Current implementation and disruptions

Documented impact on services

Due to the suspension of US-funded antiretroviral deliveries, critical gaps in ARV availability are expected as early as Q2 2025 for patients in ABC/3TC regimen.

Abacavir/Lamivudine 600/300 mg (ABC/3TC): The availability of the medication is approaching a critically low level. There are potential risks of a shortage of this medicine. The available supply will cover approximately 3.2 months (as of 01 March 2025), which means a stockout is expected by June 2025. The supply under COP23 that included the delivery of 229 packs was blocked. The delivery date to the country is currently unknown.

Lamivudine oral solution, 10 mg/ml (240 ml) 3TC fl: Delivery of 2,364 bottles for children was suspended, with no national procurement planned for 2026. Considering the expiry date of the majority of the remaining stock (June 2026), the treatment coverage is 16 months. The information is provided without considering the use of the medicine for PMTCT.

Nevirapine oral suspension 50 mg/5 ml (100 ml) NVP fl – the supply of 617 bottles is suspended. The treatment coverage with available stock is 15.4 months.

Raltegravir 100 mg (60 tablets) RAL 100mg – supply of 641 packs suspended. At the end of 2024, part of the ARV supply procured under COP23 with PEPFAR funding—579 packs (34,740 tablets)—was distributed to the oblasts. As patient enrollment and treatment optimization progress, the supply coverage will change. Considering the expiry date of the majority of the remaining stock (November 2026), the current supply coverage is 21 months.

Raltegravir 400 mg (60 tablets) RAL 400mg – the distribution of 3,471 packs to the regions is ongoing but will finish soon. Optimization based on treatment regimens using this ARV is underway, and new patients are also being initiated on therapy. Since the expiry date of most of the remaining ARV stock is set for 30 April 2026, the estimated stock coverage is approximately 14 months.

Tenofovir/Lamivudine/Dolutegravir 300 mg/300 mg/50 mg (90 tablets) TLD – In mid-March 2025, 168,397 packs of ARVs (15,155,730 tablets) procured under COP23 with US funding were delivered to the national logistics warehouse. The medicine is currently undergoing inventory control and is being prepared for distribution to the oblasts. The overall national supply coverage will amount to 9.4 months. A buffer stock of 41,273 packs (3,714,570 tablets) remains at the logistics warehouse.

Immediate Risk: Starting from April–May 2025, 193 patients out of 117473 patients on Abacavir/Lamivudine 600/300 mg (ABC/3TC) regime may face treatment interruption.

Collapse of PrEP Scale-Up and Discontinuation of Pilot CAB-LA Programs: In 2025, the PrEP program is at high risk due to halted procurement. The total stock of Tenofovir Disoproxil Fumarate 300 mg / Emtricitabine 200 mg, (TDF/FTC), across Ukraine amounts to 792,240 tablets. Based on the average monthly consumption of 150,346 tablets, the estimated supply coverage of TDF/FTC for PrEP is approximately 5.3 months. A request was submitted for 140,850 packs of TDF/FTC to be funded by the US. However, due to the suspension of US funding, this procurement is currently in question. An urgent procurement of the quantity requested using Global Fund resources is being considered.

CAB-LA: The injectable form of PrEP, CAB-LA, is supplied to two pilot regions: Kyiv and Lviv. The estimated supply coverage is approximately 14.5 months. Immediate Risk: Starting from Q2 2025, the country will likely face inability to initiate new PrEP users among key populations and a disruption in the continuity of prevention for over 13 thousand people already enrolled in the programme.

Breakdown of HIV rapid diagnostics: There is uncertainty about timely delivery of rapid diagnostics tests. Stock balance – 14,823 tests (including 470 tests expiring on 05 June 2025 and 14,353 tests expiring on 08 October 2025). The current stock is expected to last until August 2025. A delivery of 8,480 tests is expected in June 2025.

As of April 2025, the U.S. Government has suspended humanitarian assistance programs, including those funded by PEPFAR, which previously provided essential HIV-related commodities. This suspension has: 1) Blocked planned shipments of antiretroviral medications (ARVs), including major components of pre-exposure prophylaxis (PrEP), 2) Left pending orders under the COP24 procurement cycle in limbo — notably 140,850 packs of TDF/FTC for PrEP, which were to be funded by PEPFAR.

Direct Impact on Service Availability

Disruption of PrEP Services: The uncertainty with procurement for 140,850 packs of Tenofovir Disoproxil Fumarate / Emtricitabine (TDF/FTC) under PEPFAR funding has placed the national PrEP program at risk. The current supply is expected to be exhausted by mid-August 2025, based on average monthly consumption.

No confirmed delivery timeline is available, jeopardizing PrEP continuity for individuals at high risk of HIV infection, PWID, SW, MSM, serodiscordant couples.

Risk of ARV Shortages: Delays linked to the waiver’s absence are contributing to projected shortages of several essential ARVs, particularly:

Abacavir/Lamivudine (ABC/3TC) – with a stockout expected as early as June 2025.

Some ARVs are at risk of expiring before use, due to supply overlaps and administrative uncertainty (e.g., 4,450 packs of ABC/3TC and 8,300 packs of Ritonavir).

Risk to Diagnostics: The current stock of rapid diagnostic HIV tests is expected to last until August 2025.

Government convening, mitigation measures

The Ministry of Health (MoH), through the Public Health Center (PHC), is conducting rapid assessments of ARV, diagnostic, and PrEP stock levels to identify urgent supply gaps. Efforts are underway to reallocate existing stocks from regions with surplus to high-need areas, prioritizing children, pregnant women, and patients on second-line regimens.

The Government of Ukraine, in consultation with partners, is exploring the use of unspent budget lines and Global Fund reprogramming to cover immediate gaps.

The Global Fund Country Coordinating Mechanism (CCM) is actively reviewing budget flexibility for 2025–2026 to prioritize life-saving commodities. UNAIDS to support technically an immediate application by Ukraine to be submitted to the Pandemic Fund for which Ukraine would qualify. WHO and UNAIDS are in dialogue with partners to map regional lab capacity and support logistics to shift patient samples for central testing if needed.

This crisis has accelerated dialogue on transition and sustainability planning, including an appeal to pharmaceutical companies and medical goods manufacturers to explore the possibility of receiving commodities as free humanitarian or charitable assistance.

Civil society impact, resilience and response 
In response to diagnostic test shortages, civil society organizations (CSOs) and local healthcare facilities have initiated internal redistribution of rapid HIV test kits purchased with local and regional budgets, as well as other budgetary programs.

Civil society platforms actively pushed for government and international donor action by: Submitting urgent appeals to donors for temporary humanitarian shipments of ARVs and PrEP, Coordinating with Global Fund implementers (e.g., 100% Life, Alliance for Public Health) to track deliveries rapid HIV test kits and PrEP supplies.

UN response

Advocacy for emergency procurement and resource mobilization: UNAIDS and UN partners are supporting national counterparts, including the Ministry of Health (MoH) and Public Health Center (PHC), in engaging international donors to mitigate disruptions in ARV and PrEP supplies.

UNAIDS is working with the MoH and other stakeholders to develop longer-term strategies for transition and sustainability, including Diversification of procurement sources, Programmatic optimization to prioritize high-impact interventions amid constrained resources.