Welcome
Please note: This edition of the bulletin was published by MEDFASH. Click here to view the original format.
Welcome to the second issue of the MEDFASH Sexual Health & HIV Policy EUROBulletin. Since our launch issue back in July there have been some momentous policy developments at a global level and these inevitably dominate the policy round-up section below, as their impact will be felt right across Europe and beyond. The new UN Sustainable Development Goals (SDGs) set the policy framework for ensuring universal access to sexual and reproductive healthcare services and ending the AIDS epidemic by 2030; and the recent WHO guidelines on the use of antiretrovirals mark a significant step towards improving the lives of people living with HIV and reducing its transmission. Other round-up highlights from this issue include: a new HIV modelling tool from ECDC, along with a series of reports on progress in Europe’s HIV response; a new European guideline for the management of partners of persons with STIs and a series of ‘How to’ guides to support countries trying to set up dedicated sexual health clinics.
The eFeature interview this issue is with Professor Jens Lundgren, who shares his views on some of the biggest challenges and opportunities for HIV work in Europe.
eFeature
Dr Jens Lundgren, Professor of Viral Diseases at the University of Copenhagen and Chief Physician at Department of Infectious Diseases at Rigshospitalet, Copenhagen. Professor Lundgren has more than twenty years’ experience of leading major international research on infectious complications in people living with HIV and transplant recipients. In 1994 he established CHIP, the Centre for Health & Infectious Disease Research, a Global Centre of Excellence in Health, which is recognized as a World Health Organization Collaborating Centre for HIV and Viral Hepatitis. Until last year he was co-chair of the HIV in Europe initiative and is still an active member of its steering committee. In this interview, Professor Lundgren shares his views on some of the biggest current challenges for HIV work in Europe and reflects on treatment and prevention developments that are likely to have a significant impact on policy and practice across the region and beyond.
>Professor Jens Lundgren eFeature interview (PDF)
Policy development & guidance
WHO early-release guideline on HIV treatment and prevention
The World Health Organization (WHO) has recently published an early-release guideline which recommends that antiretroviral therapy (ART) should be initiated in everyone living with HIV regardless of CD4 cell count and that pre-exposure prophylaxis (PrEP) be offered to people at ‘substantial risk’ of HIV as an additional preventative option. These recommendations are based on evidence from clinical trials and observational studies released over the last two years and were developed as part of a comprehensive update of the WHO consolidated guidelines on the use of antiretroviral drugs for preventing and treating HIV infection. The guideline has been released ahead of the full publication because of the potential public health impact.
>WHO - news release - 30 Sept 2015
>Statements by partner agencies in support of guideline
United Nations (UN) new sustainable development agenda and goals
A new set of global goals was ratified by UN member states at the General Assembly on 25 September 2015. The Sustainable Development Goals (SDGs) will set the framework for global development policy over the next 15 years, including in the areas of HIV/AIDS and sexual and reproductive health. There are 17 SDGs and 169 targets including ending the AIDS epidemic by 2030 (target 3.3), ensuring universal access to sexual and reproductive healthcare services by 2030 (target 3.7), eliminating all forms of violence against women and girls (target 5.2), eliminating harmful practices such as child, early and forced marriages and female genital mutilation (target 5.3) and ensuring universal access to sexual and reproductive health and reproductive rights (target 5.6). Click on the links below to access the new sustainable development agenda and the accompanying set of SDGs and targets.
>Transforming our world: the 2030 sustainable agenda for 2030 - Sept 2015
>Sustainable Development Goals (SDGs)
How AIDS changed everything : MDG 6 - 15 years, 15 lessons of hope from the AIDS response
This report from UNAIDS celebrates the achievements of the last 15 years, including meeting the AIDS targets of Millennium Development Goal (MDG) 6 of halting and reversing the spread of HIV. With over 15 million people now on antiretroviral treatment, it looks at the significant impact the AIDS response has had on people’s lives and livelihoods, on families, communities and economies. It also includes specific lessons to take forward into the new SDGs to pave the way for ending the AIDS epidemic by 2030.
