European Action Plan for HIV/AIDS...

17th EC HIV/AIDS Think Tank Meeting

Luxembourg 8 December 2011

Martin C. DonoghoeProgramme Manager HIV/AIDS, STIs & Viral HepatitisDivision of Communicable Diseases, Health Security and EnvironmentWHO Regional Office for Europe

European Action Plan for HIV/AIDS 2012–2015

HIV epidemic in Europe still not under control

1 418

0

200

400

600

800

1 000

1 200

1 400

1 600

1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010

abso

lute

num

bers

, tho

usan

ds

Cumulative number of reported cases (in thousands),WHO European Region, 1985–2010

Sources: ECDC/WHO. HIV/AIDS surveillance in Europe 2010. Stockholm: ECDC; 2011. UNGASS country progress reports 2010 for the Russian Federation and Ukraine.

People living with HIV: fast growing numbers in eastern Europe and central AsiaEstimated number of people living with HIV in Europe, 1990-2010

Source: UNAIDS World AIDS Day Report 2011

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

2.0

2.2

2.4

2.6

Estimated

peo

ple living with HIV (m

illion)

Europe (total estimated)2 340 000

Eastern Europe and central Asia1.5 million

Western and central Europe840 000

Newly diagnosed HIV infections by mode of transmission and geographical area, 2010

Sources: ECDC/WHO. HIV/AIDS surveillance in Europe 2010. Stockholm: ECDC; 2011

Russian Federation Ministry of Health and Social Development

40%

24%

45%

17%

42%

13%

4%

4%

41%39%

29%

1%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

West Centre East

Men who have sex with men Injecting drug use Heterosexual Other and unknown

Estimated ART coverage in eastern Europe and central Asia among the worst globally

47%

49%

64%

60%

39%

23%

10%

0% 10% 20% 30% 40% 50% 60% 70%

Global coverage

Sub‐Saharan Africa

Latin America

Carribean

Eastern, Southern and South‐East Asia

Eastern Europe and Central Asia

North Africa and the Middle EastART also reduces risk of HIV transmission.

– Donnell D et al. Lancet, 2010, 375(9731):2092–2098

ART also reduces risk of HIV transmission.

– Donnell D et al. Lancet, 2010, 375(9731):2092–2098

Source: WHO/UNAIDS/UNICEF Universal Access Report 2011

Infection increasing faster than treatment

1 418

397

210

559

0

200

400

600

800

1 000

1 200

1 400

1 600

1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010

abso

lute

num

bers

, tho

usan

ds HIV

AIDS

AIDS deaths

People on ART

Cumulative number of reported cases and deaths (in thousands),WHO European Region, 1985–2010

Sources: ECDC/WHO. HIV/AIDS surveillance in Europe 2010. Stockholm: ECDC; 2011. UNGASS country progress reports 2010 for the Russian Federation and Ukraine. ART data from the WHO/UNICEF/UNAIDS monitoring and reporting on the Health Sector response to HIV/AIDS.

European Action Plan for HIV/AIDS 2012-2015: Framework for urgent action• Addresses priorities and context of the WHO European Region

• Puts into action;

– UNAIDS Getting to Zero HIV/AIDS Strategy for 2011‐2015

– WHO Global Health Sector Strategy for HIV 2011‐2015

– UN Political declaration on HIV/AIDS (2011 New York)

• Contributes to;

– Millennium Development Goals

• Coherent with;

– EC Communication on HIV/AIDS 2009‐2013

– Dublin Declaration (2004)

• Builds on existing European experience; particularly with

integration models and linkages

• Builds on partnership (Global Fund, Civil Society)

European action plan on HIV/AIDS

European vision and goals

The vision for the European Region is zero new HIV infections, zero AIDS‐

related deaths and zero discrimination in a world in which people living

with HIV are able to live long, healthy lives.

The goals for the European Region are, by 2015:

– to immediately halt and reverse the spread of HIV in Europe

– to achieve universal access to comprehensive HIV prevention, treatment,

care and support; and

– to contribute to the attainment of Millennium Development Goal 6 and

other health‐related Millennium Development Goals (3, 4, 5 and 8).


European Action Plan for HIV/AIDS 2012-2015Four strategic directions

Reducevulnerabilityand address

structuralbarriers to accessingservices

Build strongand

sustainablesystems

Leveragebroader health

outcomesthrough HIV

response

Optimize HIVprevention, diagnosis,

treatment and care outcomes

Strategic direction 1



• Universal access and HIV specific goals(Including MDG 6)


1.Optimizing HIV prevention, diagnosis, treatment, care and support outcomes

• Expanding HIV testing and counselling

• Preventing HIV transmission through injecting drug use

• Reducing sexual transmission of HIV (including men who have sex with men and sex workers)

• Eliminating mother to child transmission

• Universal access to HIV treatment and care

– To provide care

– To limit transmission

• Eliminating HIV transmission in health care



outcomesthrough HIV

response




• MDG 4: Reduce child mortality• MDG 5: Improve maternal health• Global plan to stop TB 2011-2015 goals


2. Leveraging broader health outcomes through HIV response

HIV impacts the control and health outcomes of

other diseases and conditions


Build strongand

sustainablesystems


outcomesthrough HIV

response




• MDG 8: Develop a globalpartnership for development


MDG 6 Combat HIV/AIDS, malaria and other diseases (HIV )

3. Building strong and sustainable health systems


Medicines, diagnostics and other commodities

Ensure reliable data is collected, analyzed and better used to inform policy decisions and programme planning

Ensure that health services meet the needs of service users through decentralization (when possible), integration

Involve civil society in service delivery

Ensure medicines, diagnostics and other commodities are affordable, quality assured and supplied without interruption

Service deliveryStrategic information Health financing

Improving quality; governance, partnership and alignment;

health workforce

Ensure that financing mechanisms for HIV interventions sustain coverage and reach target populations as efficiently and equitably as possible

Promote sustainability, attract available domestic resources, improve cost‐effectiveness

Reducevulnerabilityand address

structuralbarriers to accessingservices

Build strongand

sustainablesystems


outcomesthrough HIV

response




• MDG3: Promote gender equality and empower women


4. Reducing vulnerability and the structural barriers to accessing services

• Anchored in principles of:

– Equity in health (Health 2020 and the Tallinn

Charter); community participation, and protection of

human rights; evidence informed policies and ethical

public health approaches

• Addresses laws and regulations; stigma, discrimination

and other human rights abuses

• Addresses social determinants

• Strengthening community systems


“Current activities to reduce HIV infection rates are not enough to control and reverse the HIV epidemic in Europe. Above all, we need to address the social determinants of health of those who are most at risk, as they are often stigmatized and excluded from health and social services, including HIV treatment. I am delighted that countries in Europe are committed to the new European Action Plan for HIV/AIDS, which addresses these issues and provides comprehensive solutions. Now is the time for action by all stakeholders, including governments and the civil society” .

Zsuzsanna Jakab, WHO Regional Director for Europe

This paper was produced for a meeting organized by Health & Consumers DG and represents the views of its author on thesubject. These views have not been adopted or in any way approved by the Commission and should not be relied upon as a statement of the Commission's or Health & Consumers DG's views. The European Commission does not guarantee the accuracy of the dataincluded in this paper, nor does it accept responsibility for any use made thereof.

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