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Reversing the HIV Epidemic

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Source: European Centre for Disease Prevention and Control (ECDC)

HIV remains a significant public health problem in the 31 countries of the European Union and European Economic Area (EU/EEA), with around 30 000 newly diagnosed HIV infections reported each year over the last decade. In a two-day conference organised in collaboration between the Maltese Presidency of the Council of the European Union and ECDC, HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.

“This conference arose from excellent collaborative work with ECDC and Malta’s commitment and recognition of the importance of placing HIV higher up on the EU agenda during its Presidency Term” says Mr Chris Fearne, Minister for Health, Malta. “We believe that concerted efforts must include all stakeholders: including governments, healthcare providers, civil society, people living with HIV and the specialised agencies like WHO and ECDC. We believe that tackling HIV is a regional, national, corporate and individual responsibility. They all have a role to play in terms of political commitment, preventive action, universal access to healthcare, affordability and access to medicines, testing, linkage to care, focus on key populations, zero tolerance to stigma AND individual behavioural responsibility.“

He added areas of action: “Scaling up of testing is essential to reach our first 90 target. We need to make better use of various settings to enhance testing, incorporate innovative approaches to testing and reduce the barriers, especially in key populations. Knowledge of HIV status ‘in unaware persons’ might also help reduce new HIV infections – those resulting negative may then take less risks, and if linked to care should achieve viral suppression, the third 90“.

“If we take a look at the available data, we can see that Europe needs to improve its HIV response in several areas”, says ECDC Acting Director Andrea Ammon. “Currently, two out of three EU/EEA countries tell us that they do not have sufficient funding for prevention interventions. And every one in seven people living with HIV in the region are not aware of their infection. To reduce the number of new HIV infections in Europe, we need to focus our efforts in three main areas: prioritising prevention programmes, facilitating the uptake of HIV testing, for example by introducing new approaches like community-based testing or self-testing to diagnose those infected. And, of course, easier access to treatment for those diagnosed”.

Pharmaceuticals-Healthcare-Pill-World-Map-Earth-1185076Status quo of Europe’s HIV response: new ECDC report
On the occasion of the Presidency meeting, ECDC publishes an overview of achievements and gaps in the European HIV response, illustrating how countries addressed the HIV epidemic in 2016, based on their commitment outlined in the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia.

The results show, amongst others, that HIV treatment overall starts earlier across the EU/EEA and more people receive life-saving treatment. But one in six people in the EU/EEA diagnosed with HIV are still not on treatment. Those who are on treatment, however, show how effective current HIV treatment is: almost nine out of ten people living with HIV on treatment are virally suppressed. This means the virus can no longer be detected in their blood and they cannot transmit the virus to others.
The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) contributed to this overview with data on the HIV situation and prevention coverage among people who inject drugs.

EMCDDA Director Alexis Goosdeel states: “People who inject drugs have the highest proportion of late diagnosis of HIV, compared to other transmission groups. Providing voluntary testing for infectious diseases, risk behaviour counselling and assistance to manage illness at drug treatment facilities is an important additional avenue to reach this group and is among the new EU minimum quality standards for demand reduction” .

The introduction and scaling up of effective drug treatment and harm reduction measures, such as needle and syringe provision, have significantly reduced drug injecting and related HIV transmission in Europe. However, this overall positive development hides large variations between countries. Marginalisation of people who inject drugs, the lack of prevention coverage, and appearance of new drugs can trigger local HIV outbreaks, as documented in five EU countries in the recent past.

Source: European Centre for Disease Prevention and Control 

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City Health Conference 2017 Focuses on Developing Healthy Cities

city-health-20176th International City Health Conference ‘Empowerment, Engagement and Partnership: participating to develop healthy cities’ will take place in Basel, Switzerland in September 2017. Currently the call for submissions for presentations, as well as proposals for the sessions within the conference is announced.

AFEW International executive director Anke van Dam is the member of the Programme Advisory Group for the Conference.

“The City Health Conference is an important event for sharing experiences and best practices of interventions at a municipal level. Interventions about health, sports, but also about environment, housing and the homeless people, are presented and discussed. AFEW organized the City Health Conference in Amsterdam in 2014 and brought professionals from multiple disciplines together to discuss concerns and problems at city level from different angles. This is needed since more than a half of the population in the world is living in an urban setting,” Anke van Dam says.

The Conference is hosted by the University of Applied Sciences and Arts Northwestern Switzerland and organised by KnowledgeActionChange.

‘Empowerment, Engagement and Partnership: participating to develop healthy cities’ reflects the belief that measures and actions for health promotion and urban development are more effective if the affected populations play an active and co-decisive role in the process of design, development and delivery. Evidence demonstrates that such engagement and participation contributes to sustainable solutions, to a greater identification with urban public space and increased intergenerational communication.

This is an ‘inclusive’ conference, with presenters and participants including NGOs, community projects, advocacy groups, as well as urban and health planners, academics, policy makers and those who deliver services and interventions.

Currently, the organisers welcome both individual submissions for oral and poster presentations, as well as proposals for whole sessions within the conference. The deadline for the submission is March-April 2017. The programme committee will use selected abstracts to construct themed sessions. Authors will be informed if their abstract has been accepted before the posting of the near-final programme in June 2017.

To register for the conference, please, click here.

