‘Gaps in the global HIV/AIDS success story Copenhagen December 2 nd 2013 Gaps in the global HIV/AIDS success story Briefing on HIV/AIDS in Europe Martin.

‘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