Joint Action on HIV and co-infection prevention and harm reduction HA-REACT

Mika Salminen, Ph. D, Research Professor

Luxembourg, 20 April 2016

Basic facts

Budget: Approx. 3,75 million EUR

co-funding by EC – 80%

Duration: October 2015 – September 2018

Coordination: National Institute for Health and Welfare (THL), Finland

Partners: 23 partners from 18 countries

Overall objectives of HA-REACT

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

by 2020

Improved prevention and treatment of blood-borne

infections and TB in priority regions and priority groups in

the European Union

Purpose

Improved capacity to respond to HIV and co-infection risks and provide harm reduction with specific focus on people who inject drugs (PWID) in the EU

Target group: people who inject drugs

Geographical coverage of HA-REACT

Core values

Each Party commits themselves to the following core values in prevention of infections among people who inject drugs (ECDC and EMCDDA 2011):

Principles of prevention:

• A pragmatic approach to health promotion;

• The clients’ rights perspective;

• Public health objectives;

• Guidance based on scientific evidence and expert experience.

Core values cont.

Principles of service provision: • Ensure confidentiality; • Promote service accessibility; • Create a user-friendly atmosphere; • Engage in dialogue with users and promote peer

involvement; • Adopt a practical approach to the provision of services; • Refrain from ideological and moral judgement; • Maintain a realistic hierarchy of goals.

HA-REACT Work Packages

WP1. Coordination

WP2. Dissemination

WP3. Evaluation

WP4. Testing and linkage to care

WP5. Scaling up harm reduction

WP6. Harm reduction and continuity of care in prisons

WP7. Integrated care

WP8 Sustainability and long-term funding

WP4 objectives

Testing and linkage to care

Improved early diagnosis of HIV, viral hepatitis and TB, as well as improved linkage to care for PWID (WP4)

1.1. Personnel working with PWID in Hungary and Latvia trained in low-threshold testing of HIV, HCV

1.2. An interactive training manual and e-learning package on HIV and HCV testing in low threshold settings for personnel who work with people who use drugs, with special focus on women and peers, developed.

1.3. Awareness of clients of their infection status, of prevention and treatment of HIV, HCV and TB, improved.

1.4. Access to treatment after positive test result is ensured.

1.5. Gender-specific approach in testing services focused on women who use drugs developed and implemented.

WP5 objectives

Harm reduction Harm reduction scaled up in EU based on Latvian and Lithuanian cases (WP5) 2.1. PWID epidemiology and harm reduction interventions assessed in Latvia and Lithuania 2.2. Training package to care providers and policy makers on HR interventions developed and implemented 2.3. Harm reduction interventions implemented in Latvia and Lithuania

WP6 objectives

Prison settings

Increased harm reduction and improved continuity of care for PWID in prison settings (WP6) 3.1. Situation analysis / mapping of needed support in the participating countries implemented

3.2. Medical, social and other prison professionals trained to work with PWID and to provide harm reduction services (incl. OST, NSP, condom provision and psychological support)

3.3. IEC materials developed for PWID and staff in prisons

3.4. Practical toolkit for harm reduction in prisons made available

3.5. Condom provision and other harm reduction measures piloted in one prison

3.6. Policy brief developed based on experiences from the component

WP7 objectives

Integrated care

Improved provision of integrated HIV, HCV, TB treatment and harm reduction for PWID (WP7)

4.1. Capacity of health, social and civil society professionals in providing better quality of care for PWID improved

4.2. Evidence- and practice- based tools and instructional materials developed and provided for implementation of better quality care for PWID

WP8 objectives

Sustainability and long-term funding

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 (WP8)

5.1. Strategies for national AIDS programmes for planning resource mobilisation, allocation and financial sustainability for activities addressing HIV-related needs of PWID suggested

5.2. Strategies for removing provider-dependant barriers in access to high-quality HIV, co-infection and harm reduction services to PWID mapped, analysed and proposed

5.3. Strategies for removing customer-dependant barriers in access to high-quality HIV, co-infection and harm reduction services to PWID mapped, analysed and proposed

5.4. Strategies for removing structural barriers in access to high-quality HIV, hepatitis and TB services to PWID mapped, analysed and proposed

Associated partners

• Croatia (HR) Croatian institute of Public Health (HZJZ) • Croatia (HR) 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) • Germany (DE) Institut fur Suchtforschung (ISFF) • Germany (DE) Deutsche AIDS-Hilfe (DAH)

– Affiliated: Germany (DE) AIDS Action Europe (AAE)

Associated partners (2)

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

• Hungary (HU) OEK (National Centre for Epidemiology) (Országos Epidemiológiai Központ)

• Hungary (HU) 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)

• Lithuania (LT) Vilnius Center For Addictive Disorder (VPLC)

Associated partners (3)

• 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)

Altogether 23 associated partners from 18 countries!

