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DOI 10.1016/j.drugpo.2026.105369

Медицинская библиотека · The International journal on drug policy · 2026

Sounds like a (transition) plan: From absent state to NGO dominance, and back again in Ukraine's HIV prevention sector.

Dmitrieva Alexandra, Stepanov Vladimir

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Аннотация

This article examines Ukraine's Global Fund "Transition Plan" as a governance technology that reorganised time, responsibility, and uncertainty in HIV prevention, rather than as a policy instrument that simply succeeded or failed. Introduced in 2016 as a condition of continued donor support, the Plan promised a "gradual" shift from zero state financing of prevention to 80% by 2020. While the assessments concluded that Ukraine met-and even exceeded-its budgetary commitments, substantially less funding reached frontline services. We show how this gap was produced through performance-based spending, procurement rules, and audit procedures tied to pre-set coverage and service-volume targets that proved difficult to realise under punitive drug policy, repeated cycles of forced client mobility and disappearance, and broader precarity. Drawing on multi-sited qualitative fieldwork and policy analysis, we trace how donors, state bodies, and NGOs reproduced vertical governance through metrics, tenders, and accountability regimes. We situate these dynamics within a "double becoming" of Western and (post-)Soviet modernities, in which future-oriented targets produce (un)certainty while displacing attention from present constraints. The Plan thus appears simultaneously feasible, as an auditable system, and fantastic, as delivery depends on stabilising criminalised, mobile lives-producing an interpretive impasse between budgetary overfulfilment and service underdelivery. This, we argue, constitutes the Transition Plan as a broader condition, as a metaphor for post-Soviet transformation towards the "West".

Для цитирования: Dmitrieva Alexandra, Stepanov Vladimir. Sounds like a (transition) plan: From absent state to NGO dominance, and back again in Ukraine's HIV prevention sector.. The International journal on drug policy. 2026. DOI: 10.1016/j.drugpo.2026.105369.

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