Appeal against State interference in anti-AIDS/HIV programmes

The International HIV/AIDS Alliance in Ukraine and the All-Ukrainian Network of People Living with HIV have issued an open appeal to the President over systematic interference by State bodies in the implementation of anti- HIV/AIDS programmes supported by international donors. They stress that the situation is disrupting efforts to fight the HIV/AIDS epidemic, violating patients’ rights and seriously undermining the country's reputation in the world.

In their appeal they welcome the signing and entry into force on 15 January 2011 of a new version of the profile Law on Countering HIV/AIDS, and say that this is the most progressive among analogous laws in post-Soviet countries.

They point out that Article 4.8 of this Law guarantees implementation of harm reduction programmes including programmes for exchange of syringes and replacement therapy for drug addicts.

However law enforcement and control bodies are presently effectively destroying what has been achieved over many years by civic organizations and medical specialists on HIV/AIDS preventive programmes at local level. Thanks to international donors, damage reduction programmes have been reaching over 240 thousand people among the most vulnerable groups in society, with over 6 thousand drug dependent patients receiving substitution maintenance treatment in 125 treatment facilities. .

“The work of our partner organizations has been effectively paralyzed over recent months by endless checks initiated by the Prosecutor General, the Ministry of the Interior and numerous State inspectorates. Instead of productive work aimed at supporting people's health specialists have to give explanations in Prosecutor’s Offices and in law enforcement bodies as well as participate in proceedings. Programme documents are being seized from NGOs, with pretexts regarding supposed infringements of sanitary, ecological and other regulations being used to impose sanctions.  The programmes are therefore under constant threat of termination.

In 10 years of successful and recognized experience in the relevant area, in particular, as co-implementers of the National Program on HIV Prevention, Treatment, Care and Support for HIV-infected Persons and AIDS Patients in 2009-2013, the Alliance and the Network are for the first time encountering such systematic resistance to implementation of programmes supported and funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the US Agency for International Development (USAID).

In 2009-2010, the International HIV/AIDS Alliance in Ukraine and local NGOs informed the Ministry of the Interior, the General Prosecutor Office and their regional offices on numerous occasions of systematic violations of the rights of substitution maintenance treatment patients, medical staff and prevention programs participants. Practically in all cases, formal replies have been received not leading to any change in the situation.

The last straw was the order of the Drug Enforcement Department to provide information on drug users being patients of SMT programmes including their personal data and information on their health status. This demand is in clear breach of the law.

“As it turned out, currently in all regions of Ukraine law enforcement officers are urgently collecting his information, sending illegal requests to treatment facilities, arranging the so called "surveying" or "interviewing" of patients and their relatives in drug treatment clinics at the places of residence using moral pressure and threats. Such actions lead to undermining reputation and security of medical aid as well as trust to HIV/AIDS prevention programs.

In December 2010, the Global Fund to Fight AIDS, Tuberculosis and Malaria made a decision to support the proposal of Ukraine and to provide irrevocable funding of the program to fight HIV/AIDS up to 2017 with the total scope of funding amounting to USD 305 million. In March, we expect a visit of the official delegation of the Global Fund headed by its Executive Director Michel Kazatchkine to Ukraine to discuss the terms of potential funding provision. Exactly the programs aimed at HIV prevention among vulnerable groups, harm reduction and substitution maintenance treatment programs are focused on by the Global Fund. In the situation when the state provides only 45% of the funding required for the National HIV/AIDS Program, financial support of international donors is almost the only possibility to save the situation, for Ukraine, which is the leader in HIV transmission on the European continent, not to fall into the abyss from which there will be no way back.

In order to prevent the negative scenario, we encourage you to make a relevant order to the competent state bodies to stop destabilization of AIDS treatment and prevention programs implemented with the international donors' support in Ukraine. We also ask you to initiate carrying out inspections of the legality of law-enforcement and regulatory bodies' actions as to receiving confidential information on program patients and their HIV status.

We genuinely hope that you will have an opportunity to hold a cross-cutting meeting for discussing urgent problems in this area before arrival of the Global Fund delegation to Ukraine. We believe that health of our citizens will be the basis for cooperation between state structures and NGOs.

We also inform you that copies of the letter have been sent to Mr.Pshonka, General Public Prosecutor of Ukraine, Olivier Adam, UN Resident Coordinator in Ukraine, Janina Yaruzelski, Director of USAID Regional Mission in Ukraine, Belarus and Moldova, and Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

This is an open letter and we urge mass media to help giving coverage to this issue as well as the relevant actions of government authorities.”