European Centre for Disease Prevention and Control ECDC s role in the fight against HIV/AIDS in Europe Marita van de Laar, PhD Program Coordinator HIV/AIDS, STI, hepatitis HIV in Europe, Stockholm, 2 November 2009
Strategy to fight HIV/AIDS in the EU (1) Key areas 1. Leadership and advocacy 2. Involvement of civil society 3. Surveillance 4. Prevention of new infections 5. Treatment, care and support 6. Research
Strategy to fight HIV/AIDS in the EU (2) Think tank on HIV/AIDS in Europe established in 2004 to: coordinate efforts in combating HIV/AIDS; and serve as a venue for consultation between EU Commission, Member States, candidate and EEA countries.
Second HIV/AIDS strategy and Action Plan 2010 2014 ECDC's role in in the new Action Plan Support the EU Commission in the development of the EU Action Plan. Provide data on epidemiological surveillance in the EU. Evaluate key prevention strategies. Assess HIV prevention and control programmes through country visits. Contribute to the monitoring and evaluation of the EU Action Plan.
Update 2007 HIV/AIDS situation
ECDC focus on surveillance Joint HIV/AIDS surveillance by ECDC and WHO-Europe as from 2008 a sustainable system at the European level is crucial for informing about prevention efforts and healthcare planning. Behavioural surveillance related to HIV and STI: to promote second generation surveillance in Europe; to provide a clearer understanding of the epidemic in different populations; and to enable policy makers to plan and evaluate effective prevention activities in Europe.
Newly reported HIV cases, 2007 Rate per million population HIV infections newly diagnosed, per million population, reported in 2007: all cases Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2007
Newly reported HIV cases, 1995 2007 per million population by region Countries excluded (data not reported or not available for the whole period): West: Andorra, Austria (EU), France (EU), Italy (EU), Malta (EU), Monaco, Netherlands (EU), Portugal (EU), Spain (EU); Centre: Serbia; East: Russian Federation. Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2007
Newly diagnosed cases of HIV infection, WHO European Region and EU/EFTA, 2007 Number of HIV cases Rate per million population Percentage of cases WHO European Region* EU/EFTA countries* 48 892 26 279 76.4 64.1 Age 15 29 years 33% 28% Female 33% 31% Transmission mode** Heterosexual*** 36% 29% Men who have sex with men Injecting drug users 20% 39% 32% 9% * Missing data: Italy, Austria. ** Transmission group unknown is excluded in the percentages. *** Excludes persons originating from countries with generalised epidemics. Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2007
Newly reported HIV cases by mode of transmission in EU/EFTA countries Predominant transmission mode: sex between men, followed by heterosexual contact. Data were not available for: Austria, Estonia (except for IDU), Italy, and Malta. Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2007
AIDS diagnoses in EU and Baltic States 1990 2007 Data not adjusted for reporting delays. Data not available from: Italy, Liechtenstein. Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2007
ECDC activities in the field of HIV/AIDS Key prevention strategies
ECDC focus on key prevention strategy HIV testing An estimated 30% of HIVinfected people in the EU are unaware of being infected. Knowledge on practices and barriers to HIV testing and counselling in the EU is lacking. ECDC to provide evidencebased advice for improving access, offer, uptake and effectiveness of HIV testing and counselling in the EU. HIV test Photo by U. Mixer, http://flickr.com/photos/urbanmixer/1089902000/. Permission for reproduction is granted under a Creative Commons license: http://creativecommons.org/licenses/by-nc-nd/3.0/
ECDC s focus on determinants Behavioural surveillance To harmonise indicators on behaviour related to HIV and STI and to provide methodological options Survey on eight sub-populations including the general population in Member States: July October 2008 Expert consultations in 2009 Phase II in 2010/11 Review HIV in migrants Epidemiological review Access to HIV treatment Report to Commission published in 2009
Improving EU monitoring of committments The European Commission asked ECDC to develop a monitoring framework for the Dublin Declaration. Monitoring framework developed 2008/09. Increase monitoring at the EU level: Advising-group assembled - relevant stakeholders Monitoring and Evaluation workshop; 2009 Indicators harmonised with UNGASS Survey with deadline by November 2009 Report on implementation of the Dublin Declaration April 2010.
EU-level collaboration Working with the Member States: Country visits to review HIV and STI surveillance, prevention and control. Involvement of authorities, leading agencies and civil society in HIV/STI prevention Five country visits accomplished: Estonia, Romania, Bulgaria, Poland, Portugal EU-level collaboration Commission WHO/Europe & UNAIDS Civil Society EU agencies, like EMCDDA others
Conclusions The number of persons living with HIV is increasing in the EU and in neighbouring countries. The diversity of the epidemic across the region requires a targeted approach, e.g. an adapted local response. Sustain and strengthen surveillance activities in Europe to inform prevention programmes and plan health care. HIV is a global epidemic and the EU response needs to be seen in this context.
More information in: www.ecdc.europa.eu/hiv