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Geneva, Switzerland, WHO, 2014 Jul.  p.In this new consolidated guidelines document on HIV prevention, diagnosis, treatment and care for key populations, the World Health Organization brings together all existing guidance relevant to five key populations -- men who have sex with men, people who inject drugs, people in prisons and other closed settings, sex workers and transgender people --and updates selected guidance and recommendations. These guidelines aim to: provide a comprehensive package of evidence-based HIV-related recommendations for all key populations; increase awareness of the needs of and issues important to key populations; improve access, coverage and uptake of effective and acceptable services; and catalyze greater national and global commitment to adequate funding and services.
Towards universal access by 2010. How WHO is working with countries to scale-up HIV prevention, treatment, care and support.
Geneva, Switzerland, WHO, Department of HIV / AIDS, 2006. 32 p.In 2005, leaders of the G8 countries agreed to «work with WHO, UNAIDS and other international bodies to develop and implement a package for HIV prevention, treatment and care, with the aim of as close as possible to universal access to treatment for all those who need it by 2010». This goal was endorsed by United Nations Member States at the High-Level Plenary Meeting of the 60th Session of the United Nations General Assembly in September 2005. At the June 2006 General Assembly High Level Meeting on AIDS, United Nations Member States agreed to work towards the broad goal of "universal access to comprehensive prevention programmes, treatment, care and support" by 2010. Working towards universal access is a very ambitious challenge for the international community, and will require the commitment and involvement of all stakeholders, including governments, donors, international agencies, researchers and affected communities. Among the most important priorities is the strengthening of health services so that they are able to provide a comprehensive range of HIV/AIDS services to all those who need them. This document describes the contribution that the World Health Organization (WHO) will make, as the United Nations agency responsible for health, in working towards universal access to HIV prevention, treatment, care and support in the period 2006-2010. It proposes an evidence-based Model Essential Package of integrated health sector interventions for HIV/AIDS that WHO recommends be scaled up in countries, using a public health approach, and provides an overview of the strategic directions and priority intervention areas that will guide WHO's technical work and support to its Member States as they work towards universal access over the next four years. (excerpt)
Towards universal access: scaling up priority HIV / AIDS interventions in the health sector. Progress report, April 2007.
Geneva, Switzerland, WHO, 2007 Apr. 88 p.Drawing on lessons from the scale-up of HIV interventions over the last few years, WHO, as the UNAIDS cosponsor responsible for the health sector response to HIV/AIDS, has established priorities for its technical work and support to countries on the basis of the following five Strategic Directions, each of which represents a critical area where the health sector must invest if significant progress is to be made towards achieving universal access. Enabling people to know their HIV status; Maximizing the health sector's contribution to HIV prevention; Accelerating the scale-up of HIV/AIDS treatment and care; Strengthening and expanding health systems; Investing in strategic information to guide a more effective response. In this context, WHO undertook at the World Health Assembly in May 2006 to monitor and evaluate the global health sector response in scaling up towards universal access and to produce annual reports. This first report addresses progress in scaling up the following health sector interventions. Antiretroviral therapy; Prevention of mother-to-child transmission of HIV (PMTCT); HIV testing and counseling; Interventions for injecting drug users (IDUs); Control of sexually transmitted infections (STIs) to prevent HIV transmission; Surveillance of the HIV/AIDS epidemic. (excerpt)
Antiretroviral treatment for injecting drug users in developing and transitional countries 1 year before the end of the "Treating 3 million by 2005. Making it happen. The WHO strategy" (‘3 by 5').
