Impact of HCV Advocacy and Demonstration Treatment Programs Specifically Targeted at PWIDS on National Hepatitis Policy

Author: Ludmila Maistat, Pavlo Skala, Tatiana Barnard, Nataliia Kravchenko

Theme: Social Science & Policy Research Year: 2016


Ludmila Maistat, Pavlo Skala, Tatiana Barnard, Nataliia Kravchenko

Background: 3% of Ukrainians are infected with HCV. 64% of PWIDs are infected with HCV. More than 90% of HIV-positive PWIDs are co-infected with HCV. Access to treatment for key populations, PWIDs in particular, is very limited.

Description: In 2012, Alliance launched large scale advocacy campaigns aimed at scaling up access to HCV treatment in Ukraine with specific focus on PWIDs.

Methods: 1. Awareness campaigns which include: regular HCV testing and counseling; information and prevention materials distribution; referral to labs and clinics; media campaigns. 2. Community mobilization which included: a series of public events in all Ukrainian regions; mapping; wide media coverage; advocacy schools for harm reduction clients 3. Price reduction for HCV diagnostics and treatment: price negotiations; pushing national authorities to allocate funds for treatment; launch of demonstration treatment programs for PWIDs 4. Integrating HCV in harm reduction programs: training for medical doctors; schools for patients; regular screenings for key populations;

Results: large-scale mobilization and advocacy campaigns resulted in significantly raised awareness, approval of National Viral Hepatitis Program and National treatment protocol, including DAAs into the national list of essential medicines. The negotiated price for Alliance procurements became a benchmark for state procurements. HCV integration in harm reduction was crucial expanding access to HCV treatment for PWIDs in Ukraine. The first treatment programs for PWIDs were launched by Alliance, the piloted treatment model became an example for the Ministry of Health to follow, PWIDs were specified in National Treatment guidelines.

Conclusions: Combination of large scale advocacy campaign and integration of HCV services in harm reduction programs proved to be an efficient approach to improve access to HCV treatment for PWIDs. Moreover, this approach served the basis for changing the situation with access to diagnostics and treatment for general population and national hepatitis policy as a whole.

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