Ukraine. Healthcare system flowcharts. External sources of funds

It is difficult to estimate the impact of external sources of financing in Ukraine. Overall donor activity contributes very little to financing of the health sector; according to NHA, their contribution accounts for less than 1% of total health expenditure (0.3–0.7% in 2003–2008). Donors to the health sector include international organizations (United Nations agencies, the EU, World Bank, the Global Fund) as well as governments of individual countries (Japan, Sweden, the United Kingdom, United States and others). Donations are used mostly to provide technical assistance. For instance, the EU carried out several projects in Ukraine, including Primary Health Care Support (€2 million; 2002–2005), Health Financing and Management (€4 million; 2003–2006), Support for the Development of a System of Medical Standards (€4 million; 2004–2006) and Support for Secondary Health Care Reform (€4 million; 2007–2009). There are also major initiatives involved in fighting infectious diseases such as TB and AIDS, and supporting maternal and infant health programmes.

In 2006, the Global Fund approved a US$ 151 million grant to Ukraine to fund the programme HIV-AIDS Prevention, Treatment, and Care for the Most Vulnerable Populations in Ukraine, 2007–2011. In 2007, however, the Global Fund denied Ukraine’s request for a US$ 94.6 million grant to fight TB, due to an unclear spending plan. The Global Fund had already denied a grant for fighting TB in 2004. In 2006, however, the country managed to secure a grant to fight HIV/AIDS. The resources were granted directly to the Ukrainian government, but this was followed by a scandal over an increase in the price of medication. As a result, the Global Fund had to suspend financing, citing concerns over slow progress and management problems. A statement issued by the Global Fund said it had taken the decision because of implementation bottlenecks, and management and governance issues. Financing resumed after International HIV/AIDS Alliance, an NGO, was put in charge of the project. 

Following this, in 2009, the Global Fund approved a US$ 105 million grant requested by Ukraine to combat TB.
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