of February 8, 2007 No. 648-V
About approval of the Nation-wide program of counteraction to disease of tuberculosis in 2007-2011
The Verkhovna Rada of Ukraine decides:
1. Approve the Nation-wide program of counteraction to disease of tuberculosis in 2007 - 2011 (further - the Program) which is attached.
2. To the Cabinet of Ministers of Ukraine:
to annually include the tasks determined in the Program and measures in appropriate sections of the State program of economic and social development of Ukraine for the corresponding year;
by preparation of the bill on the Government budget of Ukraine for the corresponding year to provide expenses for financing of the measures determined in the Program.
3. This Law becomes effective from the date of its publication.
President of Ukraine V. Yushchenko
Approved by the Law of Ukraine of February 8, 2007 No. 648-V
According to the World Health Organization (WHO), in the world 8,9 of one million TB patients of which 1,7 of one million persons dies annually is registered. The total quantity of the people suffering from tuberculosis constitutes 50-60 million. This disease wins first place in structure of death rate from infectious and parasitic diseases.
Tuberculosis epidemic in Ukraine began in 1995. Each hour is registered four new cases and one case of death. Within the last 15 years the indicator of incidence of tuberculosis increased in time 2,4. Such situation is caused by social and economic and medical factors, in particular decrease in level of living of the population and availability of significant amount of the sick persons who are in places of detention, insufficient financing of antitubercular measures, shortcoming of skilled health workers, spread of himiorezistentny tuberculosis and HIV infection.
Level of multiresistance constitutes 10 percent of number of new cases and 30 percent of number of recurrence in Ukraine. At the patients revealed in 2005 primary himiorezistentnost of the causative agent of tuberculosis to the main antitubercular medicines constituted 25-30, secondary - 70 percent.
Spread of himiorezistentny tuberculosis leads to substantial economic losses as increases treatment cost almost by 100 times. At the same time estimated cost of medical supplies reaches 76, 5 million hryvnias, and nutrient mediums for determination of himiorezistentnost - 5, 3 million hryvnias.
HIV/AIDS epidemic leads to deterioration of the situation. Over 30 percent of HIV-positive people have tuberculosis, about 40 percent from among patients with AIDS die of it.
In the country 43 sickness rates tuberculosis are constituted by unemployed persons of working-age and 13,6 of percent - pensioners. It demonstrates that tuberculosis is disease, generally socially unprotected part of the population.
Effective measures on the proper organization of work on performing diagnosis of tuberculosis and treatment of patients are not taken. Till 2006 among methods of diagnosis of tuberculosis the benefit was provided to mass fluorographic survey which carrying out required heavy expenses. Now the phlegm dab microscopy method is applied that determines the fact of allocation of the causative agent of tuberculosis to the environment, nevertheless in healthcare institutions conditions for identification of patients in such a way are not created. Health workers of treatment and prevention facilities are insufficiently prepared for carrying out inspection and consultation of patients with tuberculosis symptoms.
The purpose of this Program is improvement of epidemic situation by decrease in indicators of incidence and death rate of the population from tuberculosis, the prevention of development of himiorezistentny tuberculosis, increase in efficiency of treatment, enhancement of system of preparation and retraining of health workers, improvement of laboratory diagnosis of tuberculosis.
For achievement it is necessary to provide with certain this Program of the purpose: enhancement of system to - and postdegree training of health workers on phthisiology and completion by highly professional personnel of TB facilities;
systematic informing the population concerning prevention of tuberculosis and treatment of patients, social advertizing of healthy lifestyle;
subordination of TB facilities to single state body concerning counteraction to HIV infection/AIDS, other socially dangerous diseases;
coordination of work of the ministries, other executive bodies and local government bodies, public organizations in the sphere of the prevention of spread of tuberculosis;
application of the standardized treatment of patients under observation of the health worker;
delivery to TB facilities of antimikobakterialny medicines;
enhancement of system of accounting and reporting under results of treatment of each patient;
taking measures to the prevention of spread of HIV-associated and himiorezistentny tuberculosis;
involvement of healthcare institutions of all patterns of ownership to performing timely laboratory diagnosis of tuberculosis using phlegm dab microscopy method;
rendering social services by the TB patient with attraction to this work of the public.
The tasks determined in appendix to the Program and measures for 2007 - 2011 for overcoming epidemic of tuberculosis are based on modern international approaches to their strategic planning according to priority - immediate, first-priority, recommended.
Financing of the Program is performed in the expense limits provided in the government budget to bodies, actionees of the Program in budgets of the Autonomous Republic of Crimea, areas, cities of Kiev and Sevastopol, and also at the expense of other sources.
The amount of financing of the Program for the government budget is determined annually proceeding from specific objectives and real opportunities.
Accomplishment of the Program will give the chance:
to annually lower by 1 percent at least the illness rate and death rates from tuberculosis;
prevent spread of himiorezistentny tuberculosis;
lower indicator of frequency of interruption of treatment to 10 percent, bring the number of the cases of tuberculosis revealed using method of microscopy of dab of phlegm among persons, the diseased for the first time, - to 50 percent.
enhance system of provision to the population of antituberculous care, preparation and retraining of health workers concerning prevention and diagnosis of tuberculosis and treatment of patients;
provide attraction over 80 percent of health workers to training in international standards;
to timely reveal TB patients;
create system of laboratory control of quality of antitubercular medicines.
As a result of stabilization of epidemic situation reduction of the expenses from the government budget provided for the prevention of spread of tuberculosis is expected.
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