Although nearly eradicated in the developed world, tuberculosis (TB) still causes the deaths of nearly 1.4 million people every year. Historically, post-Soviet states have maintained a high prevalence rate of TB, and Ukraine is no different. In addition, the country is facing increasing rates of multi-drug-resistant (MDR)-TB, which is more difficult and much more expensive to treat.
The World Health Organization’s 2013 Report features Ukraine as a country with a high MDR-TB burden, making it a top priority for assistance in TB management. With a high prevalence of HIV/TB co-infection cases — which cause one in five HIV-related deaths globally — Ukraine’s rise in MDR-TB cases also exacerbates a serious challenge in the fight against HIV/AIDS.
Yet, there is reason for hope. Ukraine has begun to align its health care system with the European Union (EU) as part of implementation of the EU Association Agreement with Ukraine. Since 2012, Chemonics has been helping Ukraine make progress in its longstanding battle with TB and supporting adoption of EU and global TB care practices through USAID’s Ukraine Strengthening TB Control Project (STbCU) project.
Below, STbCU Chief of Party Kartlos Kankadze, a program manager and medical practitioner with 20 years of experience in health program management and clinical practice, shares three activities the project is working on to help make a difference in Ukraine’s fight against TB.
Move TB and HIV case management to primary care doctors
Ukraine has maintained an unchanged, Soviet-era health system since achieving independence in 1991. Care is specialized and hospital-based, meaning patients with HIV or TB seek care in separate hospitals, which significantly increases costs. Treating TB and HIV cases together in the primary care setting would benefit patients and reduce costs. Because co-infection rates are high in Ukraine, this is one solution that would alter the landscape for individuals who are suffering from both diseases.
“There is a network of TB hospitals and HIV hospitals in Ukraine, but it’s a parallel system and they don’t communicate well,” said Dr. Kankadze. “The Soviet system has created a sub-specialty that doesn’t need to exist. If a person has medical education and can practice medicine, there’s nothing that is extraordinary that they could not manage an HIV, TB, or co-infection case.”
Bridging this parallel system is one way USAID and STbCU are helping Ukrainians living with HIV and TB receive better treatment and care to manage co-infection.
