plan to shift to a nationally-funded HIV response as opposed to the previously held international donor funding.

Working closely with the government, 100% Life, the largest patient-based and nonprofit organization in Ukraine for people living with HIV provides services for up to 90,000 patients. According to the Ukrainian Philanthropic Forum, the organization served as the nation’s largest philanthropist in both 2016 and 2017.

Moreover, in March 2019, Merck & Co. Inc., a pharmaceutical company, agreed to reduce the price of HIV treatment drug Raltegravir as a direct result of the organization’s advocacy. The cost per pill fell from $5.50 to $2.75, the lowest price for the drug in all of Eastern Europe and Central Asia. This was not the first time that 100% Life urged the company to make treatment more accessible for HIV patients. In 2016, the price reduction of HIV drug Atripla also received confirmation as Merck & Co. Inc. agreed to forgo patent protection of the drug. Estimates allege that non-patented or generic versions of the drug should result in savings that could provide up to an additional 2,800 patients with treatment annually.

Despite the intensity and duration of Ukraine’s HIV epidemic, the nation’s government and activists are continuously working to ensure treatment and prevention initiatives for the whole population. The implementation of a domestic response budget and the availability of more cost-effective treatment commence the reinvigoration of Ukraine’s approach to HIV management and restriction.

– Bhavya Girotra
Photo: Unsplash