>UNAIDS - MDG 6 - press release - July 2015
Global Strategy for Women’s, Children’s and Adolescents’ Health
The Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030 was also launched at this year’s UN General Assembly. The strategy was developed through an extensive consultation process involving governments, civil society, the private sector, UN agencies and other constituencies. A BMJ Special Supplement has also been produced to look at how the strategy can be translated into transformative actions.
WHO/UNAIDS Global Standards for quality healthcare services for adolescents
The aim of the new Global Standards for quality healthcare services for adolescents recently launched by WHO and UNAIDS is to improve the quality of healthcare services so that adolescents find it easier to obtain the health services that they need to promote, protect and improve their sexual health and well-being. AIDS is the second primary cause of death among adolescents globally and the Standards call for an inclusive package of information, counselling, diagnostic, treatment and care services that go beyond the traditional focus on sexual and reproductive health.
>WHO - press release - 6 Oct 2015
>Standards, implementation and other downloads
Ending violence and discrimination against lesbian, gay, bisexual, transgender and intersex people
Twelve UN agencies have called for an end to violence and discrimination against lesbian, gay, bisexual, transgender and intersex (LGBTI) adults, adolescents and children. In a recently released joint statement the agencies set out specific steps to protect these individuals from violence, discrimination and discriminatory laws.
>UN - news - 29 September 2015
WHO policy brief: Transgender people and HIV
This technical brief summarises essential information and existing WHO recommendations for HIV prevention, diagnosis, treatment and care among transgender populations.
>WHO - publication - July 2015
Parliament & other European institutions
Joint commitment from European Commission and WHO Europe
The European Commission and WHO’s Regional Office for Europe have reviewed their joint commitment to work together towards their shared objective of better health in Europe. Key areas outlined for scaled-up cooperation include: health security, public health information systems and health inequalities.
>European Commission - news - Sept 2015
>EC/WHO Europe cooperation document
Call for comprehensive EU-Eastern partnership policy framework on HIV, tuberculosis and viral hepatitis
AIDS Action Europe and other European civil society organisations have recently written to Jean-Claude Junker, President of the European Union (EU), calling for political leadership and support for a comprehensive EU-Eastern Partnership policy framework to pave the way for HIV, tuberculosis and viral hepatitis elimination in both the EU and Eastern neighbourhood.
European parliament adopts report calling for comprehensive sex and relationships education (SRE) in school
Last month MEPs voted to adopt the Rodrigues report on Empowering girls through education in the EU. The report recognises that sensitive, age-appropriate, and scientifically accurate SRE is an essential tool in the empowerment of girls and boys, helping them to make well-informed choices and contributing to wider public health priorities such as reducing unplanned pregnancies, reducing maternal and infant mortality, prevention and earlier treatment of sexually transmitted infections and reducing gaps in health inequality. It encourages Member States to consider making SRE compulsory in their school curricula for all primary and secondary school children.
>European parliament - 9 Sept 2015
European parliament report on the situation of fundamental rights in the EU
The European parliament voted in support of a report on the situation of fundamental rights in the EU (2013/2014). The resolution text covered a wide range of relevant issues including violence against women (text ref 58), sexual and reproductive health and rights (text ref 69-71) and the rights of LGBTI people (text ref 85).
Expert Opinion on the public health needs of irregular migrants, refugees or asylum seekers across the EU's southern and south-eastern borders
This Expert Opinion report from ECDC was produced at the request of the European Commission (Directorate-General for Health and Food Safety). The report focuses on the urgent health needs of certain migrant populations in the EU and the options for addressing these, in relation to the prevention and control of communicable diseases. >ECDC - publication - October 2015
Evidence & research
ECDC: Europe’s response to HIV
This set of monitoring reports from the European Centre for Disease Prevention and Control (ECDC) gives an overview of how countries have been responding to the HIV epidemic since the 2004 Dublin Declaration commitments. A summary of the findings is available, which combined with a series of thematic reports and evidence briefs gives a comprehensive picture of what has been achieved, where there has been less progress and priorities for future action.
