Amsterdam, 23 July 2018
As an organisation led by people living with HIV/AIDS across Europe and Central Asia, working together with the several affected communities in the last 25 years we have seen the epidemic unfold, we have taken part in the development and use of pioneering health technologies and advocated pro-active measures to redress policy failures. Many of us have gained back our lives. But we cannot sit back when members of our communities are left behind.
We cannot tolerate that 2 out of 3 PLHIV in Eastern Europe and Central Asia do not have access to ARV medication; the neglect and abuse of communities’ health caused by a punitive approach to substance use and sex work; the systemic stigma and discrimination based on sexual orientation, gender identity, ethnic origin or status of residence.
‘We have the evidence and the tools to implement in order to improve the health of millions of people left behind in Europe and Central Asia. We now need the political determination to build and retain resilient and people-centred health systems’ comments EATG Executive Director Koen Block. ‘We all must catch up with existing evidence and commitments so the people and services that are lagging behind can catch up with us and our real needs’.
- Catch up with the evidence and the commitment to end the AIDS epidemic by 2030
Achieving country commitments to end the AIDS epidemic by 2030 in Europe and globally will not happen without a scale up and combination of prevention, testing, treatment and linkage to care interventions. These interventions should be tailored to address the needs and realities of key affected populations and backed by supportive legal and policy frameworks.
Catch up and:
- Repeal punitive, restrictive and intrusive laws such as regulations criminalising sex workers or their clients, laws criminalising people using drugs, laws criminalising homosexuality, forcing mandatory and coercive testing, forcing registration, restricting access to health service for people without insurance or residence permit. These create barriers to access services for certain key populations because of the stigma and practical obstacles that they generate (see OptTEST, HAND, European Testing Week).
- Amend laws and regulations to allow trained lay providers to test outside of medical settings – where people are – or self-testing. Experience shows that community-based centres are highly effective, being proactive in their approach and having low barriers to accessing testing; thus they play a crucial role in reaching people unknowingly living with HIV and linking them to care, in particular among key populations. It is estimated that certain community testing centres across Europe are capable of detecting 20% of the HIV cases, yet many countries in our region still forbid testing by trained lay providers. This is particularly important for countries with expanding concentrated epidemics and significant late diagnosis. (see ESTICOM).
- Update policies and regulatory frameworks to facilitate access to the best and needed medicines and diagnostics at prices enabling programme scale up and sustainable use of finite and unevenly distributed financial resources among European countries.
- Reach out and catch up with key populations for better outcomes
Policy makers should ensure investment in and participation of key populations’ organisations in the design, implementation and evaluation of programmes so that they are effectively used. Meaningful and timely engagement of the numerous communities in the European region is the key to ending the epidemic.
Catch up and:
- Involve key affected communities to tailor communications throughout the cascade of HIV and co-infections, from prevention to treatment and care. For instance, implementation of PrEP in Europe needs various strategies so as to be relevant to different communities and countries. (see PreP in Europe).
- Ensure early community involvement to research agenda setting, as well as designing patient-reported outcomes. This is essential for the development of relevant, safe and effective prevention, treatment and diagnostics tools to address unmet medical needs and improve quality of life. (see ECAB, METRODORA).
- Reach out for partnerships across sectors, communities and countries across Europe to capitalise on innovative, promising and successful interventions: collaborate with LGTBI, drug users, sex workers, migrants, prisoners’ communities. (see EU CSF HIV/AIDS, Hepatitis & TB, European Testing Week).
- Catch up with our needs and integrate relevant medical and social services
Effective prevention and quality care requires the integration of services relevant to the needs of key populations affected by HIV and other commonly associated co-infections and comorbidities.
Catch up and:
- Adopt one-stop-shop approaches for prevention, counselling, screening, diagnosing and linking to care regarding commonly associated infections and conditions faced by key populations in Europe.
- Provide support beyond treatment and viral suppression. We still need to figure out what long-term care entails to deliver positive outcomes for people living and ageing with HIV in Europe and how to address other critical needs for people that they are already retained in the health systems. (see HIV Outcomes, Ageing with HIV).
- Recognise and integrate peer health workers as an essential part of responsive and sustainable health systems.
- Integrate prison settings in the regular health system to ensure equal standards of care (see HAND).
Catch up with the evidence and commitments
Reach out to communities in law/policy making, programmes and research that affect their lives
Integrate services to facilitate access and uptake of prevention, testing, treatment and care.
The European AIDS Treatment Group (EATG) is a European network of nationally-based volunteer activists and advocates comprising of more than 175 members from 47 countries in Europe and beyond. Since its foundation (1992), the EATG has been at the forefront of the development of the civil society response to the HIV/AIDS epidemic in Europe. It represents and defends the treatment-related and other interests of people living with HIV/AIDS as well as HIV and TB. For further information, please contact: firstname.lastname@example.org
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