As the war progressed, organizations responding to the crisis realized they had to be flexible and think beyond fixed and physical healthcare infrastructure. They needed to get people on antiretroviral therapy – interrupted treatment can contribute to drug resistance – and they needed to continue and scale up harm reduction programs.
Andriy Klepikov, executive director of the Alliance for Public Health, a nonprofit that focuses on HIV and TB, says his teams have deployed 37 mobile clinics from Lviv in the west to Kharkiv in the north. -east, providing more than 109,000 consultations, testing more than 90,000 people for communicable diseases, delivering nearly 2,000 tons of humanitarian aid and medical equipment to 200 health facilities and connecting small villages that would otherwise have been abandoned to their fate.
Equipped with body armor, helmets and metal detection equipment, Alliance personnel traveled to recently liberated towns and villages, some just a few miles from the front line. “We work where no one else works, where there are no hospitals, no pharmacists, no doctors,” Klepikov says.
When fuel became hard to come by last summer, they replaced their vans with bicycles. In his office in Kyiv, Klepikov proudly showed me a photo of one of the Alliance doctors providing care in a bombed-out city while riding one of the bicycles his organization had provided.
Preliminary data show that disaster has, at least for now, been averted. By the end of 2021, just two months before the start of the war, around 132,000 Ukrainians living with HIV were on ART. Since then, the latest figures available show that number has dropped only slightly to 120,000. Since the start of the large-scale invasion, Ukraine’s public health sector has connected 12,000 new people to ART. This latest available data from February 2023 also shows that in 2022, more people started taking PrEP (pre-exposure prophylaxis) than in the previous four years.
These successes have come at a high cost. Rachinska, who has lived with HIV herself for more than 15 years, continued to work in Kyiv as the sirens of air raids sounded in the capital. His mother took Rachinska’s youngest son and fled to Italy. She has only visited him a few times since then but hopes to return to Napoli in October, before his 11th birthday.
Rachinska could have joined them, but says her job – “her people”, as she calls them – comes first. Her son doesn’t blame her, she says. “I’m just like, ‘Sweetheart, mom is doing something good for people. So just forgive me,’ she cries. Her son often responds, ‘OK, do your job.’
In Kryvyi Rih, Lee, 47, says he created his makeshift sanctuary after realizing at the start of the war that at-risk populations, such as drug addicts, HIV-positive people, sex workers, LGBTQ+ people and people recently incarcerated were more likely to be returned. other spaces offering refuge. He secured funding from UNAIDS and logistical support from the Public Health Charity Foundation and set out to save people on his own.
