All-Ukrainian Network of PLWHadvocating accessibility and

quality of treatmentquality of treatment

Dmytro SherembeyCoordination Council MemberCoordination Council Member

All-Ukrainian Network of PLWH

1995 20001995-2000• HAART (antiretroviral

treatment)• No access

• Diagnostics (viral load, extrapulmonary • No accessyTB, opportunistic infections) • No access

• ST (substitution therapy)

• No access

therapy)• Stop TB Program • No access

NO CHOICE!NO CHOICE!

MORTALITY

75% of HIV positive people in Ukraine die from Tuberculosis

PROBLEMS OF PLWH WITH TBlooking for solutions

- Zhenya, 30 years old- HIV+- Diagnosed with

extrapulmonary TBextrapulmonary TB- Was refused a surgery

I tit t f Phthi i l- Institute of Phthisiology can’t say how long he

ill i f ith twill survive for without a surgery

1 year fight for the right to have a surgery

C d• Correspondence with clinics

• Meetings with chief physiciansp y

• Meetings with surgeonssurgeons

EVERYONE REFUSED

In the spotlight of Channel 5In the spotlight of Channel 5

At i t f TV• At gunpoint of TV cameras chief physician of thephysician of the Institute of Phthisiology of KyivPhthisiology of Kyiv pledged to perform a surgery on Zhenya.g y y

Zhenya todayZhenya today• ALIVE• Married• Married• Has a daughterg• Engaged in arts• Enjoys life

Reasons and consequences of discrimination of PLWH

with TBwith TB

HIV, TB, DRUG DEPENDANCE- not hospitalized

refused treatment- refused treatment- refused diagnosticsrefused diagnostics- no referrals to specialized clinics

Reasons and consequences of discrimination of PLWH with TB

- Disclose information to other healthDisclose information to other health professionals

- Refuse surgical help- Mark patient cardsMark patient cards- Refuse in admission to hospital

BUT IF YOU WERE LUCKY AND WERE ADMITTED

Hospital conditionsp

- Bad nutrition- Same room with

open form TBopen form TB patientsNo medications- No medications

- Terrible sanitary diticonditions

- No ventilation

SOLUTIONSOLUTION- We advocate for equal access to medical q

helpFor the right for anonymity and- For the right for anonymity and confidentiality

- For access to substitution therapy programsprograms

- For humane treatment conditions

- For understanding and respect

2000 20082000-2008• HAART (antiretroviral

treatment)• Partial access

• Diagnostics (viral load, extrapulmonary • Partial accessyTB, opportunistic infections) • Partial access

• ST (substitution therapy)

• Partial access

therapy)• Stop TB Program • Partial access

NEW CHALLENGESNEW CHALLENGESAb f i t t d h t t t t f- Absence of integrated approach to treatment ofTB, HIV and DRUG DEPENDANCE

- Number of people covered by programs: Substitution therapy - 5% in need 95%Antiretroviral therapy – 39% in need 61%Diagnostics - 3% in need 97%Diagnostics 3% in need 97%

OUR GOAL 100% 100% LIFEOUR GOAL 100% = 100% LIFE

2009 and Beyond2009 and Beyond

• HAART (antiretroviral treatment)

• Diagnostics (viral load, extrapulmonaryyTB, opportunistic infections)

• INTEGRATED SERVICES

• ST (substitution therapy)

S C S

therapy)• Stop TB Program

Moving force of changeMoving force of changeUnited by ideaUnited by idea

Full of activism

Selflessly protecting their rights

“CIVIL SOCIETY”CIVIL SOCIETY”

All-Ukrainian Network of People Living with HIV/AIDS

NETWORKNETWORK

ALL-UKRAINIAN NETWORK OF PLWH

www network org uawww.network.org.ua

WE STAND FORWE STAND FOR EQUAL RIGHTSEQUAL RIGHTS

FOR LIFEFOR LIFE