Global TB Caucus
Ukrainian parliament lights up for World TB Day
Ukraine lights up its Parliament building in red to mark the united efforts in response to tuberculosis
On 22 March 2018, on the eve of the World Tuberculosis (TB) Day, the Ukrainian Parliament building was lit up in red, with a message “End Tuberculosis Together” appearing on its walls. This is how our country joined the international campaign “Light up the world for TB” launched by the Stop TB Partnership. In Ukraine, this awareness-raising campaign to mark the united efforts of governmental, non-governmental and international organizations in response to tuberculosis is for the first time held at such a high political level. The theme of this year’s World TB Day is “Wanted: Leaders for a TB-free world. You can make history. End TB.”
“On the eve of the World TB Day, the Parliament is open for the activities which raise the profile of the TB problem and draw the attention of the general public to such problem,” said Serhii Kiral, MP, Head of the Parliament Platform to Fight TB. “Today, in the Parliament there is an exhibition of photos depicting people affected with TB and a national round table and civil society consultation within preparation of our country to participate in the first UN General Assembly High-Level Meeting which will be dedicated exclusively to the issues of TB. When it gets dark, we will “light up” the Parliament building to mark our united efforts in the fight against TB and commitment of our country to ending the TB epidemic in the world.”
On the same day, during the round table held in the Parliament MPs, leaders of governmental agencies, international experts, representatives of civil society and patient organizations discussed the TB situation in Ukraine and the key steps of the country to prepare for the UN High-Level Meeting.
“For the first time ever, the government fully covers the treatment of TB patients. Innovative treatment programs are implemented. Soon, we will approve the National TB Program,” said Ulana Suprun, act. Minister of Health. “With consolidated efforts of the government and the civil society, we can ensure integrated and comprehensive approach to the TB response, which means that we have a greater chance than ever to end TB.”
Participants of the round table prepared recommendations for the political declaration of Ukraine on TB, which will be proclaimed in September this year at the meeting of the UN General Assembly and discussed the need to implement people-centered models of TB care, which have already proved effective in many countries of the world.
“The approach to treating patients should change – today long-term inpatient treatment is not considered effective from the standpoint of the treatment process. Thus, in Ukraine the average period of inpatient treatment is 1.5 month for patients with susceptible TB and 5 month for patients with drug-resistant TB. While in the US, for example, the average duration of inpatient treatment for susceptible TB patients is 15 days,” said Volodymyr Kurpita, Director General of the Public Health Center of the Ministry of Health of Ukraine.
“Changes are absolutely necessary to achieve the targets set forth in the WHO End TB Strategy: we strive to switch to people-centered TB care models, use new effective approaches to financing health services, and engage civil society organizations into our activities”, informed Serhii Filippovych, Director: Treatment, Procurement and Supply Management at Alliance for Public Health. Alliance acts as the focal point of the civil society organizations for working with the Global TB Caucus in Ukraine and provides technical support to the Parliament Platform to Fight TB.
One of the key objectives of the Parliament Platform to Fight TB, which was established six months ago, is implementing effective policy to fight the epidemic, in particular launching people-centered TB care models and developing relevant legislative initiatives. People-centered approaches, which are currently implemented in Ukraine stipulate, inter alia, transition to the outpatient TB care, provided that there are no special restrictions. Many developed countries have already rejected the practice of long-term hospital stay due to the high risk of cross-infections among patients and due to the problems, which patients have to face if they fall out of the social life for long periods of time.
“The ambulatory TB care model is focused on the interests of the patient,” says Dmytro Sherembey, leader of the biggest patient organization All-Ukrainian Network of PLWH. “The old model, with patients staying in hospitals for months, is first of all dangerous for the patients themselves due to the risk of re-infections. Our experience shows that 96% of patients in the Network projects have cured tuberculosis in outpatient settings with support of social workers, while the treatment success rate in the country in general is 72%.”
Every year, over 4,000 people die of tuberculosis in Ukraine, i.e. about 10 people die every day. This situation leads to the annual indirect losses of more than $12 million. Although in the recent years there have been certain improvements of the situation, in 2017 only 21,995 new TB cases were registered, with the main problem still being drug-resistant (i.e. not susceptible to the traditional medications) tuberculosis, which requires more lengthy and costly treatment and has lower treatment success rates. According to the WHO data, about 20% of such cases in Ukraine are not detected.
Olga Klymenko, a person who defeated tuberculosis and helps other do it, told about her own experience of fighting with the disease and the importance of patients’ support: “A patient with any diagnosis is first of all a person who needs help and support. You have to live your life being isolated, helpless, having no job and no chances to get one. A life when only the severity of your drugs’ side effects defines your day and determines if you are able to smile or to get out of your bed. Trust me, psychologically you are under an immense pressure. There are people who just stop their treatment. It is important for the people who receive treatment to be able to get all the necessary human and professional support to successfully complete their therapy. Our goal is implementing outpatient TB care in our country to give the patient, considering all the medical indications, a right to choose if he would like to receive treatment in a hospital or at home, with regular visits and support of social workers.”
The need in transition to comprehensive people-centered TB care models stems from the critical situation in Ukraine and in the whole region of Eastern Europe and Central Asia with the spread of multidrug-resistant tuberculosis. Ukraine is one of the top five countries with the highest burden of this disease globally. Unfortunately, this form of TB is diagnosed in every second patient with recurrent TB and in every forth of the new TB cases.
“In the WHO European region alone, 290,000 people got sick with TB in 2016; from this number 71,000 people got drug-resistant TB forms. Every 20 minutes one person dies from TB in our region,” highlighted Ogtay Gozalov, Medical Officer on TB and M/XDR-TB at WHO Regional Office for Europe. WHO Regional Office for Europe calls for multisectoral political commitment to achieve tangible results for saving the lives of all those people suffering from TB today and ensure a TB-free world tomorrow.
“Now we are on the verge of a landmark milestone: 2018 will become a key year in the fight against TB in Ukraine. In April we are waiting for the PACE resolution on TB and in fall of 2018, apart from the UN General Assembly High-Level Meeting on TB, to which our country is actively preparing its recommendations, we also plan to hold Parliamentary hearings on the “Ways to end the tuberculosis epidemic in Ukraine.” We will continue our efforts to achieve our goal of a TB-free world,” added Serhii Kiral.
“The UN High-Level Meeting on TB to be held on 26 September 2018 is a once in a life time opportunity. This is a time for ambition and for unity. Change is needed if we are to stop the needless loss of millions of lives that TB is responsible for. We can change it. We can have strong and sustained TB responses that put people and affected communities at the center,” underlined James Malar, Communities, Rights & Gender Officer; Country & Community Support for Impact, Stop TB Partnership. “When today we “light up” the Ukrainian Parliament building here in Kyiv together with other landmarks all over the world, we hope to capture the attention of the head of state as well as the leaders who have the power to lead the change we strive for. The power to end tuberculosis.”