HA-REACT Joint Action on HIV and co- infection prevention .... H. B... · infection prevention and...

HA-REACT Joint Action on HIV and co-infection

prevention and harm reduction3rd EU Health Programme

Call: HP-JA-2014, Topic: JA-02-2014

29.6.2015 Mika Salminen/Outi Karvonen/Henrikki Brummer-Korvenkontio 1

A proposal for a Joint Action project under the EU Health Programme 2014 call• Addresses Annual Work Programme, subheading 2.2.1.2.

“Improvement of HIV and co-infection prevention and treatment in priority regions and priority groups in the European Union”

• Addresses all 4 priorities of the programme:– promoting healthy lifestyles – protection from cross border threats– contributes to priorities 3 and 4, as several work packages of the

proposal address the access to care in particularly vulnerable groups and settings

• Addresses the Communication from the Commission [COM(2009)569] on “Combating HIV/AIDS in the European Union and neighbouring countries, 2009 -2013” and its [SWD(2014)106] action plan extension 2014-2016


Focusing the action: use of ECDC and EMCDDA objective selection criteria


AT BE BG HR CY CZ DK EE FI FR DE EL HU IS IE IT LV LT LU MT NL NO PL PT RO SK SI ES SE UK

HIV trendHIV case reports and prevalence

(15% weight; no increase in case

reports or prevalence=0;

increase in one=1; increase in

both=2; high without an

increase=1)

0 0 2 0 0 0 0 1 0 0 0 1 0 0 0 0 2 1 0 0 0 0 0 0 2 0 0 0 0 0

Transmission riskprevalence of injecting drug use,

changes in injecting risk

behaviour (HCV prevalence and

trends) (10% weight; no

changes=0; moderate increase

in one criteria=1; increase in >1

criteria=2)

0 0 2 0 1 2 0 2 2 2 0 0 0 2 0 0 0 0

OST coverage% estimated problem opiate

user population receiving OST

(cut-off 30%) (25% weight; OST

coverage >30%=0; no data=1;

OST coverage <30%=2)

0 1 1 0 0 0 1 1 1 0 0 0 2 1 0 0 2 2 0 0 0 0 2 1 1 2 0 0 1 0

NSP coverageNumber of syringes given out

per PWID per year (cut-off 100

syringes) (25% weight; NSP

coverage >100=0; no data=1;

NSP coverage<100=2)

1 2 1 0 2 0 1 0 0 1 1 2 2 1 1 1 2 1 0 1 1 0 1 1 2 2 1 0 1 1

Taking part in the Joint Action x x x x x x x x x x x x x x x x x x x x

Scores (maximum 2)0,3 0,8 1 0 0,6 0 0,5 0,6 0,3 0,3 0,3 0,9 1,2 0,5 0,3 0,3 1,5 0,9 0 0,3 0,3 0 0,8 0,5 1,3 1 0,3 0 0,5 0,3

Ranking of those participating in

the JA (1=greatest

need/opportunity to improve

harm reduction situation) 6 3 8 5 2 1 4 6

NO ALERT – no evidence for increase in case reports or HIV/HCV prevalence and/or transmission risk and/or low intervention coverageCONCERN - Subnational increase in HIV/HCV prevalence and/or transmission risk or consistent but non-significant rise at national level.ALERT – evidence for significant increase in case reports or HIV/HCV prevalence and/or increase in transmission risk and/or low intervention coverage.Information unknown/not reported to EMCDDA/ECDC.

Table 1: Indicators of HIV trend, transmission risk and prevention coverage

ECDC & EMCDDA joint guidance

– Comprehensive Guidance document• Based on evidence and fully

referenced

– Two part evidence assessment

1. Needle and syringe programmes and other interventions for preventing hepatitis C, HIV and injecting risk behaviour

2. Drug treatment for preventing hepatitis C, HIV and injecting risk behaviour

4

Seven interventions, one aim: no infections

Purpose of the action

• To stop (eradicate) transmission of blood-borne and poverty related infectious diseases among people who inject drugs (PWID) in the EU

• By implementing country-tailored preventive interventions, using well tried evidence based harm reduction approaches

• Creating sustained, improved capacity of all EU countries to respond to infection risks and vulnerabilities among (PWID)

• With a specific focus on Latvia, Lithuania and Hungary, but engaging all partner countries


Geographical coverage of the HA-REACT JA


Collaborating partner

Associated partner

LatviaLithuania

Hungary

Focus country


Improved prevention and treatment of blood-borne infections and TB in priority regions and priority groups in the European Union

Improved capacity to respond to HIV and co-infection risks and provide harm

reduction with specific focus on people who inject drugs (PWID) in EU

Management of the Joint

Action

3. Harm reduction and

continuity of care for prisoners

who use drugs enhanced

(WP6)

5. National programmes updated to overcome barriers to respond to

HIV, TB and HCV-related needs of PWID in the EU, specifically in the

focus countries

Zero new HIV, reduced HCV and TB among PWID in the EU by 2020

1. Improved early diagnosis

of HIV, viral hepatitis and

TB , as well as improved

linkage to care for PWID

2. Harm reduction

scaled up in EU based on Latvian and Lithuanian

cases

3.Increased harm reduction and improved

continuity of care for PWID in

prison settings

4. Improved provision of integrated HIV,

HCV, TB treatment and harm reduction

for PWID

Structure and objectives of the Joint Action

WP4 WP5 WP6 WP7 WP8

Specific objective 1

Testing and linkage to care (WP4)

• Implement early diagnosis of HIV, viral hepatitis and tuberculosis, using outreach, low threshold services and linkage to care for the management of blood-borne infectious diseases by providing training of health and social services, professionals and community base organisations and supporting the availability of prevention and medical measures



Harm reduction (WP5)

• To implement a tailored plan to scale-up Harm Reduction Interventions in specific focus Countries (LV, LT) involving 3 areas: Assessment of PWID epidemiology and HR interventions, and identification of needs/barriers to HR implementation; (B)Training package to care providers and policy makers on key HR interventions, including face-to-face training and Guidelines and Manuals; (C) Direct support to HR interventions.



