The WHO Regional Office for Europe has launched an action plan to contain the spread of drug- resistant TB in the region by the end of 2015. This action plan was prepared in consultation with representatives of the 53 countries of the WHO European Region, experts, patients and communities affected by the disease. The plan takes into account new diagnostic techniques, patient-centered models of care and services tailored to special populations. It includes six strategic directions, such as collaboration on more effective drugs, vaccines and testing, and seven areas of intervention, such as improving access to testing and treatment. If fully implemented, the plan is expected, by 2015, to diagnose 225,000 MDR-TB patients within three days of presenting to a healthcare service with TB symptoms, to successfully treat 127,000 MDR-TB patients, and to prevent the emergence of 250,000 new MDR-TB and 13,000 new XDR-TB cases.
World Health Organization (WHO)
As in the previous years, surveillance of tuberculosis (TB) reveals a mixed epidemiological picture among the Member States of the WHO European Region. Member States in the east have much higher notification rates than the west. Although the Region comprises only 4.7% of the world’s newly detected and relapsed TB cases, it reported 309 648 new episodes of TB (34.0 per 100 000 population) out of 418 000 (range 355 000–496 000) estimated cases (47 cases per 100 000 population (range 40–55), and maintained a high case detection rate of 74% (range 63–87%). This demonstrates that the countries in the WHO European Region are leading the way in their management of a highly sensitive routine surveillance system. More than 60 000 (40 000–90 000) deaths in the Region were estimated as being due to TB, representing 6.7 cases per 100 000 population.
Global progress in both preventing and treating HIV emphasizes the benefits of sustaining investment in HIV/AIDS over the longer term. The latest report by the World Health Organization (WHO), UNICEF and UNAIDS "Report on the Global HIV/AIDS Response" indicates that increased access to HIV services resulted in a 15% reduction of new infections over the past decade and a 22% decline in AIDS-related deaths in the last five years. "It has taken the world ten years to achieve this level of momentum," says Gottfried Hirnschall, Director of WHO's HIV Department. "There is now a very real possibility of getting ahead of the epidemic. But this can only be achieved by both sustaining and accelerating this momentum over the next decade and beyond."
The WHO global health sector strategy on HIV/AIDS, 2011-2015 guides the health sector’s response to HIV. Its goals, consistent with UNAIDS strategy for the same period, “Getting to Zero” and international commitments, are: to achieve universal access to HIV prevention, diagnosis, treatment and care interventions for all in need to contribute to achieving health-related Millennium Development Goals and their associated targets by 2015.
Adopted in 2008, The Tallinn Charter: Health Systems for Health and Wealth seeks to commit Member States of the World Health Organization in the European region to improving people’s health by strengthening health systems, while acknowledging social, cultural, and economic diversity across the region. The Charter commits the Member States to: promote shared values of solidarity, equity and participation; invest in health systems; promote transparency and accountability; make health systems more responsive; engage stakeholders; foster cross-country learning and cooperation; and ensure that health systems are prepared and able to respond to crises..
The revised edition of theWHO UNODC UNAIDS Technical Guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users(Guide) is now available and has a number of OST quality indicators increased up to 26. Among others, such important quality indicators as involvement of people who use drugs (“The programme has actively involved PWID in the planning of OST services”) and established referral systems (“Formalized referral pathways between the OST programme and other relevant service providers have been established, and OST clients are referred to these services as appropriate”) are included.
The low and middle-income countries in the WHO European Region often face the double challenge of strengthening health systems while also bearing the heaviest burden of many communicable and non communicable diseases.Vulnerable populations, including migrants and people who inject drugs, within countries throughout the Region are similarly burdened by limited access to quality health services in combination with greater vulnerability to ill health. The consequences are evident in the geographic and, in many cases, societal distribution of various communicable diseases, including HIV/AIDS, tuberculosis (TB), malaria, viral hepatitis and sexually transmitted infections.
In response to the alarming problem of multidrug- and extensively drug-resistant tuberculosis (M/XDR-TB) in the WHO European Region, and in order to scale up a comprehensive response and to prevent and control M/XDR-TB, a consolidated action plan has been developed for 2011–2015 for all 53 Member States of the WHO European Region and partners. The Plan was endorsed by the sixty-first session of the WHO Regional Committee in Baku on 15 September 2011. It has six strategic directions and seven areas of intervention. The strategic directions are cross-cutting and highlight the corporate priori- ties of the Region.
The Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence review the use of medicines such as methadone, buprenorphine, naltrexone and clonidine in combination with psychosocial support in the treatment of people dependent on heroin or other opioids. Based on systematic reviews of the literature and using the GRADE approach to determining evidence quality, the guidelines contain specific recommendations on the range of issues faced in organizing treatment systems, managing treatment programmes and in treating people dependent on opioids.