New WHO recommendations to prevent tuberculosis

New World Health Organization (WHO) guidance will help countries accelerate efforts to stop people with tuberculosis (TB) infection becoming sick with TB by giving them preventive treatment.

The new consolidated guidelines recommend a range of innovative approaches to scale up access to TB preventive treatment:

  • WHO recommends a scale-up of TB preventive treatment among populations at highest risk including household contacts of TB patients, people living with HIV and other people at risk with lowered” immunity or living in crowded settings.
  • WHO recommends an integration of TB preventive treatment services into ongoing case finding efforts for active TB. All household contacts of TB patients and people living with HIV are recommended to be screened for active TB. If active TB is ruled out, they should be initiated on TB preventive treatment.
  • WHO recommends that either a tuberculin skin test  or interferon-gamma release assay (IGRA) be used to test for TB infection. Both tests are helpful to find people more likely to benefit from TB preventive treatment but should not become a barrier to scale-up access. Testing for TB infection is not required before starting TB preventive treatment in people living with HIV, and children under 5 years who are contacts of people with active TB.
  • WHO recommends new shorter options for preventive treatment in addition to the widely used 6 months of daily isoniazid. The shorter options that are now recommended range from a 1 month daily regimen of rifapentine plus isoniazid to 3 months weekly rifapentine plus isoniazid, 3 months daily rifampicin plus isoniazid, or 4 months of daily rifampicin alone.

TB preventive treatment is an affordable intervention that can prevent families from sliding into poverty and preserve the health and economy of whole communities. WHO anticipates that as new and safer drugs come onto the markets, and as prices fall, it will become a highly-cost effective way to save millions of lives.

 

Science for action on HIV, TB, and viral hepatitis in EECA

On November 18-19, with the support of the Ministry of Health of the Republic of Kazakhstan, the first scientific workshop EECA INTERACT 2019 on HIV, tuberculosis, and hepatitis in Eastern Europe and Central Asia (EECA) was held in Almaty.

The international event was organized by the Amsterdam Institute for Global Health and Development (AIGHD), the Kazakh Scientific Center for Dermatology and Infectious Diseases of the Ministry of Health of the Republic of Kazakhstan, non-profit organizations AFEW Kazakhstan and AFEW International.

For two days, more than 100 researchers, representatives of communities and clinicians from Kazakhstan, Russia, Ukraine, Belarus, Uzbekistan, Kyrgyzstan, Tajikistan, Georgia and other countries shared their experiences, the latest scientific developments in the field of treatment of HIV, tuberculosis (TB), hepatitis in order to strengthen the scientific base and improve the situation in the region.

“AFEW has been working in the Eastern Europe and Central Asia region for about 20 years and constantly experiences a lack of data on the HIV, TB and viral hepatitis epidemics in the region, – says Anke van Dam, member of the international organizing committee of EECA INTERACT 2019; executive director of AFEW International. These data are needed to develop evidence-based policies and interventions. Through EECA INTERACT, AFEW strives to stimulate and facilitate research in the region. Also our goal is to foster new research interactions among leading investigators and those who represent the potential future scientific leadership for health care and research in the region and to build research and clinical capacity across EECA”.

EECA is the only region in the world where the HIV epidemic is still growing rapidly. UNAIDS estimates that as of 2018, about 1.7 million people in the Eastern Europe and Central Asia region are living with HIV. About 38,000 people died from AIDS in 2018.

Significant barriers to prevention and treatment services remain for people living with and affected by HIV, TB, and hepatitis across the region. For example, although the HIV epidemic in EECA is concentrated predominantly among key populations, particularly among people who inject drugs, coverage of harm-reduction and other prevention programs is insufficient to reduce new infections. The region urgently needs more effective strategies of prevention, treatment, and care and support that are tailored to the particular circumstances of individual countries.

