HIV in Ukraine
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

 DonbassThe war in the Donbass region of the Ukraine has been ongoing since 2014 when groups known as the Donetsk People’s Republic (DPR) and the Luhansk People’s Republic (LPR) broke from the Ukraine. Here are 10 facts about the little-known war in Donbass:

  1. When the DPR and the LPR broke from the Ukraine in 2014 they created a federation called Novorossiya, yet the region is still more commonly known as the Donbass.
  2. In the Donbass region which is largely populated by Russian speakers, a strong “anti-maidan” movement grew in the region after the 2014 coup in Kiev. This movement’s goal was to prevent far-right groups from entering the region.
  3. Russia annexed the Crimea Peninsula of Ukraine in March of 2014 following the ousting of a pro-Russia president in Kiev. Despite Russia’s denial that it is supporting the separatists, Kiev claims that many Russian soldiers have traveled to the region.
  4. It is highly unlikely that soldiers from Russia and its allies would have traveled to the Ukraine against the will of Russian president Vladimir Putin.
  5. Fighting remains intense in the region, and civilian casualties still frequently occur.
  6. Ukraine’s pro-Russian president, Viktor Yanukovych borrowed $3 billion from Russia to resist protesters in the early days of the conflict. When he was subsequently ousted, the Ukraine failed to pay back the bond, which led to Russia suing for repayment in British courts.
  7. The U.N. human rights office reported that between February 2015 and June 2016, 261 civilians were killed on both sides of the conflict. They stress, however, that these figures are a conservative estimate, and the DPR’s number of reported casualties is much higher.
  8. There have been several truces called, including in September and December 2016, yet they have all failed to secure lasting peace.
  9. There have been two Minsk agreements, the second of which was signed by Vladimir Putin, Francis Holland, Angela Merkel and Ukranian president Petro Poroshenko. Neither agreement has succeeded in ending the war in Donbass.
  10. There was hope that the Minsk II agreement would lead to free elections in the regions and a separate status for the Donbass region.

The conflict may be occurring in a reduced capacity, but the reality remains that there is a war in eastern Ukraine. Ongoing attention is required to create a lasting peace for the communities in this region.

Eva Kennedy

Photo: Flickr