What has changed in the treatment of HIV in Ukraine

In Ukraine, patients diagnosed with HIV are treated free of charge from the first day after the test and for life. However, the number of HIV patients in Ukraine has tripled in the last three years. And every second does not know about his diagnosis. These statistics demonstrate the worthlessness of previous efforts to combat the spread of HIV / AIDS in Ukraine.

Against this background, the Ministry of Health of Ukraine approved a new protocol for the treatment of HIV infected people last year, based on the standards of the World Health Organization for the treatment of human immunodeficiency virus.

The basis of treatment in Ukraine will be a new drug called Dolutegravir. It is now recognized by the World Health Organization as the most effective and best treatment for HIV infection. It should be taken once a day and it is combined with other medicines. The cost of this drug is currently 5 UAH 40 kopecks a day.

According to experts, previously a person with HIV had to live from 7 to 9 years with the immunodeficiency virus, to try all treatment regimens, and only then was given the opportunity to try medicines, which will now become available immediately.

In addition, the diagnosis system has changed. Yes, doctors now do not need to carry out additional examinations of a patient with HIV, such as a lung X-ray, an ultrasound, a cardiogram of the heart, and others to prescribe treatment. Therefore, the patient will be able to start treatment faster.

It should be noted that Ukraine became the first country in Eastern Europe and Central Asia to adhere to this protocol.

WHO Recommendations for COVID-19

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.

Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment.  Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.

The best way to prevent and slow down transmission is be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face. 

The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).

At this time, there are no specific vaccines or treatments for COVID-19. However, there are many ongoing clinical trials evaluating potential treatments. WHO will continue to provide updated information as soon as clinical findings become available.

On March 24, there were 84 laboratory confirmed COVID-19 cases in Ukraine, 3 of which were lethal, 1 patient was recovering and was discharged from the hospital.

If symptoms of acute respiratory illness occur during or after the trip, travelers are advised to consult a doctor and provide travel history. WHO standard guidelines for the general public to reduce the impact and transmission of acute respiratory viral infection:

  • wash your hands frequently with disinfectants;
  • cover your mouth and nose with a paper handkerchief while coughing and sneezing. The handkerchief used should be immediately discarded and hand washed;
  • avoid close contact with anyone with fever and cough, if you have a fever, cough and shortness of breath, contact your doctor as soon as possible and tell him your previous travel history;
  • when visiting live markets in areas where new coronavirus cases are currently being detected, avoid contact with animals and surfaces that come in contact with animals;
  • do not consume raw or undercooked animal products. Raw meat, milk, etc. should be handled with care.

 

 

What will change in the treatment of tuberculosis

Ukraine is one of ten countries with the highest incidence of multidrug-resistant tuberculosis in the world. One of the main causes of the strained tuberculosis situation in Ukraine is the low level of treatment effectiveness. The causes of this problem are gaps in the organization of early detection of tuberculosis and diagnosis of resistance of mycobacterium to anti-TB drugs, shortcomings in ensuring adherence to the prevention, early detection and treatment of tuberculosis in the population. These reasons are due to the low level of public awareness of tuberculosis, the lack of sufficient psychosocial support services for patients with tuberculosis, and the lack of rapid implementation of new drugs and regimens recommended by the World Health Organization (WHO) 2019 the ability of physicians to prescribe an effective treatment regimen for patients with advanced resistance to tuberculosis.

On November 27, 2019, the Cabinet of Ministers of Ukraine adopted the Decree “On Approval of the State Strategy for the Development of the System of Anti-Tuberculous Medical Assistance to the Population”.

Reform of the second link has raised many questions and overgrown with untrue information. Therefore, the Ministry of Health provided answers to the most common questions regarding the reform of the TB service.

  •  Is it possible to treat tuberculosis outside the hospital?

The average duration of inpatient treatment in Ukraine is an average of 82.8 days among adults. While in most countries of the world in a hospital the patient is treated for up to 2 weeks, and then transferred to outpatient treatment. The need for hospitalization arises only when certain specific clinical reasons arise.

After starting an effective treatment regimen, the bacteriological load decreases rapidly and within a few days the patient ceases to be contagious. After treatment, patients do not pose a risk of infection to other people. For a patient with tuberculosis who is forcibly placed in a hospital for such a long period, there is a risk of developing a multidrug-resistant form of tuberculosis.

  • Does Tuberculosis Treatment Fee?

The rate for tuberculosis medical services is set at a global rate of 9 months for willingness to provide tuberculosis treatment services. It is calculated on the basis of the cure rate rate, which is UAH 20 663,68, to which the correction coefficients apply.

The correction coefficients, depending on the ability of the institution to perform surgery, are: for readiness to carry out surgical interventions according to additional conditions of purchase - 1,056 and 0,956 for unwillingness to perform surgical interventions according to additional conditions of purchase;

A common manipulation is the claim that UAH 20,000 will not only be enough to buy medicines, but also to feed the patient. And if we talk about the treatment of multidrug-resistant tuberculosis, the drugs will cost more than 100 thousand. In fact, the cost of treatment at the hospital does not include the cost of drugs. Tuberculosis drugs are purchased under a separate program - centralized by the Ministry of Health of Ukraine.

  • Will a change in the funding system reduce the budget of the health care facility 

Tubdispensaries are funded based on how many beds they have. Going for a paid service will allow you to optimize your budget and distribute it to where this medical care is actually provided. All medical facilities that will provide services under the “tuberculosis treatment” package will receive money from the NSA according to the tariff. It is important to note that the NHS tariff includes diagnostics, outpatient and inpatient treatment. The tariff does NOT include anti-TB drugs and test systems for diagnosis. The MoH buys them centrally.

The overall health budget has been increased by 10% this year, so fears of funding cuts are unjustified.

  • Will tuberculosis dispensaries continue to operate?

If the healthcare facility does not have enough patients to cover its funding needs at the rate, there are several options for the local authority.

  • Co-finance the institution under the regional program from the local budget;
  • Repurpose institution
  • Combine multiple services. This is what the Odessa Regional Center for Socially Significant Diseases did, which combined the treatment of patients with tuberculosis and tuberculosis and HIV.

 

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