Question

Aims and Objectives of tuberculosis

Answer 1

Tuberculosis (TB) is now the most common presenting illness among people living with HIV who are receiving antiretroviral therapy (ART).

Although sub-Saharan Africa carries the brunt of the global TB/HIV burden, there is evidence that in the European Region HIV-related TB rates are still rising and TB in people with HIV may be higher in the European Region than in sub-Saharan Africa. HIV infection in the European Region is mainly concentrated in marginalized groups, such as drug users and sex workers, who generally have more difficulty in accessing HIV and TB services. In Europe the uptake of ART services is generally low and lower in drug users. According to the recent Universal Access Report, European coverage of ART for those in need was 23% in 2008 for low- and middle-income countries and for drug users up to 10%.

The Global TB report suggests that only 27% of the estimated number of HIV-related TB patients are detected and that only 16% of these were receiving ART in 2008 (provisional figures). Despite this there is steady progress in implementing collaborative TB/HIV activities in Europe. There are best practices and experiences in implementing collaborative TB/HIV activities in the region that need to be nurtured and shared. For example, integration of TB/HIV services with harm reduction services has been piloted and scaled up in the Ukraine, Portugal and Moldova. Also successful experiences from other regions need to be adapted taking into consideration regional and country-specific situations. The engagement of key national stakeholders, including national TB and HIV control programmes and other partners is essential to ensure the exchange of these experiences and best practices and the inclusion of TB/HIV into national TB and HIV strategic and other operational plans, and accelerate their implementation.

To this effect, a two-day experience sharing and planning meeting for European countries will be conducted. The meeting will be held two days ahead of and in conjunction with the International AIDS Society Conference in Vienna, Austria, from 18 to 23 July 2010.

General objective

To create an opportunity for the sharing of experiences and best practices for greater political advocacy, resource mobilization and accelerated implementation of collaborative TB/HIV activities within the context of the European Region. The meeting will help countries to ensure the coherent inclusion of key activities including relevant policy and programme changes into national strategic and operational plans.

Specific objectives

Review both successful collaborative TB/HIV activities and challenges in the region and elsewhere and harvest the critical lessons learnt within the European context.

 Discuss the implications of key global and regional policies and plans on prevention, diagnosis and treatment of TB in people living with HIV in Europe.

 Share best practices for expanding the package of interventions for TB/HIV in the context of the European Region and identify critical steps and action points for national operational plans on TB/HIV.

 Discuss measures to enhance dialogue and collaboration between TB, HIV harm reduction programmes and the criminal justice system, with emphasis on the implementation of activities at district and other levels.

 Develop key actions to strengthen one monitoring and evaluation system for collaborative TB/HIV activities, and implementation of revised recording and reporting formats.

Develop a framework for country-specific target setting and critical operational research priorities to accelerate the implementation of collaborative TB/HIV activities and identify gaps and opportunities.

Expected outcomes

The current status of HIV/TB collaborative activities in the countries reviewed, challenges facing programmes identified and best practices shared.

Country-specific priority actions including urgent policy changes and national TB/HIV targets identified for inclusion into national strategic and operational plans.

Next steps in the follow-up of the implementation of country-specific priority actions and the country operational plans, including coordination among the different stakeholders identified and agreed.

Participants

The participants of the meeting will be heads of communicable diseases department within ministries of health, heads of national AIDS commissions and national TB and AIDS programme managers of countries of the WHO European Region. Other participants will include national harm reduction programme managers, criminal justice health system officials, regional and national key AIDS and TB stakeholders active in the European Region and members of the TB/HIV Working Group. Additionally provincial and regional HIV and TB stakeholders will be invited from HIV-prevalent provinces and states of selected countries. The total participants list is expected to be 150-200.