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Halting the HIV Epidemic in Eastern Europe and Central Asia: Challenges and Solutions

This session will explore the reasons behind the rapidly growing HIV epidemic in Eastern Europe and Central Asia, and discuss the necessary steps to halt its spread. It will address issues such as low access to HIV testing and counseling, poor ART coverage, and the need for better integration of services. Join us to learn how we can reduce vulnerability and improve health outcomes in this region.

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Halting the HIV Epidemic in Eastern Europe and Central Asia: Challenges and Solutions

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  1. Why is the HIV epidemic in Eastern Europe and Central Asia the fastest growing in the world and what do we need to do to halt it? XIX International AIDS Conference Regional Session on Eastern Europe and Central Asia Martin C. Donoghoe on behalf of the XIX International AIDS Conference Regional Working Group for Eastern Europe and Central Asia

  2. HIV epidemic in Europe still not under control Cumulative number of diagnosed cases (in thousands),WHO European Region, 1986–2010 Sources: ECDC/WHO. HIV/AIDS surveillance in Europe 2010. Stockholm: ECDC; 2011. 2010 UNGASS country progress reports for the Russian Federation and Ukraine.

  3. Low access to HIV testing and counselling among populations most at risk in eastern Europe and central Asia - respondents who reported receiving an HIV test and learning the results in the preceding 12 months, selected countries 2005, 2007 and 2009 Source: UNAIDS/WHO. HIV/AIDS in Europe and central Asia. Progress Report 2011

  4. People living with HIV: fast growing numbers in eastern Europe and central Asia Estimatednumber of people living with HIV in Europe, 1990-2011 Europe (total estimated) 2.4 million [2.1 million – 2.7 million] Eastern Europe and central Asia 1.5 million [1.3 million – 1.8 million] Western and central Europe 860 000 [780 000 – 960 000] Source: UNAIDS. Together we will end AIDS. 2012

  5. Estimated ART coverage in eastern Europe and central Asia among the worst globally (2011) ART also reduces risk of HIV transmission – Donnell D et al. Lancet, 2010, 375(9731):2092–2098 Source: UNAIDS. Together we will end AIDS. 2012

  6. Proportion of people who inject drugs receiving ART in low- and middle-income countries in the WHO European Region * Preliminary ART data and 2010 HIV surveillance (case reporting) data

  7. Infection increasing faster than treatment Cumulative number of reported cases and deaths (in thousands),WHO European Region, 1986–2010 Sources: ECDC/WHO. HIV/AIDS surveillance in Europe 2010. 2010 UNGASS country progress reports for the Russian Federation and Ukraine. WHO/UNAIDS/UNICEF monitoring and reporting on the Health Sector response to HIV/AIDS.

  8. HIV infection 1984–2010: WHO European Region Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010 8

  9. WHO European Region: geographical areas East West Centre Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010 9

  10. HIV infections diagnosed 2010 in WHO European Region: geographic area *No data from the following countries: Austria, Liechtenstein, Monaco. ** Countries with no data on age or transmission mode excluded. *** Excludes individuals originating from countries with generalised epidemics. Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010 10

  11. HIV infections diagnosed 2010: WHO European Regioncases per 100 000 pop Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010 11

  12. HIV infection 2004–10:WHO European Region three geographical areas Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010 Data not consistently reported or not available from: Austria, Monaco, Russian Federation. 12

  13. HIV infections diagnosed 2010 WHO European Region: transmission mode and geographical area Sources: ECDC/WHO. HIV/AIDS surveillance in Europe 2010. Russian Federation Ministry of Health and Social Development

  14. HIV infections 2004–10: transmission groups in WHO European Region - East Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010 Data not consistently reported or not available from: Estonia, Russian Federation. 14

  15. AIDS diagnoses 2004–10: WHO European Region three geographic areas and EU/EEA Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2010 Data not consistently reported or not available from: West: Andorra, Denmark, Monaco, Sweden; Centre: Turkey; East: Russian Federation, Ukraine. 15

