Public Health Catastrophe Looms in Ukraine, Experts Warn

More than one in four new HIV infections in Ukraine are among the country’s approximately 350,000 injecting drug users. Before the war, Ukraine’s harm reduction policy enabled more than 17,000 of its citizens to receive so-called opioid replacement therapy.

The demand for treatment has increased as access to street drugs has declined during the conflict. But now, stocks of the opioid substitution drugs methadone and buprenorphine are unlikely to last longer than one to two weeks, experts say.

That is why the WHO and other non-profit organizations are asking for donations of medicines from the Czech Republic, Austria and other countries. The Global Fund, a massive global health organization, has made more than $3 million available over the next year to purchase these treatments.

Some experts feared that if Russian forces were to gain the upper hand, drug users in Ukraine would be in grave danger. Opioid replacement therapy is illegal in Russia. Within 10 days of the annexation of Crimea in 2014, Russia closed all methadone supply centers, resulting in overdose deaths and suicides.

“You can’t stop these treatments overnight,” said Dr. Kazatchkine.

Women who use drugs are particularly stigmatized and discriminated against by state organizations and medical institutions, said Tetiana Koshova, Kiev regional coordinator for the Ukrainian network of women who use drugs.

Before the war, the organization helped 50 to 70 women every month, but now that number has doubled, Ms Koshova said.

Ms. Koshova was diagnosed with HIV in 2006, at the age of 27, and said she was concerned about the availability of HIV drugs as the war continues. While warehouses still have stockpiles of antiretroviral drugs, “the situation could change at any time, as missiles are flying everywhere and destroying everything indiscriminately,” she said.

SOURCE – www.nytimes.com

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