HIV in Europe welcomes the European Parliament resolution on the EU response to HIV/AIDS in the EU and neighbouring countries and the strong commitment to HIV expressed by the European Commission

The resolution and discussion comes at a particularly crucial point in time, as it demonstrates the political will of the European Parliament and the Commission that the economic and financial crisis should not have a negative impact on essential investments in HIV/AIDS response” says Ton Coenen, co-chair of the HIV in Europe initiative, Aids Fonds & Soa AIDS Nederland.

In his speech in plenary, Commissioner Dalli reassured the audience that “fighting HIV/AIDS remains high on the Commission’s agenda” and that “the Commission will continue to play its full and active role now and in the future”. He also stressed that HIV features prominently in the Commission proposal for a new Health Programme which Parliament will be debating soon.

“The situation of economic hardship in Europe currently endangers a comprehensive European wide response at national level, and this call of the European Parliament upon all relevant actors to implement the EU communication on HIV/AIDS” stresses Nikos Dedes, HIV in Europe Steering Committee member, chair of Positive Voice, Greece. “The resolution and debate in the parliament reminds us all that Europe is not only about solidarity when it comes to finances but ultimately about the well-being of its citizens - including the health of its most vulnerable populations.” In particularly in Greece, there is indication that the back-lash in the response has already lead to a rise in HIV infections in people who inject drugs.

The EP resolution calls on the Commission and Council to

- implement the Commmunication on ‘Combating HIV/AIDS in the European Union and neighbouring countries 2009-2013’ and its accompanying Action Plan by:

- scaling up the implementation of prevention strategies which effectively target regional or local epidemiologic trends and needs, and working towards universal access to prevention, testing, counselling, treatment, care and support;

- supporting an effective response to HIV/AIDS in priority regions, such as the worst affected EU Member States, the EU's worst affected neighbouring countries and the Russian Federation and other CIS countries,

- developing means to reach and support the population groups which are most at risk and most vulnerable to HIV/AIDS across Europe;

- demonstrate political leadership in addressing the continued HIV epidemic in Europe, to develop country-specific HIV action plans and to support effective responses to HIV in neighbouring countries through policy dialogue, technical capacity-building and support for civil society engagement;

- invest needed resources to guarantee equitable access to HIV prevention, testing, treatment, care and support, to address stigma and other barriers for timely access to counselling, testing and early care; to increase investment on research to achieve an effective cure and to improve instruments and actions addressing co-infections such as tuberculosis or Hepatis B and C, among others, through improved access to screening and effective access to treatment.

- promote early diagnosis and care by the implementation of evidenced-based testing and linked treatment strategies

“We in particular welcome the strong call for an effective response to HIV/AIDS in priority regions, such as the worst affected EU Member States, the EU's worst affected neighbouring countries and the Russian Federation. HIV in Europe is keen to foster the policy dialogue with the EU neighbouring countries”, says Professor Jens Lundgren, Copenhagen HIV Programme (CHIP) and co-chair of the HIV in Europe initiative. “And we will continue to support the implementation of the EU Communication by developing further sound public health practices in the area. In particular, we intend to facilitate the development of indicator-disease based HIV testing guidelines”, he adds.

The upcoming HIV in Europe Conference during the upcoming Danish Presidency (March 19-20 2012, Copenhagen) will be co-financed by the EC, and will bring together civil society, policy makers, health professionals and European public health institutions to enhance the evidence base around topics related to optimal testing and earlier care of HIV.

The HIV in Europe Copenhagen 2012 conference aims to

-provide an overview of European initiatives and best practices on optimal testing and earlier care
-present and discuss the outcomes of the pilot projects of HIV in Europe and discuss progress in the projects initiated in 2011
-provide opportunities for multi-stakeholder dialogue to develop creative solutions to unresolved challenges in research and implementation of HIV policies and programmes to improve early diagnosis and care of HIV across Europe
-increase public awareness of the public health problems associated with late presentation for HIV care
-present data available on the cost-effectiveness of HIV testing demonstrating how scaling up HIV testing can contribute to more sustainable health systems
-sustain the political discussion of the WHO EURO testing guidelines (2010) and ECDC testing guidelines (2010) and their implementation at national level
-accompany and complement ongoing debates at EU HIV/AIDS Civil Society Forum and Think Tank level in the area.

The call for abstracts is open until 9 Dec, the call for scholarship applications until 10 Dec 2011. For more information, see www.hiveurope.eu


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Background:

European Parliament resolution of 1 December 2011 on the EU response to HIV/AIDS in the EU and neighbouring countries, mid-term review of Commission Communication

The HIV in Europe initiative:
HIV in Europe is a pan-European initiative initiated in Brussels in 2007. The initiative provides a European platform for exchange and activities to improve early diagnosis and earlier care of HIV across Europe. The initiative is directed by an independent group of experts with representation from civil society, policy-makers, health professionals and European public health institutions.
The overall objective of HIV in Europe is to ensure that people living with HIV enter care earlier in the course of their infection than is currently the case, as well as to study the change in the proportion of HIV-positive persons presenting late for care.
HIV in Europe initiative website: http://www.hiveurope.eu

Late HIV diagnosis in the EU:
Despite strong evidence that earlier treatment reduces morbidity and mortality, an estimated one-third of the people living with HIV in the EU remain undiagnosed until only late in course of their HIV infection. As they may have almost no symptoms for many years, testing is the only way o achieve early diagnosis, enabling early referral for treatment and care. People diagnosed early may also be less likely to transmit the virus to others because of both lower infectivity when treated as well as changes in sexual and drug injecting behaviour.

Late presenter consensus definition:

The consensus definition of late presentation for HIV care:
“Late presentation”: Persons presenting for care with a CD4 count below 350 cells/mL or presenting with an AIDS-defining event, regardless of the CD4 cell count.

“Presentation with advanced HIV disease”: Persons presenting for care with a CD4 count below 200 cells/mL or presenting with an AIDS-defining event, regardless of the CD4 cell count.

For further background information see:

HIV in hiding: methods and data requirements for the estimation of the number of people living with undiagnosed HIV, AIDS 2011, 25:1017–1023.

ECDC Guidance on HIV testing: increasing uptake and effectiveness in the European Union (2010)
ECDC Guidance to HIV testing in Brief (2010)

European late presenter working group: Later presentation of HIV infection: A consensus definition, HIV Medicine 2010, Published Online: 17 Jun 2010
Scaling up HIV testing and counseling in the WHO European Region as an essential component of efforts to achieve universal access to HIV prevention, treatment, care and support (WHO 2010)

Guidelines for testing HIV, viral hepatitis and other infections in injecting drug users (EMCDDA 2010)

Guidance on testing and counselling for HIV in settings attended by people who inject drugs (WHO/UNAIDS 2009)

EU Communication on combating HIV/AIDS in the EU and neighboring countries (2009-2013) on the Commission’s Health and Consumer Policy website