Ukraine experiences one of the mostsevere HIV epidemics in Europe. This policy brief is aresult of a team effort involving the State InstitutionUkrainian Center for Socially Dangerous Disease Control ofthe MOH of Ukraine, and international partners. The studywas part of the regional initiatives on HIV allocativeefficiency analysisi and funded and technically supported bythe World Bank and UNAIDS. We greatly acknowledge thecontributions of all the team members, stakeholders andother partners. There are major opportunities, but alsomajor risks in relation to HIV investment decisions inUkraine in the coming five years. While decreasing fundingwould lead to a marked increase in deaths, new infectionsand future health care costs, a smart approach to increasingHIV investment, could avert around half of the newinfections and deaths up to 2030 compared to business asusual. The keys to success are (1) scaling up ART; (2)reforming procurement to reduce unit costs for drugs anddiagnostics; (3) sustaining prevention programs for keypopulations and further enhancing coverage with stronggeographical prioritization; (4) establishing domesticfinancing and management of community systems for preventionand adherence support; and (5) strengthen integration withother health, social and drug-use treatment programs. Boldand immediate investment in the mentioned key programs andmeasures to improve efficiency are needed to avoid largeincreases in future health care cost and, most importantly,prevent over 150,000 new infections and save over 110,000lives by 2030.
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