hiv/aids treatment and care clinical protocols for the who european region 23 november 2007 world...
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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
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
110,000
120,000
HIV AIDS AIDS Deaths
* Preliminary and incomplete data
WHO/UNAIDS estimates, end of 2007:PLHIV: 2,360,000 (1.8–3.2m)
Number of cases reported to WHO, end 2006:New HIV infections: 1 012 820 New AIDS cases: 327 068New AIDS deaths: 177 641
Newly reported HIV cases, 19892006
010,00020,00030,00040,00050,00060,00070,00080,00090,000
100,000
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
010,00020,000
30,00040,00050,00060,00070,000
80,00090,000
100,000
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
010,00020,00030,00040,00050,00060,00070,00080,00090,000
100,000
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
HIV cases: 458 215AIDS cases: 287 589AIDS deaths: 159 974
HIV cases: 503 766AIDS cases: 23 606AIDS deaths: 10 134
HIV cases: 26 922AIDS cases: 15 873AIDS deaths: 7 533
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
Advocacy and strategic informationwww.euro.who.int/aids
The goal