Due to the absence of the unified state procedure for procurement of the second line drugs for the treatment regimens, drugs are procured individually; frequent delays by the drug suppliers lead to the interruption of treatment regimens by the patients. Thus, periodic delays of anti-TB drugs of the second line occurred in 2012 and 2013 in the regions of Ukraine. Under the round 9 grant of the Global Fund, second-line drugs have been procured since 2012 under complete schemes, which since 2013has ensured treatment to all MDR-TB patients involved in the project across Ukraine (nearly 12% of all MDR-TB patients across the country). The unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care “Tuberculosis” provides monitoring of treatment of the patients of category 4 (page 72), and also monitoring and treatment of any side effects. Drugs preventing and removing side effects must be procured for the funds of local budgets and must be handed over to patients free of charge. However, currently drugs are not provided in full. Ukrainian Centre for Socially Dangerous Diseases Control regularly monitors compliance with the above mentioned requirement during the monitoring visits.
6. An uninterrupted second-line TB drug supply should be ensured for all drug-resistant TB patients (including poly- and multidrug-resistant cases). Second-line drug procurement must also include those drugs used during the ambulatory phase for the treatment of adverse reactions. These drugs should all be given free.