Collaborating partners

• Czech Republic: The Czech AIDS help Society (CSAP) • Czech Republic: The national institute of Public Health (SZU) • Czech Republic: Ministry of Health (MZ CR) • Spain: Coordinadora Estatal de VIH-SIDA (CESIDA) • ECDC • EMCDDA • Belgium: Free Clinic • Cyprus: Medical and Public Health Services of the Ministry of Health of the

Republic of Cyprus • Lithuania: Vilnius University • Norwegian Institute of Public Health • Public Health Agency of Sweden • UK: Department of Health, London

HA-REACT management structure

21.4.2016 Outi Karvonen 18

WP2 Dissemination REGIONH/CHIP Denmark

WP3 Evaluation UKE (ZIS) Hamburg

WP4 Testing DAH, Berlin

WP5 Harm reduction ISCIII/CIBER, Spain

WP6 Prison ISFF, Frankfurt

WP7 Integrated care NIHD (TAI), Estonia

WP8 Sustainability REGIONH/CHIP Denmark

DG SANTE

CHAFEA

Steering Committee Coordination Team

WP leaders

Advisory Board

Partnership Forum Associated Partners Collaborating Partners

WP1 Coordination Team THL

Advisory Board

• CHAFEA

• DG SANTE

• DG HOME

• ECDC

• EMCDDA

• WHO/EURO

• Civil Society Forum on Drugs /Correlation network

• Civil Society Forum on HIV/AIDS

• European network of people who use drugs (EuroNPUD)

• Eurasian Harm Reduction Network (EHRN)

Advisory Board cont.

• European Association for the Study of the Liver (EASL)

• European Liver Patients Association (ELPA)

• NDPHS Expert Group on HIV, TB and Associated Infections

• UNODC

• Primary healthcare organization (to be defined)

Latest and current activities

• 1st Steering Committee in Luxembourg, 8-9 December 2015

• Kick-off in Vilnius, 14 January 2016

• 1st Advisory Board and 2nd Steering Committee in Vilnius, 15 Jan 2016

• Logical Framework Approach workshops during spring 2016: – WP4 Testing and linkage to care, Budapest, 15-16 February

– WP8 Sustainability and long-term funding, Riga, 14-15 March

– WP5 Scaling up harm reduction, Vilnius, 16-17 March

– WP6 Harm reduction and continuity of care in prisons, Prague, 18-19 April

– WP7 Integrated care, Tallinn, 25-26 April

• WP5 training seminars in Vilnius, 11-12 April and in Riga, 14-15 April

• Steering Committee meeting in Berlin on 12 May

Dissemination principles

• The Joint Action external dissemination plan to be developed by CHIP, the lead partner, is based on four principles:

• Regular communication: At a minimum, every month the project will share information with a variety of stakeholders, as per below and seek to engage non-partner countries, like Bulgaria and Romania, as well as neighbourhood countries.

• Multilingual: The project language is English, but as an international joint action, materials will be translated into at least one other language when relevant and feasible. Additionally, the news content, for example, will be disseminated by AIDS Action Europe in English and Russian (including the website).

• Use of existing channels (#HAREACT): Dissemination will seek to capitalise on existing communication platforms and accounts, as well as scheduled events such as conferences, relying on all project partners and particularly the associate partners. These include gatherings of the European AIDS Clinical Society (EACS), the European Association for the Study of the Liver (EASL) and the International AIDS Society (July 2018, Amsterdam) as well as relevant national and regional events.

• Target audiences: National policy-makers, professional medical associations (nurses, general practitioners, specialists on infectious diseases, particularly HIV, hepatitis and TB); NGOs; CBOs and patient organisations; national and European policy organisations, security and prison health specialists; as well as drug agencies.

Be involved

• “Throughout the three-year project period of the Joint Action, the coordinators and partners will share information publicly on a frequent and regular basis and link activities to the most important meetings, trainings and events of the JA.

• The project seeks to be highly visible in its field by reporting on progress, results and deliverables to intended project beneficiaries and a broader specialised audience.”

To do this, we need your involvement!

Dissemination activities

1. Social media (#HAREACT):

LinkedIn, Twitter, Facebook, Instagram…

Key influencers (e.g. Advisory Board) to further disseminate project information

2. Project blog: content from other WPs including any partner

3. Letters, viewpoints, roundtable discussions and editorials

4. Press releases when relevant (3) – including at the start and close of the project

5. News posts in other organisations’ newsletters/websites/listservs – 4 per year

More information available:

www.hareact.eu/en

#HAREACT