February 25-28, 2004

Kiev, Ukraine

Regional:

Moldova, Russia & Ukraine.

Conference Goal:

The ultimate goal of the conference is to improve the care and treatment of HIV/AIDS patients in Moldova, Russia and Ukraine, and to make sure that palliative care is available for these patients from the time of diagnosis on and not limited to the last days or weeks of life.  Pain and symptom management for HIV/AIDS patients should be an essential component of any HIV/AIDS national plan.

Conference Objectives:

• To bring ministry of health, national AIDS programs, ministry of finance, narcotics control, medical and nursing education, and HIV/AIDS health care providers and palliative care providers and people living with HIV/AIDS together to learn from one another and to ultimately improve the care provided to HIV/AIDS patients.
• To analyze the state of the epidemic in these three countries, symptom prevalence, assessment and management.
• To discuss the role of opioids and other essential drugs and what needs to be done to make them available for patients with HIV/AIDS at home as well as in hospital for pain management.
• To discuss the development of palliative care programs and inpatient units and financing issues.
• To evaluate the need for professional and caregiver education and support.
• To discuss the possibilities and ways of integrating palliative care into national AIDS policies and programs.

Conference Evaluation [view evaluation]

To view conference presentations and other materials, please go to the agenda below and click on links next to each presentation title.

Conference Agenda [word version]

