Thousands of patients in Ukraine are receiving lifesaving drugs to treat HIV and opioid addiction through a US-funded group still operating despite the Russian invasion. Supplies are running out and making deliveries is a complicated calculation with unpredictable risks.
Officials say the Alliance’s quiet work on public health shows how US aid is reaching individuals in the beleaguered nation, on a different wavelength from US diplomatic and military support for the Ukrainian government.
The Ukraine-based humanitarian organization has been operating for more than 20 years. He has received millions of dollars from the United States Agency for International Development as well as the Centers for Disease Control and Prevention and other federal programs to fight HIV around the world.
Executive director Andriy Klepikov said the shutdown was not an option during the invasion. Ukraine has one of the most severe HIV epidemics in Western Europe and patients need their medication daily.
He said his group had drawn up a “risk management plan” to continue their work if fighting broke out. But he did not consider the scale of the assault unleashed by the Russian forces, and that forced the group to adapt.
In areas of Ukraine that have escaped the worst, the organization is still able to deliver medicine through postal and parcel services. For refugees who have left the country, social workers link up with aid groups who can restock medicines. In places under attack but still under Ukrainian control, medical vans deliver supplies via convoys. The group was even able to obtain deliveries in areas controlled by Russia, with the help of intermediaries. It also distributes tuberculosis drugs.
When asked how long this could last, Klepikov replied:
“We Ukrainians are quite resilient. I’m not the best soldier. But in the field of medicine, humanitarianism, public health, human rights, that’s my field, and I will do the best I can. He has been interviewed by telephone several times recently.
“We are still serving thousands of people” with medicine, Klepikov said. “It’s over five thousand.”
The group’s fleet of medical vans have been put into service to transport injured civilians to hospitals capable of handling complex cases and to deliver essential supplies for daily life.
American officials say they are impressed by the attitude of the Ukrainians, which evokes the tenacity of the British during the London Blitz during the Second World War.
“Going into the war, I think we assumed the services probably wouldn’t work anymore, and we totally got it,” said Ryan Keating, a CDC epidemiologist overseeing AIDS prevention and treatment assistance. for Ukraine. But “in most cases, across the country, our partners continued to work every day.”
Keating tells the story of a nurse at a clinic in a hard-hit town who, when the air raid siren sounded, first collected the HIV drugs and then rushed to the bomb shelter. -bombs. Health personnel continued to communicate with clients of the air-raid shelter.
For the Alliance, each day becomes a test. The group has lost contact with its customers in Mariupol, which has a large population of HIV-positive patients. This coastal town was relentlessly battered by the Russians, and reports indicate that much of it is reduced to rubble. An Alliance medical van was destroyed in a bombardment, Klepikov said.
Normal patterns of communication between clients and their social workers and clinicians were severely disrupted. A clinic or office may be closed. Patients may have moved to safer areas. Messaging apps and online forums filled some of the gaps, just as telehealth became the fallback in the United States during the first wave of the coronavirus pandemic.
An Alliance-supported website has become a place where patients can seek advice for war trauma. According to one of the group’s periodic situation reports, the main concerns of patients are acute stress, high anxiety mixed with sadness, fear of death, guilt after evacuating to a safer area, and guilt for not not do enough.
“The importance of this work increases dramatically in the context of war,” said Klepikov, who holds a doctorate in philosophy.
The United States has a long-standing relationship with the Ukrainian group through a program called the President’s Emergency Plan for AIDS Relief.
Efforts are underway to replenish Ukraine’s drug supply, said Dr. Ezra Barzilay, CDC’s national director for Ukraine. Antiretroviral drugs are used to treat HIV, and drugs such as buprenorphine and methadone are used for opioid addiction. Two Ukrainian factories that made drugs to treat opioid addiction were attacked.
HIV and opioid addiction are related medical problems because the virus that causes AIDS can be transmitted through infected needles used to inject drugs. The Alliance estimates that 100,000 Ukrainians living with HIV are in cities and districts affected by the Russian invasion. By the time the war broke out, more than 17,000 patients suffering from opiate addiction were receiving treatment.
“Having the drugs in the country doesn’t necessarily make them work,” Barzilay said. “You might have thousands of pills in one town and the next town might not have access to them. They drive drugs from place to place.
Program director Klepikov said he remembered an event long ago with the US ambassador to kick off US support for his organization. “I fear that what we have achieved in 21 years could be destroyed in a few days because of Russian aggression in Ukraine.”
President Joe Biden’s Secretary of Health Xavier Becerra said the Department of Health and Human Services is coordinating with the State Department to deliver medical supplies to Ukraine and preparing to help resettle the Ukrainian refugees. “We want to be there,” Becerra told The Associated Press. “At HHS, we also have a role to play.”