methadone_decision

Ukrainian government decision on methadone will help scale up HIV prevention with drug users
(Intl. HIV/AIDS Alliance, 29 January 2008)
http://synkronweb.aidsalliance.org/sw53188.asp?trackingid=46&newsletterid=173

On 19 December 2007, in a move welcomed by Ukrainian AIDS-service NGOs and international organisations, the Ukrainian Ministry of Health decided to allow the importation of methadone, which is used to treat drug dependency and prevent HIV infection among injecting drug users. The move comes after years of coordinated advocacy efforts led by the Alliance in Ukraine, and will allow the scaling-up of existing substation therapy programmes.

Ukraine is experiencing one of the fastest-growing concentrated HIV epidemics in Europe. According to recent statistics, over 60% of people living with HIV in Ukraine acquired the virus through injecting drug use. The first batch of methadone to be imported into Ukraine at the start of 2008 will provide substitution therapy for 2,220 people over a six-month period. The methadone will be administered through 23 licensed state medical institutions across Ukraine.

Ukrainian AIDS-service and harm reduction organisations see methadone as a new boost to existing buprenorphine based substitution therapy programmes. Currently, 536 people (almost two-thirds of whom are HIV-positive) receive substitution therapy with buprenorphine through Global Fund-supported projects. Methadone - a much cheaper medicine - will allow the scale-up of these existing substitution therapy programmes.

Methadone has been the subject of controversy since the beginning of the Global Fund-supported programme in Ukraine in 2003. Civil society organisations in Ukraine, led by the Alliance, and international donors have been calling on Ukraine's government to support the introduction of methadone-based substitution therapy for drug users. In November 2007, the Global Fund announced it would suspend the programme if the government didn't support the introduction.

In November 2007, after increased pressure on the government from civil society organisations, Ukraine's president Viktor Yuschenko called a special meeting of the cabinet and civil society representatives, including the Alliance, to coordinate efforts to respond to HIV.

"As a synthetic opioid drug used to prevent withdrawal symptoms in patients who are addicted to opiate drugs, methadone is often viewed as an officially distributed narcotic," explained Alliance Ukraine's Pavlo Skala. "However, it is the only effective evidence-based method of HIV prevention in concentrated epidemics among injecting drug users."(врёт сукин сын)

"We have massive HIV prevention and drug-related harm reduction programmes run by national and international NGOs, specially tailored for injecting drug users. However, without specialised medical services, in particularly substitution therapy, our prevention efforts will be incomplete and have little effect," said Alliance Ukraine's Sergiy Filipovych. "Moreover, without the introduction of methadone-based substitution therapy, Alliance Ukraine as principal recipient of the Global Fund to Fight AIDS, Tuberculosis and Malaria in Ukraine wouldn't be able to reach some of the targets set."

By July 2008, the number of patients receiving substitution therapy is expected to rise to 3,000, and by 2009 it will reach 6,000 people - a target set by the Global Fund and agreed by the National Coordination Council to fight HIV/AIDS and Tuberculosis in Ukraine.