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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

The Endless War in the DonbassThe War in Donbass is still ongoing after its onset in 2014. What started as a trade disagreement between the former Ukrainian President Viktor Yanukovych and Russia, spiraled into civil protest which shifted into a bloody civil war among the protestors and the military.

Living in a War Zone

Since then, the civil war has worsened, affecting a majority of the citizens who reside in the war zone. There will be no signs of a permanent ceasefire within the country until common ground is found between the resistance and Russia’s military presence. Nick Thompson, a reporter for CNN, stated in 2016 that, “Ukraine’s prolonged stalemate is causing grief and isolation among millions living in the conflict zone, the United Nations warns, 9,500 people have been killed in the violence and more than 22,100 injured, including Ukrainian armed forces, civilians and members of armed groups, the UN says.”

Damaged Healthcare Facilities

Along with the high casualty rate, health care for citizens is becoming harder to reach due to the destruction of many hospitals and healthcare clinics in the region. Nearly one-third of medical facilities in the Donbass region have reported damage as a result of the conflict from the civil war.

The destruction of medical facilities is only worsening the burden placed on the citizens of the Donbass by the war. The significantly reduced accessibility of healthcare is compounding the many elements of poverty that have stricken the region.

A Weakened Economy

Before the war, the urbanized area of the region accounted for nearly 15 percent of Ukraine’s population and produced 16 percent of its domestic product. The GDP in Ukraine in 2013 was approximately 183.31 Billion USD until the conflict arose, which dropped the GDP by nearly 50 percent.

This reflects the economy present within the region and asserts the idea that individuals, as well as the country, are suffering from the effects of the civil war. Many have been forced out of their homes to migrate to other parts of Ukraine leaving displaced individuals in need of aid. While the EU expanded sanctions against Russia for a brief period, they shrank back in 2015, reducing Russia’s incentives to end the conflict.

The War in Donbass has permanently affected the people who once lived there or are currently residing in the war zone. This war has created many new elements of poverty by damaging the economy and reducing healthcare access. Many reforms will have to be established in order to combat against this civil war and rebuild the region once the war has ceased.

Struggling Peace Agreements

NATO has increasingly worked on their relationship with Russia in order to hinder the war but most of these agreements have failed to appease both sides.

While the outlook for the Donbass region may appear grim, the EU can still hold its considerable sanction power over Russia. Additionally, peace agreements are still in the works, despite their failures to reach a quick conclusion. A number of organizations are undergoing efforts to support the people of the region. For instance, the People’s Project of Ukraine, a non-profit organization, is engaging in crowd-sourcing efforts to support those displaced by the war. Consider donating to projects such as these if you are interested in helping the people of Ukraine.

– Elijah Jackson
Photo: Flickr


After Ukraine’s 2014 revolution and reorganization of its government, several of the southeastern regions of Ukraine took up arms against the new government. These regions of primarily Russian-speaking Ukrainians, collectively termed the “Donbass,” feel that the new government of Ukraine does not represent the people, and so they have attempted to set up their own, separate government. Here are 10 facts about the War in Donbass, to help raise awareness around the current conflict:

  1. The war in Donbass has claimed about 10,000 lives since it began in 2014, between the forces of the new government and the pro-Russia separatists in Donbass.
  2. Though the Russian government continues to deny claims that it began the war in the Donbass, Russia has been providing supplies and arms to the separatists for years. Considering Russia’s 2014 annexation of Crimea, Ukrainians fear that they are next on Russia’s list.
  3. Roughly 100,000 professional soldiers and volunteer combatants are scattered around the “gray zone” that exists between the opposing sides’ territories.
  4. The U.N. High Commissioner of Refugees reports that over 1.6 million Ukrainians have been displaced by the fighting, most of them moving away from the fighting towards Kiev. Russia reports that as many as twice that number have similarly fled the fighting eastwards into Russia.
  5. A peace deal, known as Minsk II, was agreed upon and signed by both sides in Minsk, Belarus in 2015, but the implementation of said deal has been a disaster. Neither Russia nor the new Ukrainian government wants to admit responsibility for the conflict, so the process of peace has stalemated.
  6. During the 2016 U.S. Presidential election, many Ukrainians had hope that the new president would be tough on Russia’s involvement in Ukraine and would provide aid for the people in the war zones. The election of President Trump – and his seemingly pro-Russia leaning – has led to much discouragement and disappointment that the aid they counted on is not forthcoming.
  7. Experts have come to believe that the conflict – which has never been an official war between Ukraine and Russia – will only end if Russia concedes a defeat in the Donbass – an outcome many consider highly unlikely – or if Russia ramps up into a full-scale invasion of the Ukraine.
  8. To that end, Russia has been quietly moving to improve its military infrastructure by creating new divisions that can be rapidly expanded should it mobilize its forces, as well as deploying existing forces along the Ukrainian border.
  9. In mid-September, Russian president Vladimir Putin stated that he was open to allowing U.N. peacekeepers into the separatist areas of east Ukraine, though the Ukrainian government insists that Russian forces not be among said peacekeepers.
  10. The U.S. envoy to Ukraine, Kurt Volker, said in late September that the U.S. is against working with Russia to bring in the U.N. peacekeeping forces, as it would only further destabilize the country. Volker also stated that he believes Russia and the separatists are finally willing to come to the table with a resolution to the conflict.

The war in the Donbass is a highly complex and constantly evolving situation, and these 10 facts only serve to summarize some of the more recent developments and how they affect the overarching conflict.

Erik Halberg

Photo: Flickr