Newly elected co-chair of the Eastern Europe and Central Asia region of the Global TB Caucus, Ms Lada Bulakh is a committed member of the Ukrainian Parliament who is also leading the profile subcommittee on epidemic security, HIV/ AIDS and socially dangerous diseases.
Ms Bulakh has a long experience working with TB, starting in 2003 when she was leading the NGO "100% of Life. Kyiv Region", which successfully implemented various projects for the prevention and treatment of TB, especially for patients with multidrug-resistant TB.
We met Ms. Bulakh to learn more about her history, her ambitions and her future projects with the Global TB Caucus.
Interviewer: Ms Lada, when did you join the Global TB Caucus and for what reasons?
Ms Lada Bulakh: During the first month of my work in the Ukrainian Parliament, I joined myself and involved 49 of my fellow MPs into the international network of MPs “Global TB Caucus”. The proposal to create an inter-factional parliamentary association to strengthen the response to TB was addressed to me by the Global TB Caucus Manager in the EECA region, Ms Alesya Matusevych, and the ICF “Alliance of Public Health”, which is the focal point for NGOs work with Global TB Caucus.
For many years I have been practically familiar with the imperfect work of our national TB system, I know how difficult it is for people in Ukraine to treat tuberculosis, unfortunately, I personally also lost loved ones who died at a young age from the disease, which can be cured. It took me less than a day to ask my fifty colleagues in the Parliament to sign the Barcelona Declaration and to join a global platform of fighting against TB.
We understand that only through joint efforts, through the exchange of experience and best practices, through the strengthening of political will and the appropriate influence on the governments of the countries, we can overcome the global epidemic.
Interviewer: What is the situation of the TB epidemic in Ukraine? What challenges does your country face and more globally what challenges does the EECA region face?
Ms. Lada Bulakh: Unfortunately, tuberculosis affects almost every country in the world, and Ukraine is not an exception. More than 3700 people die from TB every year in our country, about 10 patients every day. Indirect economic losses in this situation amount to more than $12 million annually, and although there has been some improvement in recent years, 21 323 new cases of tuberculosis have been reported in 2018 alone.
At the same time, according to WHO, about 23% of cases in Ukraine are not detected, and the main problem remains resistant tuberculosis, which requires longer and more costly treatment and has a lower chance of a successful outcome. Ukraine remains a country with a high burden of disease in which the risks of TB proliferation continues in the face of hostilities and humanitarian crises.
At the moment, the medical reform is being implemented in Ukraine, which has also significantly affected TB services. Starting from April 2020 new principles of financing and organization of TB institutions are launched - there will be a transition from pay for bed to payment for services rendered; The role and primary responsibility of the primary care network is increasing as more outpatient treatment models are introduced. In this situation, we are forced to expect new challenges and a slight worsening of the overall epidemiological situation, with further adjustments to certain constituent approaches and, as a result, improvements over time.
Recently, the Government of Ukraine approved two key documents in the field of TB control - the State Strategy for Combating HIV / AIDS, Tuberculosis and Viral Hepatitis for the Period up to 2030 and the State Strategy for the Development of the System of Anti-TB Medical Assistance to the Population. Now, among my immediate plans to amend the current TB Law, since reform requires the harmonization of all state documents, first and foremost, of the highest level, in order to identify common principles and algorithms for TB prevention, diagnosis and treatment. In most of the CEEC countries, a few years ago, we took the course of implementing patient-centered approaches to combating TB, increasing stigma and discrimination. People affected by TB and civil society organizations are increasingly playing a role in shaping anti-TB policy. I think it is important for all countries in the region to overcome the epidemic by introducing the latest methods of therapy with patient-centered models of treatment, improving the quality and availability of diagnostics, conducting broad public awareness work - as a preventive and symptomatic symptom diseases, treatment options, etc.) and aimed at overcoming stigma and discrimination against people affected by TB. Of course, the main problem for the region remains multidrug-resistant tuberculosis, and it is of utmost importance here to promote patient care on the one hand and to ensure infection control rates and to minimize re-infection in healthcare facilities.
Interviewer: What are your priorities and next projects as co-chairs of the Global TB Caucus?
Ms. Lada Bulakh: I think my main role is to increase the relevance of TB control at the highest international level and to attract the political will of the entire region to pool our efforts. Parliamentarians are those people who can really influence the necessary changes in the legislative framework and contribute to the inclusion of TB in the high-level agenda. Increasing international practical engagement, in my view, could be one of the important steps towards overcoming the epidemic.
For example, I plan to invite my fellow MPs from other countries to join efforts to combat TB among migrants during the Global TB Caucus Summit in Cape Town. We have already developed a preliminary algorithm for this work and are now awaiting the signing at the Summit of the relevant memorandum with effective agreements between the countries.