>ECDC - news release - 8 Sept 2015
>ECDC Summary Report: From Dublin to Rome: ten years of responding to HIV in Europe and Central Asia
>Thematic report: Men who have sex with men
>Thematic report: People who inject drugs
>Thematic report: Continuum of Care
>Evidence brief: HIV testing in Europe
>Evidence brief: HIV and treatment
>Evidence brief: HIV and leadership
>Evidence brief: HIV prevention in Europe
>Evidence brief: HIV and men who have sex with men
ECDC: Sexually Transmitted Infections in Europe 2013 report
The new ECDC report on sexually transmitted infections in Europe covers data and trends on the five sexually transmitted infections (STI) under surveillance in the countries of the European Union and European Economic Area (EU/EEA): chlamydia, gonorrhoea, syphilis, congenital syphilis and lymphogranuloma venereum (LGV). While trends in the number of chlamydia infections appear to have stabilised in recent years, gonorrhoea rates have gone up by 79% since 2008, particularly among men.
>ECDC - surveillance report - 17 Sept 2015
Understanding the impact of smartphone applications on STI/HIV prevention among MSM in the EU/EAA
This new ECDC report, produced in collaboration with the Terrence Higgins Trust (a UK NGO), looks into the role of smartphone applications directed at men who have sex with men (MSM) and how this affects the HIV epidemic across the EU/EEA. This refers to apps both as a tool for MSM to find partners and also as a possible platform for outreach work in the field of HIV prevention and sexual health. >ECDC - technical report - 30 Sept 2015
ECDC: New HIV modelling tool
The new HIV Modelling Tool from ECDC was developed in collaboration with a team of international experts and is now available for download as a desktop application. With this new tool, epidemiologists, HIV programme managers, public health professionals as well as researchers will be able to calculate the estimated HIV incidence in a given population which is different from the number of newly reported cases collected in the surveillance systems.
>ECDC - new HIV modelling tool - 15 Sept 2015
Treatment & service guidelines
WHO guidelines on HIV testing services
The Consolidated guidelines on HIV testing services bring together existing guidance relevant to the provision of HIV testing services (HTS) and addresses issues and elements for effective delivery of HTS that are common in a variety of settings, contexts and diverse populations. The document also provides a new recommendation to support HTS by trained lay providers, considers the potential of HIV self-testing to increase access to and coverage of HIV testing, and outlines approaches to HTS that are needed to support the new UN global HIV targets.
>WHO - publication - July 2015
2015 European guideline for the management of partners of persons with STIs
This guideline has been produced by the European branch of the International Union against Sexually Transmitted Infections (IUSTI- Europe). It provides recommendations concerning the infections that require partner management, the lookback periods and the main steps to follow for partner management (offering support to patients, notifying partners, identification of contacts). It is available on the IUSTI website and has also been published in the Journal of the European Academy of Dermatology and Venereology.
>IUSTI guidelines - partner management - 2015
Emergency Contraception (EC) guidelines in Europe
A number of European countries - including Germany, Italy, Portugal, Romania and Spain - have updated guidelines on emergency contraception during 2015. In addition, Croatia issued national guidelines for oral EC in September this year. For more information on EC guideline development in Europe go to the European Consortium for Emergency Contraception (ECEC) website.
>European Consortium for Emergency Contraception
Reports & resources
JUSTRI – new ‘How to’ guides to setting up dedicated clinics
JUSTRI, a UK-based, international not-for-profit organisation which provides resources and education for those working with HIV, viral hepatitis and TB, has recently published three new guides on how to establish a dedicated HIV sexual health clinic, a clinic for women with HIV and a viral hepatitis clinic. The guides are free to download and have templates that can be used to help when setting up any of these services.
>JUSTRI - How To guides - Oct 2015
>How to establish an HIV sexual health clinic
>How To establish an HIV women's clinic
>How To establish a viral hepatitis clinic
ChlamydiA Testing Training in Europe (CATTE)
CATTE is a European project set up to develop training for general practice staff delivering chlamydia screening and other sexual health services to young adults. The project is led by Public Health England’s Primary Care Unit in conjunction with partners from Estonia, France and Sweden. The project has devised training packages from an education-based intervention, evaluated in a randomised control trial in England, which significantly improved chlamydia testing rates in general practice. The CATTE intervention has been developed further to ensure it fits the context of countries it is being delivered in. Click the link below for more information about the intervention in each of the participating countries.
