Combating tuberculosis, HIV and viral hepatitis B and C

On October 24, a meeting of the Regional Council for Coordination of Actions in Response to the Spread of Tuberculosis, HIV and Other Socially Significant Diseases at the Lviv Regional Military Administration was held under the chairmanship of Khrystyna Petrivna Zamula, Deputy Head of the Lviv Regional Military Administration, Head of the Coordination Council. The Lung's Health Center was represented by Deputy Director General Z.R. Nakonechnyi and Head of the outpatient department for the treatment of HIV-positive/AIDS patients, Secretary of the Coordination Council A.L. Sorokolit.

The following issues have been submitted for consideration by the coordinating council:

- On approval at the level of the Lviv Regional State Administration of the “Regional Action Plan for the Implementation in 2024-2026 of the Strategy for Combating HIV/AIDS, Tuberculosis and Viral Hepatitis for the Period up to 2030”, in accordance with the Order of the Cabinet of Ministers of Ukraine of 18.06. 2024 №564-r “On approval of the operational plan of measures for the implementation in 2024-2026 of the State Strategy in the field of combating HIV / AIDS, tuberculosis and viral hepatitis for the period up to 2023”, in order to counteract the spread of tuberculosis, HIV / AIDS, viral hepatitis in the Lviv region. Survey of key and most-at-risk populations (including IDPs) in 2024;

 - On the adoption of the Strategy for the Development of the System of Tuberculosis Medical Care for the Population for 2024-2026, approved by the Order of the Cabinet of Ministers of Ukraine of August 2, 2024, No. 726-p;

 - Assessment of the epidemic situation with the incidence of viral hepatitis B and C in the Lviv region;

 - On the status of implementation of the program for the prevention of mother-to-child transmission of HIV and the activities of the regional validation committee for the elimination of mother-to-child transmission of HIV for 6 months of 2024 in Lviv region. On the introduction of a new reporting form - “Report on the implementation of activities of the Regional Roadmap for the Elimination of Mother-to-Child Transmission of HIV in Lviv Oblast for the second quarter of 2024” in Microsoft Excel format (“Reporting on indicators” and “Report on the implementation of activities”).

On the prevention of all forms of violence, stigma and discrimination, protection of the rights of women living with and vulnerable to HIV;

 - Assessment of the epidemic situation with HIV in the Lviv region; effectiveness of prevention programs; availability and quality of antiretroviral therapy; expansion of HIV testing, including through the project of the international organization PATH - REACH 95; problems of stigma and discrimination against HIV-positive people.

Discussion on inclusion in the coordinating council: Oleh Romanchuk - project coordinator of the charitable organization “FREE ZONE”, as a representative of the interests of people serving sentences in the institutions of the State Criminal Executive Service of Ukraine (SESU), and reintegration of representatives of the community of convicts and released persons into comprehensive medical and social support; Andriy Bohoslovets - project manager of the NGO “Alliance. Global”;

 - Presentation of the work of the Lviv branch of the International Anti-Drug Association to create a healthy and safe society where everyone has a chance to live a full life without addictions (rehabilitation programs, preventive measures, social support and cooperation with other organizations).

It is recommended that by November 1, the Department of Health submit for approval to the Lviv Regional State Administration a draft order of the Head of the Lviv Regional State Administration “On Approval of the Regional Action Plan for the Implementation in 2024-2026 of the Strategy for Combating HIV/AIDS, Tuberculosis and Viral Hepatitis for the Period up to 2030” with defined indicators of implementation of measures.

The fact of an increase in new cases of HIV infection over the past three years in the Lviv region by +16.0% was noted. The growth rate of HIV infection is associated with the conditions of our country's martial law. Under martial law, the risk of getting infected has increased not only for high-risk groups, including drug addicts, sex workers, homeless people and people below the poverty line, but also for the rest of the population (increased risk of unprotected sex and drug use). Those who were forced to leave their homes due to the war are particularly at risk of infection (change in social conditions). Lviv region has become an intermediate bridge where different categories of people stay for a certain period of time.

On the implementation of measures to detect tuberculosis among IDPs in 2024. According to the Ministry of Social Policy of Ukraine, the number of IDPs in the region is 224244 people, 1436 of whom are in places of temporary residence. TB screening covered 60451 people, including 1436 among those in places of temporary residence, which is 100% (from ICC). The number of people diagnosed with TB is 27, 26 of whom started treatment.

Since the beginning of the year, the radiology team of the Center for Pulmonary Health has been making visits to diagnose tuberculosis using a mobile X-ray vehicle. In total, about 1000 people are examined during such visits per month. Thus, on October 15, the medical team of the Center for Pulmonary Health visited the Pilgrim's House in the village of Stradch, where internally displaced citizens are currently receiving shelter. The medical workers examined both the residents of the shelter (IDPs) and the villagers, providing comprehensive medical care, namely:

- 15 X-ray examinations in a mobile X-ray room;

- 21 consultations with a pulmonologist with treatment recommendations;

- more than 40 ultrasound examinations of the abdominal cavity and thyroid gland.

During the meeting of the Coordination Council, the issues of prevention of mother-to-child transmission of HIV were discussed; prevention of all forms of violence, stigma and discrimination, protection of the rights of women living with HIV and vulnerable to HIV by the regional representative of the CO “Positive Women”, as well as social support for vulnerable groups by non-governmental HIV service organizations in the region, in particular, CO “100 percent of life in Lviv”. The experience of work on social adaptation of drug addicts from the Lviv branch of the International Anti-Drug Association was presented.

Despite the challenges posed by the war, Lviv Oblast is committed to ensuring the sustainability of HIV and TB services, as well as removing barriers to human rights and gender-based violence by 2030.

Based on the results of the meeting, the following protocol decisions were adopted, aimed at: increasing accessibility to HIV testing for the population; expanding systematic tuberculosis screening coverage through radiological examination of individuals from risk groups; and enhancing the provision of opioid substitution therapy services for people who inject drugs, as part of HIV/AIDS, tuberculosis, and viral hepatitis prevention efforts. The General Director of the State Institution "Lviv Regional Center for Disease Control and Prevention of the Ministry of Health of Ukraine," N.O. Ivanchenko, emphasized to healthcare institutions the importance of ensuring the diagnostic protocol for viral hepatitis B and C at the Lviv Regional Center for Disease Control and Prevention (Lviv, 27 Krupyarska St.).