Thread by @veruka2

Ok, I promised an update on what's happening with folks on MOUD, PLWH, and PLW TB in Ukraine. It's not much, but here's what I know. 1/24

On Friday, Feb 25, the Ukrainian Ministry of Health announced that plans were underway to ensure access to medications, that hospital pharmacies remained open even if local pharmacies closed due to shelling. They indicated that medical dispensing would continue uninterrupted.2/24

On Saturday, Feb 26, the MOH declared that accounting for reimbursements was not needed from health care providers. The National Health Service would just pay out 1/12 of each facility’s current annual contract every month while hostilities continued. 3/24

The MOH also created a hotline on Saturday Feb 26 for citizens experiencing difficulty accessing insulin and other medicines. 4/24

On Sunday Feb 27, the National TB Program made its first announcement, stating that all TB clinics continue to operate, that TB medications will be given for free (as they were before) and that patients can take 30 days of medication home at a time to avoid dangerous travel. 5/24

The TB Program also said agreements had been reached with Moldova to ensure continued care for TB, HIV, hepatitis, “ETC,” for Ukrainians who cross the border into Moldova, and that negotiations are underway with Romania and Poland. Not clear if MOUD is implied in that “ETC.” 6/24

This post also linked to the FB page of the Moldovan Anti-Tuberculosis Society. 7/24
facebook.com/anbsmit

On Tuesday March 1, the MOH made its first announcement regarding antiretrovirals for HIV. It began by stating the importance of avoiding interruption to ART for HIV. 8/24

It stated PLWH could receive ART at any AIDS Center or “Trust” clinic (for HIV), regardless of their address or which clinic they are registered at. It said AIDS Centers or the National Center for Public Health would be able to confirm all prescriptions when they arrived. 9/24

On March 1, the Ministry of Health also posted an updated list of pharmacies where insulin is available. 10/24

Wednesday March 2, the National TB Program made a similar announcement. “To our dear patients, we understand that this war has forced some of you to change your place of residence and, thus, where you receive healthcare.”11/24

The announcement then linked to a list of available TB treatment locations, similar to the list of pharmacies with insulin available, which was distributed a day before. 12/24

Today, Friday March 4, the National TB Program announced that the TB hospital in Chernihiv, northeast of Kyiv, had suffered heavy shelling, which destroyed the local TB hospital. “Enemy troops fired on the Chernihiv TB Center. The institution was destroyed.” 13/24

The announcement about the Chernihiv TB center noted that there were no casualties among staff or patients, but all medical stockpiles were destroyed. Government authorities are working on solutions. 14/24

Today, March 4, the National TB Program announced that the WHO Center for Cooperation in the Study and Research of Multi-Drug Resistant Tuberculosis in Latvia and the Latvian Anti-TB Society had opened a hotline for Ukrainians seeking TB care outside of Ukraine. 15/24

On Friday March 4, the National TB Program also posted names and contact information of TB doctors still serving patients in Poltava, the region due west of Kharkiv. Kharkiv is being destroyed by military bombardments and people are fleeing. 16/24

On Friday March 4, the National Center for Public Health announced that efforts have been made to coordinate HIV care for Ukrainians who have fled abroad. The Euroguidelines in Cent and Ea Europe Network Group developed a resource for people to locate care providers abroad. 17/24

About MOUD: On Th March 3, the MOH shared a new resource for locating medications within Ukraine. The link can be used to search national inventory. It’s not clear how accurate this is though. The site warns that pharmacies may be unable to update their inventory bc war. 18/24

It should be noted that methadone and buprenorphine, as in the US, are typically not dispensed via commercial pharmacy but via specialized narcology centers and other registered MOUD programs. Thus, existing stocks seem to not be listed here. But I'm not 100% on that. 19/24

Today, March 4, I learned from other harm reduction supporters in Ukraine that the city of Kharkiv has no remaining MOUD. No methadone. No buprenorphine. As of Jan 1 2022, 588 people were receiving MOUD in Kharkiv Oblast. 20/24
phc.org.ua/kontrol-zakhvo…

In Odessa, per my contact, patients are being told that there is medicine to distribute tomorrow, Saturday, but there will be none left on Sunday. As of Jan 1 2022, 733 patients were receiving MOUD in Odessa Oblast. 21/24
phc.org.ua/kontrol-zakhvo…

So, things look dire. Nevertheless, people are doing what they can for each other. MANY harm reduction organizations run FB groups. People post and communicate with each other about what clinics have methadone or ART to distribute each day. 22/24

And many orgs reach their participants through other services like Signal and Telegram. They are still out there. Virtus has been delivering ART to residents of Dnipro all through the shelling. 23/24

If you're in the US and thanking your lucky stars that Putin isn't tearing your vital health care infrastructure to shreds, remember that every day is a great day to support your local syringe exchange. 24/24
nasen.org/map/

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