Ukraine to implement a new integrated approach to TB prevention and care
The Ukrainian government, policy-makers and nongovernmental organizations have committed to support country progress towards achieving the goals of the Tuberculosis Action Plan for the WHO European Region 2016–2020. With support from WHO and international health partners, in 2018, Ukraine started implementing a new approach to TB control aimed at improving detection, treatment and financing of tuberculosis (TB) health-care services.
The most significant changes, including the shift from long-term hospitalization to outpatient treatment, were presented on World TB Day, 24 March 2018, during a press conference in Kyiv.
From long-term hospitalization to outpatient treatment
"The approach to patient treatment should change – long-term hospitalization today is not considered effective from both a medical and economic perspective. In Ukraine, the average hospitalization period for TB patients is 1.5 months, rising to 5 months for those with multidrug-resistant forms. This will be reduced to approximately 15 days in accordance with international standards," said Volodymyr Kurpita, Director of the Centre for Public Health of the Ministry of Health of Ukraine during the press conference.
WHO, international partners and patient organizations have been advocating the adoption of the outpatient model for many years. "The patient's interests are at the centre of the outpatient model,” said Dmytro Sherembey, head of the largest national patient organization, the All-Ukrainian Network of People Living with HIV. “The old model, keeping patients in hospital for months, puts patients at risk because of exposure to potential re-infection. In addition, outpatient treatment avoids patient isolation, and helps them to maintain their work and social life.”
Ukrainian government ensures state-funded TB treatment
The Ministry of Health foresees the adoption of the new National TB Control Programme in the nearest future. One of its most important elements is financial security. “Starting from this year, for the first time, TB patients in Ukraine will receive state-funded treatment,” said Deputy Minister of Health, Olga Stefanyshyna. She expressed the hope that consistency in all TB-related policies will increase Ukraine’s chances of ending TB.
Adoption of WHO-recommended methods to improve TB detection
According to the Ministry of Health of Ukraine, about 35 000 Ukrainians are registered with TB, about 8000 of which have drug-resistant TB. In 2017, about 22 000 new TB patients registered, ranking Ukraine second among countries of the WHO European Region for the prevalence of multidrug-resistant TB in both repeated and new cases.
This is still an underestimation because, according to the latest WHO TB surveillance report, every fourth case of drug-resistant TB in the Region remains undetected.
To improve early detection of TB cases, Ukraine’s acting Minister of Health, Ulana Suprun, announced the adoption of WHO-recommended methods: targeted screening at primary health care level and bacteriologic examination of clinical specimens. Until now, chest photofluorography remained the main screening tool in Ukraine. The new method will be used only for high-risk populations.
Getting ready for the United Nations High-Level Meeting on TB
In view of the United Nations High-Level Meeting on TB that will take place in September 2018 in New York, high-level stakeholders such as Ukrainian lawmakers, Ministry of Health managers, patients organizations, WHO and other international partners met on World TB Day at the Ukrainian Parliament. All speakers emphasized the need for stakeholders to cooperate to achieve the goals of the Tuberculosis Action Plan. Participants agreed on a resolution indicating the preparatory work for Ukraine’s participation in the High-Level Meeting.