Ensuring high-quality of HIV care for displaced people from Ukraine
Since the onset of Russia’s aggression towards Ukraine on 24 February 2022, and as of 11 April 2022, more than 4 million Ukrainian people have fled to Poland, Hungary, Slovakia, Romania and the Republic of Moldova. Whilst countries bordering Ukraine have received most of the displaced people so far, it is envisaged that there will be further migration across Europe in weeks to come.
It is estimated that prior to the war there were more than 250 000 people (1% of total population) living with HIV in Ukraine, of whom around 130 000 were receiving antiretroviral therapy.
As the displacement of people from Ukraine escalates, it is imperative that countries across Europe receiving these displaced people are prepared to ensure high standards of HIV prevention, treatment and care.
The Council of the European Union has adopted a Temporary Protection Directive which offers an appropriate response to the present situation by providing immediate protection and rights, including rights to medical assistance.
Partners at European AIDS clinical Society (EACS), together with the Euroguidelines in Central and Eastern Europe (ECEE) network group, the WHO Collaborating Centre at the Centre of Excellence for Health Immunity and Infections (CHIP) and the Public Health Centre, MOH, Ukraine were tasked by the WHO Regional Office for Europe to produce a standardised protocol for the clinical management and medical data sharing for displaced people living with HIV from Ukraine.
To ensure that appropriate systems are in place for the clinical management and data sharing for displaced people from Ukraine living with HIV across Europe, it is critical for countries across Europe to consider the following actions:
- urgently develop and deploy national plans to provide free and easily accessible HIV care including the provision of antiretroviral therapy, therapy for co-infections, prevention of opportunistic infections and opiate agonist therapy, where needed, for Ukrainian people.
- have a provision for a network of designated and accessible clinics to provide HIV testing and antiretroviral therapy, and testing and care for viral hepatitis, tuberculosis and sexually transmitted infections. These services need to take into account language, culture and mental health needs of displaced people.
- ensure secure electronic transfer of medical information between Ukraine and receiving countries using the link and form provided3, and within and between countries to facilitate safe and rapid provision of care.
- hold stocks of antiretroviral therapy to be able to provide at least 90 days of therapy for displaced people in case of onward transit to other EU countries, preferably using the same regimen as the one prescribed in Ukraine.
- take the opportunity to provide easy access to HIV and other blood-borne virus testing for displaced people, as a part of general health screening and for those being admitted to hospital for care.
- provide documentation confirming HIV status and details of tests carried out and antiretroviral therapy dispensed for those transiting onwards within or out of country.
If the considerations above are addressed, we would ensure the highest standards of care for those people living with HIV fleeing Ukraine and that the displacement of people from Ukraine does not have a negative impact on the aspirations of achieving the UN Sustainable Development Goals by 2030.