“I hope EECA INTERACT will become an effective forum for discussion, the issues raised at scientific discussions, the exchange of experience, will allow us to put the necessary emphasis on the near and long-term prospects, and familiarize a wide circle of participants with new methods, developments and approaches on these issues. The abstracts will be appreciated, feedback will be established, the scientific community and the geography of further cooperation and investment will expand. This activity is necessary to achieve UNAIDS goals 90-90-90”, says Bauyrzhan Bayserkin, head of the local committee of the EECA INTERACT 2019 workshop; Doctor of Medical Sciences; Director of the Kazakh Scientific Center of Dermatology and Infectious Diseases of the Ministry of Health of the Republic of Kazakhstan.

EECA INTERACT 2019 took an innovative approach by bringing together experts in HIV, TB, and hepatitis to participate in the International Conference Committee developing the scientific program.

It included experts in the field of HIV, TB and hepatitis from around the world, including Michel Kazatchkine, UNAIDS Special Advisor on HIV, TB and Hepatitis in the EECA region; Catherine Hankins, professor, Deputy Director, Science at AIGHD, co-chair of the annual INTEREST conference; Alexey Alexandrov, head physician of the Minsk Regional Clinical Center “Psychiatry-Narcology”; Sergey Dvoryak, founder and senior scientist, UIPHP, professor at the department of social work, and many others.

EECA INTERACT will be an annual event and will be held in different countries of the EECA region to enable scientists from all countries to demonstrate their discoveries.

See more pictures here.

 

 

 

Good practices of intersectoral collaboration for HIV, tuberculosis and viral hepatitis

The WHO Regional Office for Europe is collecting examples of good practices of intersectoral collaboration for HIV, tuberculosis and viral hepatitis for publication in a dedicated compendium.

This compendium will include examples of actions undertaken by sectors outside the health sector, possibly (but not necessarily) in collaboration with the health sector. The practices should be aimed at improving the outcomes or the determinants of the HIV, tuberculosis and viral hepatitis epidemics, as encouraged by the UN Common Position on ending HIV, TB and viral hepatitis through intersectoral collaboration. They should also be accompanied by impact evaluations and credible monitoring mechanisms or research.

The above-mentioned UN Common Position was developed with an inclusive and consultative process to identify shared principles and key actionable areas within and beyond the health sector to address HIV, tuberculosis and viral hepatitis in Europe and central Asia. It was successfully launched at a side event to the UNGA in New York in November 2018 and subsequently distributed within UN system to all UN Resident Coordinators of the region.

The good practices must be submitted in either English or Russian using the form provided below. All submissions will be reviewed by the WHO Regional Office for Europe against the following criteria: relevance, sustainability, efficiency and ethical appropriateness. The authorship of each good practice will be highlighted in the compendium, which is expected to be published in 2020.

The deadline for submission is 18 November 2019. If you have any questions, please do not hesitate to contact daram@who.int. 

Why do researchers need to participate in the EECA INTERACT 2019 workshop?

Bauyrzhan Satzhanovich Bayserkin, head of the local committee of EECA INTERACT 2019 workshop; Doctor of Medical Sciences, Director of the Kazakh Scientific Center of Dermatology and Infectious Diseases (Kazakhstan) talks why researchers should participate in the EECA INTERACT 2019 workshop.

What do EECA researchers need today? First of all, it is the intensification of scientific discussions, improving the quality and effectiveness of research results, the exchange of experience, also with practitioners, as well as the timely tracking of new methods, developments in medicine and related disciplines.

It is assumed that the participant’s research work will be tested at the seminar; scientists, colleagues, and practitioners will discuss it and give their feedback, the network of the participant will expand. Researchers can get a job in the future, they can count on mutual assistance in research activities, communication with more experienced conference participants from other countries.

Also, within the framework of the seminar, specialists participating in the conference will ask colleagues some questions about the abstracts that need to be discussed. Such work will indicate inaccurate formulations or incorrect accents, demonstrate “white spots” in activities, and establish a discussion. Discussions and questions will indicate the relevance of the topic. All these things together will contribute to the personal and professional growth of the participants. Also, participants will have the opportunity to expand the geography of their publications, citation index, etc.

In addition, representatives of third-party organizations that will attend the workshop may be interested in further cooperation, investment, etc.

All this will contribute to the improvement and strengthening of the healthcare system and civil society.

