The tuberculosis epidemic in Ukraine is characterized by drug-resistant tuberculosis strands. Among new tuberculosis cases in 2019, 27% involved drug-resistant tuberculosis and thousands of other cases were classified as multidrug-resistant tuberculosis (MDR-TB). Ukraine suffers from close to the highest rate of MDR-TB in the world. Tuberculosis in Ukraine is only successfully treated at a rate of 76% for various reasons, including patients stopping treatment prematurely, further complications, the high prevalence of MDR-TB and receiving treatment too late.

Current Efforts

In an effort to reduce the burden of tuberculosis in Ukraine, USAID is working with U.S. government agencies and other partners on various projects. Many programs have been introduced in recent years to strengthen the fight against tuberculosis in Ukraine. For example, the Management Sciences for Health (MSH) implemented the Safe, Affordable and Effective Medicines for Ukrainians (SAFEMed) project to ensure transparency and cost-efficiency within the Ukrainian health system. The programs work to increase public access to medicines and commodities essential to treating tuberculosis. Moreover, PATH, a global nonprofit working to improve public health, began the USAID-supported Serving Life Project to reduce the spread of tuberculosis and other diseases by improved detection. Serving Life specifically aims to increase the care and treatment of people living with tuberculosis in pre-trial detention centers, prisons and post-prison settings.

The Transportation Problem

Affordable medication and proper detection are the first steps in the fight against tuberculosis as “timely access to diagnosis and treatment make a difference in tuberculosis care.” However, many parts of Ukraine suffer from lacking specimen transportation systems. With inefficient or even nonexistent systems, the fight against tuberculosis in Ukraine becomes more difficult as these systems delay access to tuberculosis testing and treatment.

The failures in specimen transportation have potentially increased the already high rates of multidrug-resistant tuberculosis, a tuberculosis strand much more challenging to treat. This is because multidrug-resistant tuberculosis arises from the incomplete treatment of tuberculosis, occurring when public health systems are unable to deliver reliable and consistent tuberculosis treatment to patients. Strains on the healthcare system only exacerbate these inefficiencies as the system becomes overloaded. For example, when COVID-19 reached Ukraine, COVID-19 treatment received priority. As a result, many tuberculosis patients were forced to resort to their own methods of specimen transport.

USAID Introduces New Transportation Plan

When USAID’s Support TB Control Efforts in Ukraine activity began in October 2019, Ukraine’s lacking specimen transportation system was identified as one of the weakest links in the fight against tuberculosis in Ukraine. USAID then began a functional transportation system in the Cherkasy Oblast of Ukraine in June 2020. The program uses USAID-provided coolers to preserve specimens in transport and works to plan more flexible and adaptable transportation routes. As a result, transport vehicles are now able to do rounds four times a week while also ensuring weekly delivery to and from each primary healthcare facility. While the program began in Cherkasy, it has expanded to seven other oblasts in Ukraine within less than a year of the program’s inception.

With efforts from organizations to address the tuberculosis epidemic in Ukraine, it is hopeful that Ukraine will see its case numbers dropping.

– Kendall Carll
Photo: Flickr