Wednesday, February 25
16:00		Registration [participants list]
19:00		Dinner
20:00		Faculty Meeting Chair: Mary Callaway, Associate Director, International Palliative Care Initiative, Network Public Health Program, Open Society Institute – New York, USA
Thursday, February 26
08:00		Breakfast
09:00		Welcome Yevhen Bystrytsky, Executive Director, International Renaissance Foundation – Kyiv, Ukraine
09:15		Introduction of Participants and Goals of the Conference Mary Callaway, Associate Director, International Palliative Care Initiative, Network Public Health Program, Open Society Institute – New York, USA
09:30		Epidemiology of HIV/AIDS in Moldova, Russia, Ukraine Dr. Irina Eramova, Medical Officer, MD, PhD, WHO Regional Office for Europe, Copenhagen, Denmark [view presentation]
10:00		What is Palliative Care?  Dr. Frank Ferris, Medical Director, Palliative Care Standards and Outcome Measures, San Diego Hospice and Palliative Care, San Diego, USA
10:15		Discussion
10:30		Coffee Break
11:00		Palliative Care and HIV/AIDS Dr. Peter Selwyn, M.D., M.P.H., Professor of Family Medicine and Internal Medicine; Chairman, Department of Family and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA [view presentation] [view paper]
12:00		WHO HIV/AIDS Guidelines for Care Igor Oliynyk, Coordinator, HIV/AIDS/STI Program, WHO Country Office, Kiev, Ukraine [view presentation (russian)]
12:30		Discussion
12:45		Lunch
13:45		Pain Assessment and Management in Patients with HIV/AIDS Dr. Peter Selwyn [view presentation] [view paper]
14:30		Clinical Case Presentation (Faculty and Participants on Pain Management – Addiction, Physical Dependence, Tolerance  Dr. Frank Ferris [view presentation]
15:20		Discussion
15:30		Coffee Break
16:00		Common Symptoms and Management Dr. Frank Ferris [view presentation] [Common Physical Symptoms] [Pain Management]
16:45		Clinical Case Presentations (Faculty and Participants) on Symptom Management - 3-4 Symptoms) Dr. Frank Ferris [view presentation]
17:45		Discussion
18:00		Adjourn
19:30		Dinner
Friday, February 27
08:00		Breakfast
09:00		Psychological Issues in Patients with HIV/AIDS: Depression, Delirium, and Dementia Virginia O'Dell, Technical Officer, HIV Department and Department of Health Systems, Policy and Operations, World Health Organization, Geneva, Switzerland [view presentation] [Palliative Care- abstract] [Psychosocial Support- abstract]
09:25		Developing a Palliative Care Program for AIDS Patients Julie Dixon, MPH, Head, Care & Support Project, AIDS Foundation East-West, Moscow, Russia [view presentation]
09:50		Caring for Children and Adolescents with HIV/AIDS Dr. Nancy Hutton, MD / Director, Pediatric and Adolescent HIV/AIDS Program; Medical Director, Harriet Lane Compassionate Care, Johns Hopkins Children's Center, Baltimore, USA [view presentation]
10:25		Coffee Break
10:55		The Last Hours of Life Dr. Frank Ferris [view presentation] [Last Hours of Living]
11:20		Spiritual Care Deacon Ivan Didenko, Head of the Coordination Committee of Inter-Church Help, Kiev, Ukraine [view presentation text (russian)]
11:45		Discussion
12:00		Lunch
13:00		What Could the Role of the Nurse be in Caring for HIV/AIDS Patients? Mimi Rivard, Nurse Practitioner, MSN, Leeway, Inc., New Haven, CT, USA Juul Bockling, Nurse/trainer; Registered Nurse, MSF-Holland, Odessa, Ukraine [view presentation] [handout 1] [handout 2] [handout 3] [handout 4] [handout 5]
13:25		What Could the Role of the Social Worker be in Caring for HIV/AIDS Patients? Gary L. Stein, JD, MSW, Executive Director, New Jersey Health Decisions, New Jersey, USA [view presentation] [Challenges and Changing Roles in HIV-AIDS Social Work]
13:50		Discussion
14:05		Stigma and Discrimination in Caring for HIV/AIDS Patients Dr. Tim Clary, Senior Technical and Policy Advisor for HIV/AIDS and Reproductive Health, Kiev, Ukraine [view presentation]
14:25		Ethical and Legal Issues in Caring for Patients with HIV/AIDS – Clinical Case Presentations (Stigma, Discrimination, and Pain Management in IVDU) Dr. Frank Ferris [view presentation] Gary L. Stein [The Rights of People Who Are HIV-Positive] [Seven Legal Barriers to End-of-Life Care]
16:00		Adjourn
16:15		Tour Kiev
19:30		Dinner
Saturday, February 28
08:00		Breakfast
09:00		Overview of Opioid Availability David Joranson, MSSW, Senior Scientist, Director, Pain and Policy Studies Group, University of Wisconsin Comprehensive Cancer Center, Wisconsin, USA [view presentation] [Overview of Opioid Availability]
09:15		Country Reports: Opioid Regulations and Patient Access in Moldova, Russia and Ukraine Speakers from Moldova, Russia, and Ukraine
10:00		Discussion
10:15		Coffee Break
10:45		CONCURRENT WORKSHOPS Workshop A: How to Make Opioid Analgesics Accessible* David Joranson [view abstract] Workshop B: Caring for Children and Adolescents with HIV/AIDS Dr. Nancy Hutton Workshop C: Integrating Palliative Care into National AIDS Standards Dr. Frank Ferris [view presentation] * The first 15 minutes of the opioid workshop will be everyone together, followed by 90 minutes of three groups, one for each country.
12:30		Lunch
13:30		Report back to group on action plans and next steps
14:15		Closing Remarks Chair: Frank Ferris [view presentation]
14:30		Adjourn
		...
		Photos [view photographs] Conference evaluation [view evaluation] Conference report [word version]
Additional material:
1. Achieving balance in national opioids control policy- WHO guidelines for assessment [view guidelines]
2. Report on the Risks of a Generalized HIV/AIDS Epidemics [view report]
3. A guide for patients, family members & community caregivers [view guide]
4. What is Palliative Care? Frank D. Ferris, MD [view presentation] [view abstract]
5. Web resources: Center for Palliative Studies, San Diego Hospice and Palliative Care                               The Education in Palliative and End-of-life Care (EPEC) Curriculum

