Global IssuesCivil Society Responds -- as Health-Care Facilities in Ukraine Come Under Attack
GENEVA, May 06 (IPS) - The writer is UNAIDS Deputy Executive Director and is leading UNAIDS’ humanitarian response.Alongside the devastation caused by bombs and bullets, the war in Ukraine has wrought another danger that can be as deadly as the violence itself: the disruption of access to health services for people who will not survive if cut off from health care.
Health provision has been badly hit, and supply lines crucial for the delivery of medicines severely disrupted. The World Health Organization (WHO) has verified 186 attacks on health-care facilities since the war began.
WHO’s survey showed that of the Ukrainian households in which someone has a chronic health condition, one in three are now unable to get the medicines and care they need.
People living with HIV depend upon daily medication to keep them healthy and alive. More than 40 health-care facilities that provided HIV treatment, prevention and care services before the war have closed or been destroyed.
Many Ukrainians hemmed in by the conflict are unable to make a journey to the health facilities that remain. Approximately 260 000 Ukrainians are living with HIV. UNAIDS is working with partners to ensure the continuity of HIV services. Disruption to treatment services puts their lives on the line and risks a resurgence of the country’s HIV pandemic.
In what is a huge achievement, medicines have successfully been brought into Ukraine, thanks to PEPFAR (the United States President’s Emergency Plan for AIDS Relief), which has committed US$ 13 million to procure 51 million emergency doses of HIV medicines, enough to keep Ukrainians living with HIV supplied with life-saving treatment for a year.
The Global Fund to Fight AIDS, TB and Malaria also is fast-tracking US$15 million in emergency funds for Ukraine and some nearby countries to enable continued provision of life-saving care.
Now that HIV medicines have reached Ukraine, attention is focused on getting them to everyone who needs them. Before the war, the Ukranian AIDS response had built up an exemplary model of community-led services working in partnership with government. It’s the resilience of that network of community-led services built up over decades that has enabled the AIDS response to continue.
The Public Health Center of the Ministry of Health of Ukraine and civil society organizations such as 100% Life, the country’s biggest network of people living with HIV, are working together to maintain services.
Delivering medicines in this war is a huge logistical and security challenge. Several volunteer drivers working for 100% Life have been killed while trying to deliver desperately needed HIV medicines to front-line areas.
Despite the enormous difficulties involved, grass-roots organizations are a lifeline for many people who move to safer places within or outside the country, providing them with humanitarian aid and HIV medicines—even in areas of intense conflict. Their courageous work is saving lives, but the needs and challenges are huge and growing, and resources are not sufficient.
“The situation for people living with HIV in Ukraine is desperate. We are trying to deliver medicines, food and other emergency assistance to people in need, but the work is dangerous and volunteer drivers are putting their lives at risk. If we don’t get more help, I am not sure how much longer we can continue, especially reaching people in the front-line zones,” Dmytro Sherembey, the Head of the 100% LIFE Coordination Council, has shared.
That is why UNAIDS has issued an urgent call to the international community to upscale support to help these everyday heroes to save lives.
The challenge to reach people in need has been greatly exacerbated by the displacement of people. According to the Office of the United Nations High Commissioner for Refugees, there are now 7.7 million internally displaced people in Ukraine.
The war has also caused millions of Ukrainians to flee their homes and seek refuge in neighbouring countries, including Czechia, Hungary, Poland, Romania and Slovakia.
It is estimated that up to 30 000 Ukrainian refugees may currently need HIV medicines as the stocks they carry with them become depleted. WHO has helped to broker a deal with the pharmaceutical company ViiV Healthcare to provide donations of HIV medicines to Czechia, Poland and other European Union countries receiving large numbers of Ukrainian refugees.
Ensuring that the medicines get to those who need them requires the involvement of communities of people living with HIV and key population networks in host countries to ensure tailored outreach and trust-building. These community-led organizations require upscaled international support too.
It’s clear from listening to those receiving and providing health services on the ground that what Ukraine most needs is peace. That is why the United Nations Secretary-General has called for a complete cessation of hostilities and the withdrawal of all Russian troops from Ukraine.
The damage of this awful war means, however, that even once there is peace, enormous and long-term needs for international assistance will remain. Support will be needed in particular for community-led organizations, whose partnership with the public health system is key to ensuring health for all.
Meanwhile, as the impact of the war worsens, the world must increase support to Ukrainian civil society organizations to maintain health provision. This is vital to preventing a resurgence of Ukraine’s HIV pandemic. And for Ukrainians living with HIV, it is literally a matter of life and death.
Civil society networks, on whose creativity and courage?HIV services depend, are managing to get life-saving HIV medicines to people. They do it on a shoestring, powered only by determination and love of humanity.
Many of those involved are themselves people living with HIV—they understand the gravity of what is at stake if they cannot continue their work. The help they provide to save lives risks their own. They do not seek international admiration, but they do need an upscaling of international help. And they need it now.
IPS UN Bureau
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