Addiction. 2006 Sep; 101(9):1246-1253.The objective was to describe and estimate the availability of antiretroviral treatment (ART) to injecting drug users (IDUs) in developing and transitional countries. Literature review of grey and published literature and key informants' communications on the estimated number of current/former injecting drug users (IDUs) receiving ART and the proportion of human immunodeficiency virus (HIV) attributed to injecting drug use (IDU), the number of people in ART and in need of ART, the number of people living with HIV/acquired immunodeficiency syndrome (AIDS) (PLWHA) and the main source of ART. Data on former/current IDUs on ART were available from 50 countries (in 19 countries: nil IDUs in treatment) suggesting that ~34 000 IDUs were receiving ART by the end of 2004, of whom 30 000 were in Brazil. In these 50 countries IDUs represent ~15% of the people in ART. In Eastern European and Central Asia IDU are associated with > 80% of HIV cases but only ~2000 (14%) of the people in ART. In South and South-East Asia there were ~1700 former/current IDUs receiving ART (~1.8% of the people in ART), whereas the proportion of HIV cases associated to IDU is > 20% in five countries (and regionally ranges from 4% to 75%). There is evidence that the coverage of ART among current/former IDUs is proportionally substantially less than other exposure categories. Ongoing monitoring of ART by exposure and population subgroups is critical to ensuring that scale-up is equitable, and that the distribution of ART is, at the very least, transparent. (author's)
Lancet. 2004 Dec 4; 364:2007-2008.Mikhail Rukavishnikov sits in his modern apartment in central Moscow sipping tea. To the casual visitor he has all the trappings of Russia’s emerging middle class who have overcome the chaos of the 1990s and made a comfortable life. He has an office job with a big Russian firm, a decent apartment, a big TV, and money to travel abroad on holiday. But Rukavishnikov and his girlfriend are among the million Russians living with HIV. “I toyed with drugs when I was younger and got infected. We had no idea then of the dangers. We had never heard about HIV/AIDS and Russian awareness is still catching up with the rest of the world”, says Rukavishnikov. Drug abuse in Russia is rampant and is still the main route of HIV transmission, but the spread of the disease has reached a critical point: public-health officials warn that the virus has begun to move from the high-risk groups such as drug users, sex workers, and prisoners, to a bridge population. A recent report by UNAIDS says the Russian epidemic is growing out of control, as infection spreads faster than in any European country. (excerpt)
Strategies for involvement of civil society in HIV testing within context of “3 by 5”: Focus on marginalized communities. Issue paper: 3rd Meeting, UNAIDS Global Reference Group on HIV / AIDS and Human Rights, 28-30 January 2004.
Geneva, Switzerland, Joint United Nations Programme on HIV / AIDS [UNAIDS], 2004. 3 p.For “3 by 5” to be successful in meeting its objectives, barriers that limit marginalised groups from accessing HIV testing must be addressed so that these communities can gain the benefits of scale up efforts. There is no simple rule which can be applied to marginalised groups to “demarginalise” them. Sex workers and intravenous drug users (both of whom may be engaged in acts outside the law in selling sex and buying/selling/using drugs) are marginalised in ways which go beyond simple application of the law. They face stigma and discrimination but then working with them and supporting them may fall outside the work of most civil society organizations. Strategies for delivering support, information and services – if not done on a self-help basis – will most likely involve delivery by small support groups rather than mainstream organizations. Yet it is precisely wide engagement with civil society organizations which may offer necessary protection and support to these marginalised groups. Organizations of drug users, sex workers and other marginalised groups can articulate their concerns and speak for themselves but there is little doubt that working collaboratively with other civil society players, including mainstream human rights organizations, can amplify their effectiveness and, at times, offer them protection. (excerpt)
Geneva, Switzerland, WHO, 2003.  p. (WHO/HIV/2003.16)Scaling up access to antiretroviral treatment (ART) must build on existing clinical or public health services and extend their coverage. It also means making the most of synergies between prevention and care, recognizing that people are more likely to follow prevention advice when they receive comprehensive services. To accomplish this, it will be necessary to exploit opportunities—or entry points—for identifying people who could benefit from treatment. Entry points must provide, or facilitate the link to, HIV testing and counselling, the gateway to treatment services. (excerpt)