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‘Gaps in the global HIV/AIDS success storyCopenhagen December 2nd 2013
Gaps in the global HIV/AIDS success story Briefing on HIV/AIDS in Europe
Martin Donoghoe, Programme Manager, HIV/AIDS, STIs and viral hepatitis
• HIV epidemic steadily growing• East/West divide (new cases; AIDS and AIDS deaths)• Treatment gap in East• HIV concentrated in key populations (East and West)• Insufficient testing and counselling (East and West)• Insufficient prevention for key populations (East and
West)• Response
HIV epidemic in Europe
New HIV infections 2003-2012: Global (estimated) Western and Eastern Europe (estimated and reported)
2003 2004 2005 2006 2007 2008 2009 2010 2011 20120
20000
40000
60000
80000
100000
120000
140000
160000
0
500000
1000000
1500000
2000000
2500000
3000000
3500000Eastern Europe - estimated Eastern Europe - reported
Western Europe - estimated Global -estimated (right side scale)
AIDS related deaths 2001-2012: Global ,Western and Eastern Europe (estimated)
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000Eastern Europe Western Europe Global (right side scale)
HIV epidemic in Europe not yet under control Cumulative number of diagnosed cases (in thousands),WHO European Region, 1986–2012
0
200
400
600
800
1 000
1 200
1 400
1 600
1 800
1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010
ab
so
lute
nu
mb
ers
, th
ou
sa
nd
s
2011
1 543
People living with HIV: numbers fast growing in eastern Europe and central AsiaEstimated number of people living with HIV in Europe, 1990-2011
Source: UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2012.
Europe (total estimated)2.4 million [2.1 million – 2.7 million]
Eastern Europe and central Asia1.5 million[1.3 million – 1.8 million]
Western and central Europe860 000[780 000 – 960 000]
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 20110.0
200,000.0
400,000.0
600,000.0
800,000.0
1,000,000.0
1,200,000.0
1,400,000.0
1,600,000.0
1,800,000.0
2,000,000.0
2,200,000.0
2,400,000.0
2,600,000.0
Estimated ART coverage* in eastern Europe and central Asia among the worst globally (2012)
75%
72%
68%
61%
50%
35%
22%
0% 10% 20% 30% 40% 50% 60% 70% 80%
Latin America
Carribean
Sub-Saharan Africa
Global coverage
Asia Pacif ic
Eastern Europe and Central Asia
North Africa and the Middle East
Source: UNAIDS. Global Report 2013 * coverage based on 2010 WHO guidelines
Treatment increasing but HIV infection increasing faster
0
200
400
600
800
1 000
1 200
1 400
1 600
1 800
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
HIV
AIDS
AIDS deaths
People on ART
HIV testing and prevention services in eastern Europe and central Asia
Not accessible to key populations
Poor coverage
Poorly integrated
Percentage of people who inject drugs receiving opioid substitution therapy: eastern Europe and central Asia (2011)
Source: WHO/UNAIDS/UNICEF monitoring and reporting on the Health Sector response to HIV/AIDS
0%
2%
4%
6%
8%
10%
12%
14%
16%
% IDUs receiving OST
* 2010 data
WHO response to HIV/AIDS in Eastern Europe and Central Asia
Reducevulnerabilityand address
structuralbarriers to accessingservices
Build strongand
sustainablesystems
Leveragebroader health
outcomesthrough HIV
response
Optimize HIVprevention, diagnosis,
treatment and care outcomes
Four strategic directions of the European Action Plan for HIV/AIDS 2012–2015
Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection
Martin C. Donoghoe Programme Manager HIV/AIDS, STIs & Viral Hepatitis Division of Communicable Diseases,
Health Security & Environment WHO Regional Office for Europe
[email protected]://www.euro.who.int/aids