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HIV/AIDS Treatment and Care Clinical protocols for the WHO European Region 23 November 2007 World AIDS Day. Jeffrey V. Lazarus WHO Europe, STI/HIV/AIDS Programme. Annual number of newly reported cases – all WHO EURO countries. WHO/UNAIDS estimates , end of 2007:
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HIV/AIDS Treatment and Care Clinical protocols for the WHO European Region 23 November 2007 World AIDS Day Jeffrey V. Lazarus WHO Europe, STI/HIV/AIDS Programme
Annual number of newly reported cases – all WHO EURO countries WHO/UNAIDS estimates, end of 2007: PLHIV: 2,360,000 (1.8–3.2m) Number of casesreported to WHO, end 2006: New HIV infections: 1 012 820 New AIDS cases: 327 068 New AIDS deaths: 177 641 *Preliminary and incomplete data
Newly reported HIV cases, 19892006 HIV cases: 503 766 AIDS cases: 23 606 AIDS deaths: 10 134 HIV cases: 26 922 AIDS cases: 15 873 AIDS deaths: 7 533 HIV cases: 458 215 AIDS cases: 287 589 AIDS deaths: 159 974
Policy framework • Universal access by 2010 to HIV/AIDS prevention, treatment, care and support, 2006 • Global STI Strategy • Dublin Declaration on Partnership to fight HIV/AIDS in Europe and central Asia (2004) • Global Health Sector Strategy for HIV/AIDS, 2003 • UNAIDS/WHO “3 by 5” Initiative • UNGASS Declaration, 2001 • Millennium Development Goals, 2000 • Regional WHO resolutions
5 pillars for UA by 2010 • 1. Enabling people to know their HIV status through confidential HIV testing and counselling • 2: Maximizing the health sector's contribution to HIV prevention • 3: Accelerating the scale-up of HIV/AIDS treatment and care • 4: Strengthening and expanding health systems • 5: Investing in strategic information to guide a more effective response How WHO is working with countries to scale up HIV prevention, treatment, care and support: http://www.who.int/hiv/toronto2006/towardsuniversalaccess.pdf
HIV/AIDS Treatment and Care protocols for CIS countries • Developed and published in March 2004 • Rationale • Scale up access to treatment and care • Availability of funds (GFTAM, WB) • Similar health care systems • No guidance at country level on provision of comprehensive HIV/AIDS treatment and care • Background for developing National Protocols
Process and progress • Series of technical consultations • HIV/AIDS Clinical Staging and AIDS case definition (May 24-26, Copenhagen) • Sexual and reproductive health for PLHIV (June 1-3, Stresa, Italy) • HIV/Hepatitis co-infection (June 9-11, Lisbon) • HIV/AIDS treatment for IDUs (June 13-15, Lisbon) • Vaccination of PLHIV (June, Copenhagen)
Identified gaps • Clinical management of HIV/Hepatitis co-infection • Sexual and reproductive health for PLHIV • Vaccination of PLHIV • PMTCT for female IDUs
Identified chaptersto be improved • HIV/AIDS treatment and care for IDUs • Management of TB/HIV co-infection • HIV testing and counselling • ART for adults
The result: 13 protocolsEdited by Irina Eramova, Srdan Matic, Monique Munz • 1. Patient evaluation and antiretroviral treatment for adults and adolescents • 2. Management of opportunistic infections and general symptoms of HIV/AIDS • 3. Palliative care for people living with HIV/AIDS • 4. Management of tuberculosis and HIV coinfection • 5. HIV/AIDS treatment and care for injecting drug users • 6. Management of hepatitis C and HIV coinfection • 7. Management of hepatitis B and HIV coinfection • 8. Prevention of hepatitis A, B and C and other hepatotoxic factors in people living with HIV/AIDS • 9. Support for sexual and reproductive health in people living with HIV/AIDS • 10. Prevention of HIV transmission from HIV-infected mothers to their infants • 11. Paediatric HIV&AIDS treatment and care • 12. Immunization of people living with HIV/AIDS and people at risk of HIV infection • 13.Post-exposure prophylaxis for HIV infection