P  R  O  G  R  A  M    O  R  G  A  N  I  Z  E  R  S

OPEN SOCIETY INSTITUTE The Open Society Institute (OSI) is a private operating and grantmaking foundation based in New York City that serves as the hub of the Open Society Network, a group of autonomous foundations and organizations in over 50 countries. This network implements a range of initiatives that aim to promote open society by shaping government policy and supporting education, media, public health and human and women’s rights, as well as social, legal and economic reform. To diminish and prevent the negative consequences of globalization, the Network seeks to foster global open society by increasing collaboration with other nongovernmental organizations, governments and international institutions. OSI was created in 1993 by investor and philanthropist George Soros to support his foundations in Central and Eastern Europe and the former Soviet Union. Those foundations were established, starting in 1984, to help former communist countries in their transition to democracy. The Network has expanded its geographic reach to include foundations and initiatives in Africa, Central Asia and the Caucasus, Haiti, Latin America, Mongolia, Southeast Asia, Turkey and the United States. OSI also supports selective projects in other parts of the world.   OSI's Network Public Health Programs in CEE and the FSU (http://www.soros.org/initiatives/ihrd) focus on promoting effective public health policy development, supporting the development of a population-oriented public health infrastructure, strengthening the capacity of professional organizations to develop and implement quality standards and professional ethics, and promoting public involvement in health.

International Renaissance Foundation - Kiyv   International Renaissance Foundation (IRF) is an autonomous representative of the Open Society Institute network in Ukraine.  International Renaissance Foundation actively cooperates with international and various Ukrainian organizations, for instance with different UN and WHO programs, technical assistance programs from different countries, ministries and government agencies in Ukraine (in particular, in late 2002 the International conference “Care, Treatment and Support for People With AIDS” was held in cooperation with the WHO and UNAIDS representatives in Ukraine), mass media, educational institutions, international and Ukrainian NGOs and their coalitions.  The Ukrainian Harm Reduction Association is one of IRF’s key-partners. On average, IRF annually supports about 1,000 projects.  Together with Open Society Institute, IRF has been the main grant-giver for the network of preventive projects conducted among HIV-vulnerable groups.  In 1999-2002, IRF directly invested about $ 2,000,000 into preventive activities (conducted by Ukrainian NGOs) benefiting more than 10,000 persons throughout Ukraine.  Since 2002, the International HIV/AIDS Alliance has also been supported the IRF network of preventive projects. Public Health program goal.  The Public Health program is aiming at improving public health through further development of normative and professional principles of the area, public involvement in solving important public health problems and improving prevention and recovery efforts. Program Implementation Principles.  The Public Health program is implemented through grant competitions, tenders, and operational events.  The Program’s operation is based on a partnership between all sectors of the society for solving urgent problems of public health with special focus on development of relevant public initiatives. Program target groups are public health NGOs, educational institutions, academic institutions, Ministry of Public Health Care of Ukraine. www.irf.kiev.ua

OPEN SOCIETY FUND - LITHUANIA Open Society Fund–Lithuania (OSFL) is an independent, non-governmental, non-profit organization, founded in 1990. Its primary aim has been to support the development of an open, democratic, civil society in Lithuania during its transitional period. Throughout the years of its activities the OSFL and its partners have initiated and stimulated changes in self-management and self-government, human rights, dissemination of multinational culture, education, science and information, and other areas that produce the greatest impact on the formation of a free and creative personality and civil responsibility. Nearly 50 million US dollars have gone towards the achievement of those objectives. The mission of the OSFL is to foster an open society, to strengthen its ideals and values at the level of governmental institutions, to prevent the monopoly of power and single truth. The building of an open society is a never-ending process involving a continuous change of challenges in a dynamic reality, discussions on the values of an open society, fostering the skills of analytical thinking and meeting the challenges of the future. The Foundation works in its priority areas through the Science and Education, Culture, Law, Civic Initiatives, Information, Public Health, Baltic-American Partnership and other programs. More information about OSFL activities is available at http://www.osf.lt and http://politika.osf.lt The general aim of all the public health programs is to contribute to the implementation of the major social rights in the area of medical care, to influence state health policies, to facilitate changes in people’s attitude toward their health, to create equal possibilities for everybody, the most vulnerable in particular, to access medical care and relevant information by implementing the principle “healthy individual – healthy society”. This aim was pursued through ten programs of the Open Society Institute network. Open Society Fund-Lithuania began overseeing logistical administration of the Open Society Institute’s Network Public Health Program’s Seminar Series in January 2003 (http://health.osf.lt).