As of the end of 2014, 4 international training centers to fight HIV, tuberculosis and other socially dangerous diseases (hereinafter – ITC) have been established. These centers are located in Vinnytsia (opened in 2012), Zaporizhzhia (opened in June 2013), Lviv and Kharkiv (opened in December 2014). Each center functions in close cooperation with institutions of medical postgraduate education, structural subdivisions of state administrations in charge of healthcare issues, and the respective regional healthcare facilities – regional AIDS prevention centers and tuberculosis institutions. The centers hold trainings on fundamentals of antiretroviral therapy, and management of HIV/TB co-infection cases, traineeships; the program of clinical mentorship is being implemented. According to 2014 data, 123 doctors, 84 nurses, and 39 social workers and psychologists underwent trainings at the ITCs. Eighty-four professionals underwent traineeships.
Results of monitoring/mentoring visits to the regions
In 2014, we started the practice of joint visits of technical and methodological support specialists of the department of organization and provision of medical assistance to HIV-infected patients and the specialists of the tuberculosis department of the UCDC to healthcare establishments that serve the patients with HIV and tuberculosis. These joint visits allowed propelling the interaction of the two services in the regions to the next level and getting the work on prevention, diagnostics, and treatment of HIV/TB infection going. Except infectiologists and phthisiologists, technical assistance teams included also a pharmaceutist and a specialist in substitution maintenance therapy.
Over period under review, the experts visited 22 regions, where they familiarized with the work of AIDS centers on fighting HIV-infection epidemics, tuberculosis institutions, district and municipal healthcare institution that provide care to tuberculosis patients. The experts visited detoxication and dermatovenerologic institutions in some regions. The results of these visits were presented at the regional administrations and departments of healthcare determining weak and strong points in the work of AIDS service and tuberculosis service on the implementation of the National HIV/AIDS and Tuberculosis Programs, and rounds 9 and 10 of GF projects.
The following questions were considered in the course of monitoring visits:
• consulting and HIV-infection testing;
• medical supervision of patients;
• provision of laboratory examination and other diagnostic services to HIV-infected and tuberculosis patients;
• organization of antiretroviral therapy, treatment and prevention of opportunistic infections;
• organization of activity on detection and diagnostics of tuberculosis;
• organization of treatment of patients with tuberculosis including fighting spread of the multi-drug resistant tuberculosis;
• infection control;
• pharmaceutical management of medications;
• provision of comprehensive services to patients with opioid addiction;
• medical and social support and cooperation with NGOs;
• interaction between the HIV-infection/AIDS service and tuberculosis service;
• the state of decentralization and integration of services in the region.
Recommendations provided by the UCDC experts as a result of technical assistance visits have become the basis for further improvement of work in the area of fighting HIV-infection and tuberculosis in the region. After the visits, all regions presented the plans of measures to solve the problems found.