| Summary: | Ukraine experiences one of the most severe HIV epidemics in Europe. This policy brief is a result of a team effort involving the State Institution Ukrainian Center for Socially Dangerous Disease Control of the MOH of Ukraine, and international partners. The study was part of the regional initiatives on HIV allocative efficiency analysisi and funded and technically supported by the World Bank and UNAIDS. We greatly acknowledge the contributions of all the team members, stakeholders and other partners. There are major opportunities, but also major risks in relation to HIV investment decisions in Ukraine in the coming five years. While decreasing funding would lead to a marked increase in deaths, new infections and future health care costs, a smart approach to increasing HIV investment, could avert around half of the new infections and deaths up to 2030 compared to business as usual. The keys to success are (1) scaling up ART; (2) reforming procurement to reduce unit costs for drugs and diagnostics; (3) sustaining prevention programs for key populations and further enhancing coverage with strong geographical prioritization; (4) establishing domestic financing and management of community systems for prevention and adherence support; and (5) strengthen integration with other health, social and drug-use treatment programs. Bold and immediate investment in the mentioned key programs and measures to improve efficiency are needed to avoid large increases in future health care cost and, most importantly, prevent over 150,000 new infections and save over 110,000 lives by 2030
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