Ukraine is the second highest TB-burdened country in the Eastern European region and also has a severe HIV epidemic. Although the government has sought to transition from a rigid model of health care to one that can effectively meet the needs of its citizens, barriers to a sustainable, efficient health care system are still prevalent.
At the national level, the lack of a common structure that bridges the various vertical reporting systems and program performance indicators makes data collection and analysis extremely difficult. Furthermore, delays and unpredictable distribution schedules result in common stock-outs, compounded by a lack of storage space and inaccurate quantification of pharmaceutical needs. Outdated or incongruent government regulations can also stymie implementation and create constraints to improving pharmaceutical management practices.
Systems for Improved Access to Pharmaceuticals and Services Program
Since 2011, the USAID-funded SIAPS Program has been providing technical assistance in pharmaceutical management and systems strengthening for the HIV and TB programs as well as for reforms to enhance transparency in Ukraine’s pharmaceutical sector. SIAPS has played a key role in helping Ukraine strengthen its pharmaceutical system through improved governance and setting policies that will enhance the availability of quality-assured medicines to treat common ailments, including infectious diseases.
Project highlights include:
Building institutional capacity: The management of pharmaceutical information is essential for curbing the spread of TB. The Ministry of Health adopted e-TB Manager as the national TB registry in 2015 and trained 21 power users from regional TB facilities, who then provided training at all facilities supported by the Ukrainian Center for Disease Control (UCDC). With the national rollout of e-TB Manager, the time needed to prepare facility-, regional-, and national-level TB reports decreased from several days to one to two hours, and compliance with national quarterly reporting guidelines increased from 77% to 98%.
In addition, e-TB Manager increased adherence to national TB treatment protocols. TB data from the state penitentiary system have been integrated into the national system, which enabled the UCDC to more accurately assess and monitor epidemiological trends, identify potential issues, and plan regional interventions. e-TB Manager has been rolled out in every region of Ukraine, and 507 active users at more than 1,000 facilities track nearly 130,000 TB cases. More than 1,000,000 electronic transactions were reported in the system in 2013.
Streamlining medicine selection: To streamline medicine selection, there was a need for a harmonized essential medicines list (EML) and system. SIAPS supported the coordination of stakeholders, legislation development, and establishment of an EML expert committee and introduced the Health Technology Assessment, thereby institutionalizing the medicines selection process. The new national took effect on July 1, 2017, as the sole list of medicines eligible for public procurement.
Reforming health care: SIAPS has contributed to health care reform in Ukraine by providing technical assistance for policy development, capacity building, and governance improvements. SIAPS supported the development of the national medicines policy, a concept paper for health care financing reform, and a concept note on reforming public procurement of medicines. The Affordable Medicines state reimbursement program was made possible with technical support from SIAPS. As of April 2017, the program covered 21 essential medicines for cardiovascular disease, type 2 diabetes, and asthma.
Leadership, Management & Governance Project/Ukaine
LMG/Ukraine supports the PEPFAR-Global Fund Country Collaboration Initiative (CCI), an effort to better coordinate PEPFAR and GFATM investments and efforts in select countries, including Ukraine. The CCI is a 3-year effort aimed at both increasing coordination between PEPFAR and GF-funded HIV programs, and enhancing performance of GF grants in order to expand access to high-quality HIV/AIDS services. LMG supports this initiative to build the programmatic, financial and operational capacity of the Ukrainian Centre for Socially Dangerous Disease Control (UCDC) as one of the Global Fund Round 10 Principal Recipients (PRs) for the HIV grant (and now also PR of the TB Round 9 grant). LMG builds on the progress achieved by the AIDStar-Two Project in their year of work (July 2012-July 2013) to further strengthen UCDC – the only Government of Ukraine (GoU) entity acting as a PR - and build the institution’s overall capacity as the key national agency for the control of HIV/AIDS and tuberculosis.
UCDC is a specialized agency of the Ministry of Health of Ukraine, which performs the functions of intersectoral and interdisciplinary coordination of enterprises, institutions and organizations involved in activities aimed at (i) prevention and treatment of HIV, TB and other infectious diseases; (ii) providing organizational and technical assistance to health care institutions, specialized health care institutions and structural units of health care institutions; (iii) performing diagnostics and providing medical preventive care to people infected with HIV/AIDS, tuberculosis, and other infectious diseases; (iv) and supporting organizations providing specialized health care, diagnostic treatment, counselling for people infected with HIV/AIDS, tuberculosis, and other infectious diseases.
The CCI/LMG-Ukraine program is designed to help the PR to rapidly address grant conditions and management actions required by GF. LMG works closely with UCDC staff as well as with the Ministry of Health of Ukraine, State Service on HIV/AIDS and other Socially Dangerous Diseases, other PRs, and other US Government-funded programs and development partners working in Ukraine.
|Project Name||Health Systems||Health Areas||Date|
|Safe, Affordable, and Effective Medicines for Ukrainians||Global Health Security, Financing Health Services, Leadership, Management & Governance, Pharmaceutical Management||HIV & AIDS, Tuberculosis||2017 - 2022|
Leadership, Management and Governance Project
|Leadership, Management & Governance||Women's, Children's, and Adolescents' Health, HIV & AIDS, Tuberculosis||2012 - 2017|
Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program
|Pharmaceutical Management, Financing Health Services, Global Health Security||Malaria, Tuberculosis, HIV & AIDS, Women's, Children's, and Adolescents' Health||2011 - 2018|