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Improving Outcomes for People Living with HIV

2136950249_b3e5f6a6fa_bThis is a call to action for European governments, international organisations, patient organisations, and the wider health community to align on a new HIV policy agenda that addresses the crucial unmet needs of people living with HIV (PLHIV) – to ensure they can live longer in good health, and participate fully in society and the economy.

Current HIV policy frameworks rightly focus on prevention, diagnosis and effective treatment (viral suppression), but do not go beyond this to address other health and social challenges faced by PLHIV. In Europe, where viral suppression should increasingly be the norm, it is vital that policy makers and healthcare providers recognize these challenges and respond.

An integrated approach is needed to improve:

  • Health outcomes – by addressing the increased risk that PLHIV will develop other medical problems (co-morbidities) – including mental health issues.
  • Social outcomes – in particular by combating stigma and discrimination, and ensuring that PLHIV are able to secure and retain employment and housing.

Effective action to improve outcomes, and reduce the health burden and costs associated with HIV, can bring meaningful economic benefits and reduce demands on European healthcare systems.

We call on the EU and Member States to:

1. Revisit the Dublin Declaration on Partnership to Fight HIV/AIDS, and ensure that its monitoring adopts a ‘life-long’ approach to the health and social inclusion of PLHIV.

2. Identify and agree on policy indicators necessary to monitor and assess country performance in improving health and social outcomes for PLHIV.

3. Adopt in 2017 an integrated EU Policy Framework on HIV/AIDS, viral hepatitis and TB – thereby extending the focus of the EU Action Plan on HIV/AIDS, which comes to an end in 2016.

Background

Whilst important progress has been made in the global response to HIV/AIDS, with the European Union (EU) playing an instrumental role, the European region – and in particular Eastern Europe – now has the fastest growing HIV epidemic globally. 29,992 people were diagnosed with HIV in the EU/EEA in 2014. At the same time, PLHIV are living longer, which has created new challenges relating to the prevention, treatment, and management of co-morbidities.

With the EU Action Plan on HIV/AIDS expiring at the end of 2016, and the Dublin Declaration on Partnership to fight HIV/AIDS now more than a decade old, European governments and the EU institutions have an opportunity to make progress on their political commitment to fighting both the transmission of HIV, as well as its health and social impacts – including the Sustainable Development Goals (SDGs).

Continuing challenges include the strengthening of prevention programmes, reducing late diagnoses, ensuring equity and universality of access, and the social consequences of HIV that stem from stigma and discrimination. Governments and health systems must respond to the fact that PLHIV are living longer. We must ensure that PLHIV remain in good health as they grow older, and can lead successful, productive and rewarding lives. This aspiration should motivate the HIV response in all European countries – not only those that already perform well in relation to the UNAIDS targets for diagnosis, treatment and viral suppression.

The Beyond Viral Suppression Initiative

The Beyond Viral Suppression initiative arises out of a shared recognition among leading HIV experts that there are crucially important issues relating to the health and social inclusion of PLHIV that have to date received insufficient attention from policy makers and healthcare providers, and which must now form part of our HIV response.

In an era when ageing populations and health system sustainability are central challenges for all European countries, the initiative will also aim to inform debates about cost-effective strategies for co-morbidity prevention and management, whilst ensuring patient-centered healthcare delivery. Our recommendations should therefore be of high relevance both to policy makers and the wider health community.

The steering group is co-chaired by: Nikos Dedes, the Founder of Positive Voice (the Greek association for PLHIV) and a Board member of the European AIDS Treatment Group (EATG); Professor Jane Anderson of Homerton University Hospital NHS Foundation Trust in London; and Professor Jeffrey Lazarus of ISGlobal, Hospital Clínic at the University of Barcelona, and CHIP, Rigshospitalet, University of Copenhagen. The initiative is enabled by sponsorship provided by Gilead Sciences and ViiV Healthcare.

The initiative is developing a performance assessment of HIV services ‘beyond viral suppression’ – focusing on: access to appropriate health services; health outcomes – co-morbidity and co-infection prevention, and health-related quality of life; and social outcomes.

A research team supported by a study group of leading academics will seek to identify the policy indicators necessary to assess countries’ performance at improving health and social outcomes ‘beyond viral suppression’. Our aim is thereby to complement the work of other initiatives focusing on HIV prevention, diagnosis, and access to high quality treatment and care.

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Website about Health for Migrants is Available in 13 Languages

 

health-site_engThe information about body, family planning and pregnancy, infections, sexuality, relationships and feelings, rights and law can be found on the website Zanzu – my body in words and images. This projects for migrants was developed by the Flemish Expertise Centre for Sexual Health Sensoa and the German Federal Centre for Health Education (Bundeszentrale für gesundheitliche Aufklärung) BZqA. The information is available in 13 languages, including Russian and English.

Information on the website is presented in easy interactive form. Pushing the image brings the reader to other pictures, behind which they can find important information. Section “Dictionary and translations” will provide users with the translations of most widely-used words on the topics mentioned above. On the website there are also contacts of the doctors who help migrants with their health issues.

Besides, on the site there is information for professionals in English, Dutch and French languages. This section contains advice to the foreign professionals on how to talk to migrants and why it is important to discuss their health issues. The content on the website was approved by an international advisory board of European experts in the field of sexual and reproductive health including representatives of WHO.