How the Ministry of Health of Ukraine is trying to shift responsibility for its mistakes to the Ukrainian Parliament

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The Verkhovna Rada Committee for Public Health has rejected an inadequate draft National Targeted Social Programme for TB Control for 2018-2021.

 

The Ministry of Health of Ukraine developed and in January 2019 submitted draft Law of Ukraine on approving the National Targeted Social Programme for TB Control for 2018-2021 (No. 9467) to the Ukrainian Parliament.

On 24 April 2019, this draft Law of Ukraine was reviewed at a meeting of the Verkhovna Rada Committee for Public Health.

Having reviewed the draft law, people's deputies of Ukraine serving on the Committee noted a number of its shortcomings that make it impossible for the Verkhovna Rada of Ukraine to approve the draft law with the proposed content of the National Programme.

"Stop TB Together" Coalition of Organisations also carried out detailed analysis of the draft programme that had been provided for the Committee's members.

Participating in the meeting of the Committee was co-head of the Coalition Igor Gorbasenko who, based on the results of analysis of the draft programme, said that the programme must be returned to the Cabinet of Ministers and Ministry of Health of Ukraine so that they revise and improve it and gave a number of important remarks regarding the draft law.

The main shortcomings of the draft programme, based on the results of its analysis by the community dealing with TB:

In particular, the section "Purpose of the Programme" says:

"As a result of implementation of the National Targeted Social Programme for TB Control for 2012-2016, TB incidence among the population decreased by 9 per cent".

However, an audit carried out by the Auditing Chamber of Ukraine (Decision No. 9-1 of 11 April 2017) showed that:

"almost 82% of the measures provided for by this programme that had expired as of 1 January 2017 were implemented partially or weren't implemented at all.

Overall more than 3.2 bln UAH were allocated for its implementation, including 2.1 bln from the state budget and 1.1 bln UAH as international assistance".

That is, the more funds are allocated and the less measures provided for by financed plans are implemented, the better the indicators are?

According to the WHO, the average estimated TB incidence among children in Ukraine is 37.4 per 100,000, or 2,500 children, i.e. it is 4.5 times the official statistical figure, while in economically developed countries cases of TB in children are very rare (Tuberculosis surveillance and monitoring in Europe, WHO 2017, 162 p.).

The inadequacy and declarative nature of the programme unprecedented in all the years the TB epidemic has existed in Ukraine are apparent, first and foremost, from the content of the section "Decisive political measures and support systems (systemic support for and reform of services provision)".

A clear proof of the lack of political will to overcome the TB epidemic in Ukraine is that there are:

(Because in the section "Purpose of the Programme" the Ministry of Health declares the following: "Ineffective use of funds to finance TB control measures which are spent on supporting the existing network of TB establishments with an excessive number of beds that are in an unsatisfactory condition, without proper adherence to the principles of infection control...").

Based on the results of review of the draft Law of Ukraine on approving the National Targeted Social Programme for TB Control for 2018-2021 (No. 9467), the Verkhovna Rada Committee for Public Health took the decision to return the draft law to the Cabinet of Ministers of Ukraine so that they improve it.

Documents that are highest-level road maps, such as a law, must not look like they were drawn up "just to be" and be submitted poorly prepared to 450 people's deputies of Ukraine for approval. For more than two years, since the previous TB control programme had expired, the country didn't have a new national TB programme through the fault of the Ministry of Health of Ukraine and the Cabinet of Ministers of Ukraine amid the TB epidemic.

To sum up the aforesaid: both the absence of such a programme for two years and the very low quality of the submitted draft Programme show that, contrary to the needs of Ukraine's people, the senior officials of the Ministry of Health of Ukraine and the Cabinet of Ministers of Ukraine just don't need a National Programme that provides for allocating strictly controlled funds from the state budget, or perceive such a programme as a hindrance.

The reason for this is that for many years the Ministry of Health of Ukraine and the Cabinet of Ministers of Ukraine have uncontrolledly and irresponsibly used international donor assistance funds, first of all funds allocated by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

A kind of "replacement therapy" or, more precisely, living off money provided by donor countries' taxpayers.

Although international assistance programmes should just be a complementary supplement to certain items of a national programme.

This strategy by the Ministry of Health of Ukraine and its upsetting results have already attracted the attention of both authorised state bodies, in particular, the Auditing Chamber of Ukraine, and Ukrainian journalists who conduct independent journalist investigations.

And we'd like to express gratitude to the Verkhovna Rada Committee for their principled position that once again made it impossible to defile and compromise Ukrainian lawmaking in the area of public health.

Co-head of "Stop TB Together" Coalition of Organisations, member of the National Journalist Association of Ukraine    Igor Gorbasenko

Head of the Board of the Charitable Organisation "The Ukrainians Against Tuberculosis" Foundation" Vitalii Rudenko