  16. Vulnerability and marginalisation Key laws supporting or blocking universal access in countries in the east of the region, July 2010 Source: UNAIDS/WHO. HIV/AIDS in Europe and central Asia. Progress Report 2011

  17. Poor scale up of services

  18. Reported HIV infections acquired through injecting drug use: eastern Europe and central Asia (2010) Data sources: ECDC/WHO. HIV/AIDS surveillance in Europe 2010. UNGASS country progress report of the Russian Federation 2010

  19. Number of syringes distributed per IDU per year by needle and syringe programmes: eastern Europe and central Asia (2011) Data source: WHO/UNAIDS/UNICEF monitoring and reporting on the Health Sector response to HIV/AIDS

  20. Poor integration of services Reduce vulnerability and address structural barriers to accessing services Leverage broader health outcomes through HIV response Build strong and sustainable systems Optimize HIV prevention, diagnosis, treatment and care outcomes Data source: WHO Regional Office for Europe. European Action Plan for HIV/AIDS 2012-2015

  21. Percentage of people who inject drugs receiving opioid substitution therapy: eastern Europe and central Asia (2011) * 2010 data Data source: WHO/UNAIDS/UNICEF monitoring and reporting on the Health Sector response to HIV/AIDS

  22. TB and hepatitis co infection

  23. HIV infection among all TB cases tested for HIV in the WHO European Region (2006-2010) Source: ECDC/WHO. Tuberculosis surveillance and monitoring in Europe, 2012

  24. TB/HIV co-infection WHO European Region (2010) Timely detection and appropriate treatment is a challenge. Almost 16 000 (80%) TB/HIV cases out of an estimated 20 000 (range 16 000 – 25 000) were detected in 2010 and only 70% were offered antiretroviral treatment. Source: ECDC/WHO. Tuberculosis surveillance and monitoring in Europe, 2012

  25. HIV programme source of funding in Europe and central Asia, 2008 or 2009 Source: UNAIDS/WHO. HIV/AIDS in Europe and central Asia. Progress Report 2011

  26. Percentage of HIV programme spending on key populations originating from international funding sources, most recent year West and centre: Belgium, Bulgaria, Croatia, Czech Republic, Hungary, Montenegro, Poland, Romania, Switzerland, United Kingdom. East: Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, Ukraine, Uzbekistan. Source: UNAIDS/WHO. HIV/AIDS in Europe and central Asia. Progress Report 2011

  27. Summary: HIV transmission in Eastern Europe and Central Asia Grows at alarming rate Poor access to treatment Vulnerability and marginalisation Poor (integration of and scaling up) services TB (and hepatitis) co infection Funding 27

  28. Acknowledgements Andrew Ball Senior Strategy and Operations Adviser, HIV/AIDS Dept WHO, AIDS 2012 Conference Coordinating Committee Fabiano Bertini AIDS 2012 International Conference Secretariat, International AIDS Society Sergii Dvoriak Director of the Ukrainian Institute on Public Health Policy Bernard Kadasia AIDS 2012 International Conference Secretariat, International AIDS Society Anna Koshikova Head of the Analytical Team, All-Ukrainian Network of PLWH Jean-Elie Malkin Senior Adviser to Executive Director/Acting Director of the Regional Support Team for Europe and Central Asia UNAIDS Mara Nakagawa-Harwood AIDS 2012 International Conference Secretariat, International AIDS Society Serge Votyagov Executive Director of the Eurasian Harm Reduction Network (EHRN)

  29. Question 1 to the panellists How can we scale up access to ART and increase early HIV diagnosis and treatment?

  30. Question 2 to the panellists How can we leverage broader health outcomes through the HIV response and build stronger and more sustainable health systems?

  31. Question 3 to the panellists How can we respond to reduce vulnerability and marginalisation?

  32. Question 4 to the panellists • How can we respond to the funding crisis?

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