More about the workshop read here

#EECAINTRACT

 

 

 

 

Monitoring of HIV-related stigma and discrimination

The ways in which HIV-related stigma and discrimination are manifested and experienced are complex and varied. Many different measures from different perspectives are currently used to monitor HIV-related stigma and discrimination.

To better understand the status of HIV-related stigma and discrimination and progress towards their elimination, support advocacy for addressing HIV-related stigma and discrimination and highlight data gaps, UNAIDS is coordinating the development of summary measures of HIV-related stigma and discrimination. Please see the concept note for more background information.
Starting on 19 August 2019 for a period of three weeks, various elements of the draft measures will be discussed. A few key questions will guide the moderated discussion each week. Inputs and recommendations from each week will be shared at the start of the following week and used to inform the next element of the measures to be discussed.
To participate in the consultation please read more information here.

Through the 2016 Political Declaration on HIV and AIDS, the global community committed to eliminating HIV-related stigma and discrimination by 2020 “for the equal enjoyment of all human rights and equal participation in civil, political, social, economic and cultural life, without prejudice, stigma or discrimination of any kind” of people living with, at risk of and affected by HIV.
The proposal is to develop one summary measure of HIV-related stigma and discrimination and four accompanying summary measures of stigma and discrimination experienced by sex workers, gay men and other men who have sex with men, people who inject drugs and transgender people related to factors other than HIV. This will make it possible to capture the diverse forms of stigma and discrimination that may be experienced by key populations most affected by HIV that may not be directly due to HIV but that have important impact on the HIV response.

This virtual consultation aims to encourage broad participation, particularly of people living with and affected by HIV, gay men and other men who have sex with men, transgender people, young people, sex workers, people who use drugs and women, from all regions. Contributions through this consultation will be used to inform the development of the measure(s) and ensure they are people-centered, reflecting the lived experiences and realities of people, and meaningful to inform programmatic action.
A summary of inputs and recommendations from the consultation will be shared in September 2019. 

On the Edge

Text: Marina Maximova 

A photo exhibition “On the Edge” was opened on the 9th of August in Almaty, Kazakhstan.
 
The heroes of the photographs are former prisoners who have been on the edge, experienced stigma and discrimination, found the strength to break out of the vicious circle and became happy and helpful members of society. Thanks to different organizations which work in the prevention and treatment of HIV infection, tuberculosis, hepatitis. With their help these people participated in social support programs, self-help groups, they made their best to reduce self-stigma.
 
Each photo here has its own story. However, these stories are very similar.
“I did well at school. I wanted to continue my study at the university, but my parents made me to get married. I gave birth to my son and I was engaged in housework. My husband lost his job and began to rebuke me that I was staying at home. We didn’t have money. Due to constant scandals, we got divorced. I wanted to come back to my parents’ house, but they did not accept me. Because of constant stress, I began to drink alcohol, made new friends. Then I committed a crime and went to jail. There I was diagnosed with #HIV infection”. This is a story of Bihalichi.
 
“I was born and raised in an ordinary family. I graduated from 10 classes of high school, went to university as a mechanical engineer. I got new friends and after the third year, I left the institute. There were a lot of quarrels in our family. I started to use drugs and drink alcohol. I could not find a normal job, and I really needed money. I committed a crime and went to jail. After being released, I couldn’t find a job anymore and continued to use drugs. After – prison again and HIV”. This is a story of Sergey.
 
“The photos are designed to show the importance of people’s open-minded attitude towards each other and the positive results of such an attitude – when prisoners, DUIS employees, doctors, NGOs help each other to improve the world around them,” says Roman Dudnik , director of the AFEW Kazakhstan public foundation.
 
A lot of former prisoners dream to break with crimes and to start a new life. But they do not receive any support, people don’t believe in them. Companies don’t hire them and don’t help. As a result, these people return to their usual environment.
 
This photo exhibition is part of a regional photo project. Nowadays similar events are held in Bishkek and Dushanbe. This event is a part of the HIV Project, implemented by the #AFEW #Kazakhstan Public Foundation, with financial support from the United States Agency for International Development (USAID).
The photo exhibition “On the Edge” is open until the 19th of Augustat SmArt.Point (Bayzakova St., 280).