How the Global Fund supports the continuity of life-saving services in Ukraine

How the Global Fund supports the continuity of life-saving services in Ukraine

Eastern Europe and Central Asia is the region of the world where HIV acquisitions are increasing the fastest. Ukraine is home to the second-largest HIV epidemic in Eastern Europe - an estimated 260.000 people lived with HIV when the war began. In the past decade, significant progress in the HIV response was made. These gains were already at risk before the war, with COVID-19 disrupting the provision of health services and prevention. Russia’s invasion brought new challenges with the destruction of critical health infrastructure and the forced displacement of millions of people.

Provision of services and supplies to key populations—such as people who use drugs, sex workers, gay men and other men who have sex with men and transgender people—who are often stigmatised and marginalised, is particularly challenging. Communities on the front line are making exceptional efforts to reach people in need, but the fragility of access to medication and prevention services could spark an upsurge in HIV and other infectious diseases.

Listen to this episode of HIV unmuted, the IAS podcast Ukraine and HIV: Health on the frontlines” on how the Russian invasion of Ukraine could mean a resurgence of Ukraine’s AIDS epidemic.

The Global Fund proved to be not only the most adaptable but also the most supportive donor in the war situation, which prioritized people’s lives - not only in services but also in the community in respecting human rights - Valeria Rachinska, 40, from Luhansk region, has been living with HIV for 17 years - see here full testimony in Results UK report “Health Systems in Crisis: The Global Fund’s impact in Ukraine”

The Global Fund’s support to Ukraine

Since its creation, the Global Fund invested a total $850 million in Ukraine. This included deploying funding in the country through the Global Fund’s Breaking Down Barriers initiative, which aims to reduce human rights- barriers to HIV, TB and malaria services. To respond to COVID-19, the Global Fund mobilised an additional $52.7 million through its COVID-19 Response Mechanism.

Following Russia’s invasion of Ukraine, the Global Fund has actively participated in the emergency response by working with recipients, communities, and other partners to maintain essential HIV and TB services and community systems, including by:

  • Approving US$30 million to top up its Emergency Fund - a fund designed to provide adaptability and swift support to countries in times of crisis - including US$15 million to support the continuity of HIV and TB prevention, testing and treatment services.
  • Reprogramming US$15 million of Ukraine’s existing grant to allow recipients to react to emerging needs by adapting their services.
  • Providing funding to additional mental health services and support to victims of sexual and gender-based violence and expanding legal support linking internally displaced persons, victims of hostilities, and other persons in need to medical and basic social services and supporting the issuance of personal documentation. 
  • Topping up the existing TB/HIV grant in Moldova to maintain uninterrupted HIV and TB treatment for Ukrainian refugees and the host population.

The Global Fund has temporarily taken over funding key state commitments: opioid substitution therapy, civil society and community-led HIV prevention, care and support, which has allowed services to continue despite the war as well as the enrollment of displaced persons.

For more on the Global Fund’s support of Ukraine read this blog.

Investing in the Global Fund

The Global Fund had already shown its ability to support countries to build capacities not only to fight HIV, TB, and malaria but also to detect and respond to emerging infectious diseases. Fully funding the Global Fund is all the more important in view of the war in Ukraine to ensure the continuation of a sustainable response to HIV and TB - including for displaced and marginalised communities - thereby preventing the resurgence of HIV and TB in Europe. The Global Fund is also providing critical funding to community-led organisations, which are a central element of resilient health systems in view of their capacity to swiftly adapt their operations, allowing for the continuity of essential services. By being deeply rooted in marginalised communities, communities-led organisations are also critical to ensure that no one is left behind, including in times of war.

Going forward, substantial funding is needed to allow the Global Fund to get back the response to HIV, TB and malaria on track, to continue responding to emerging crises, whilst investing in the long term strengthening of health systems, and to continue supporting marginalised and vulnerable populations, including by addressing human rights and gender-related barriers.

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