Prison settings (WP6)

• To increase the access (availability and coverage) to harm reduction services and continuity of care for drug users in prisons by assessing the essential components that need to be created and maintained to ensure the linkage between community and prison health services



Integrated care (WP7)

• To improve the provision of integrated HIV, HCV, TB and drug treatment services in a client-centred and client-friendly manner whilst also guaranteeing high levels of confidentiality and to ensure better collaboration between HIV, HCV, TB and drug treatment service providers



Sustainability and long-term funding (WP8)

• To help national AIDS programmes and other relevant governmental and nongovernmental programmes in the three focus countries (Hungary, Latvia and Lithuania) develop sustainable, effective evidence-based approaches to meeting the HIV-related needs of people who inject drugs


WP leaders• WP1: Coordination

– Mika Salminen, Outi Karvonen, Henrikki Brummer-Korvenkonti, THL Finland

• WP2: Dissemination– Jeffrey Lazarus, CHIP, Denmark

• WP3: Evaluation– Marcus Martens, ZIS, Hamburg

• WP4: Testing and linkage to care– Alexandra Gurinova, Ludger

Schmidt, Deutsche AIDS-Hilfe, Germany

• WP5: Harm reduction– Luis Sordo, CIBER, Spain

• WP6: Harm reduction and care in prisons

– Heino Stöver, ISFF, Frankfurt

• WP7: Integrated care– Aljona Kurbatova, NIHD, Estonia

• WP8: Sustainability and long-termfunding

– Jeffrey Lazarus, CHIP, Denmark

29.6.2015 Mika Salminen/Outi Karvonen 13

Thank you for your attention


Associated and affiliated partners: 24+2 from 19 countries

• Belgium (BE) Modus vivendi asbl

• Croatia (HR)

– Croatian institute of Public Health (HZJZ)

– Life Quality Improvement Organisation FLIGHT(LET)

• Czech Republic (CZ) National monitoring center for drugs and additions (NMS)

• Denmark (DK) Centre for Health and Infectious disease Research, Rigshospitalet University of Copenhafen (CHIP)

• Estonia (EE) National Institute for Health Development (NIHD)

• Finland (FI) National Institute for Health and Welfare (THL)

• Germany (DE)

– Zentrum fur interdisziplinare Suchtforschung der Universitat Hamburg (ZIS)

– Institut fur Suchtforschung (ISFF)

– Deutsche AIDS-Hilfe (DAH)• Affiliated: Germany (DE) AIDS Action Europe (AAE)

• Greece (EL) Hellenic Center For Disease Control Ανd Preventlon (HCDCP)


• Hungary (HU)

– OEK (National Centre for Epidemiology) (Országos Epidemiológiai Központ)

– Office of the Chief Medical Officer (OCMO), (OTH, Országos Tisztifőorvosi Hivatal)

• Iceland (IS) Landspitali University Hospital

• Italy (IT) Istituto Nazionale Malattie Infettive (INMI)

• Latvia (LV) Center For Disease Prevention and control of Latvia

• Lithuania (LT)

– Center For Communicable Diseases And Aids (ULAC)

– Vilnius Center For Addictive Disorder (VPLC)

• Luxembourg (LU) Directorate of Health (Ministry of Health) – Division of Health Inspection

• Malta (MT) Ministry for Energy and Health (MEH)

• Poland (PL) National Centre AIDS Agenda of the Ministry of Health (NAC Poland)

• Portugal (PT) Directorate-General of Health (DGS)

• Slovenia (SI) Association SKUC Miran Solinc

• Spain (ES) Instituto de Salud Carlos III

– Affiliated:Centro de Investigacion Biomedica end Red (CIBER)

Collaborating partners: 12 with an additional 4 countries and 2 EU agencies• Norway (NO) Norwegian Institute of

Public Health, Oslo

• Sweden (SE) Public Health Agency of Sweden, Stockholm

• United Kingdom (UK) Department of Health, London

• Cyprus (CY) Medical and Public Health Services of the Ministry of Health of the Republic of Cyprus

• Czech Republic (CZ): – The Czech AIDS help Society (CSAP)

– The national institute of Public Health (SZU)

– Ministry of Health (MZ CR)

• Spain (ES) Coordinadora Estatal de VIH-SIDA (CESIDA)

• Belgium (BE) Free Clinic

• Lithuania (LT) Vilnius University

• EU Agencies– European Centre for Disease Prevention and

Control (ECDC)

– European Monitoring Centre for Drugs and DrugAddiction (EMCDDA)


HA-REACT Joint Action on HIV and co- infection prevention .... H. B... · infection prevention and...

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