TRP: New training module on emergency contraceptive pills
A new training module on emergency contraceptive pills (ECP) is now available for clinical healthcare providers and pharmacists. These modules are part of the Training Resources Package for Family Planning (TRP) led by USAID, WHO and UNFPA in partnership with several other organisations.
>ECP for clinical healthcare providers
>ECPS training for pharmacists
Sexual and reproductive health and rights, and HIV: 101 workshop guide
The International HIV/AIDS Alliance has published a facilitator’s guide on how to plan, deliver and evaluate a workshop for key young populations on linking up HIV and sexual and reproductive health and rights.
>IAA - publication - August 2015
UNAIDS Terminology Guidelines – 2015
UNAIDS has published updated guidelines on ‘preferred’ terminology in relation to HIV and AIDS. The guidelines are reviewed on a regular basis.
>UNAIDS - 2015 terminology guidelines
WHO: World report on ageing and health
This recently released WHO report highlights that comprehensive public health action on population ageing is urgently needed. With advances in medicine helping more people to live longer lives, including those with HIV, the number of people over the age of 60 is expected to double by 2050 and will require radical societal change. The executive summary is available in a number of languages including Spanish, French, Portuguese and Russian.
>WHO - publication launch - 30 Sept 2015
New psychoactive substances in Europe: Innovative legal responses
This short report from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) provides an overview of how European countries are developing innovative legal responses to the challenges presented to public health and drug policy by the rapidly evolving market for new psychoactive substances.
Rights & advocacy
OHCHR information series on sexual and reproductive health and rights
The UN Office of the High Commissioner for Human Rights (OHCHR) has developed an information series which consolidates the relevant human rights standards on key aspects of sexual and reproductive health and rights. The purpose of the information series is to provide detailed guidance for lawmakers, policymakers, judiciaries, health service providers, civil society and other stakeholders, to support the adoption and effective implementation of laws, policies and programmes to respect, protect and fulfil women’s sexual and reproductive health and rights. The series is currently available in English and Spanish.
>OHCHR - sexual and reproductive health rights - July 2015
>Contraception and family planning
>Lesbian, gay, bisexual and transgender and intersex people
Amnesty International to adopt policy to protect human rights of sex workers
The International Council of Amnesty International has agreed to develop and adopt a policy that supports the full decriminalisation of all aspects of consensual sex work. The policy will also call on states to ensure that sex workers enjoy full and equal legal protection from exploitation, trafficking and violence.
>Amnesty International - news - August 2015
Country-specific news
Pharmacy HIV testing programmes in Spain
A study looking at in-pharmacy HIV testing programmes in three Spanish regions has shown them to be a valuable addition to other testing programmes. During the study period over 200 new infections were diagnosed, amounting to 10.6% of all HIV diagnoses over the three regions. Click below to access the full article.
>PLoS ONE 10(8): e0134631. doi: 10.1371/journal.pone.0134631. 2015
Polish anti-abortion bill rejected
Last month the Polish parliament rejected a draft bill attempting to ban access to legal abortion in all cases. The bill aimed to amend the Act on Family Planning, Protection of the Human Foetus and Conditions of Pregnancy Termination and related Acts and was submitted by the committee Stop Abortion. Prior to the parliamentary debate the Federation for Women and Family Planning (FWFP) and a host of other NGOs and organisations from the international community urged the Polish government to consider the impact of this proposed bill. FWFP also led a protest against the bill in front of the Polish parliam
Campaigns
2015 European HIV-Hepatitis Testing Week
European HIV-Hepatitis Testing Week will take place this year between 20-27 November. Testing week 2015 offers partners across Europe the opportunity to unite for one week to increase awareness regarding the benefits of HIV and hepatitis testing, so that more people become knowledgeable about their risks, understand that there is effective treatment available and are aware of their HIV and / or hepatitis status. Last year over 700 organisations took part. Click the links below for more information, to sign up and to access the campaign materials.