Regional Knowledge Hub for the Care and Treatment of HIV/AIDS in Eurasia

Ensuring universal access to treatment and care for people living with HIV and to comprehensively address their health problems, including preventing and treating co-infections and co-morbidities are main objectives of the European Action Plan for HIV/AIDS 2012-2015.

In 2010, in response to new and important evidence on approaches to treatment and care of HIV infection, the World Health Organization issued new global recommendations on antiretroviral therapy for adults and adolescents, infants and children and HIV-infected pregnant women. While global WHO recommendations cover key global issues; regional and country adaptation is needed to reflect the regional context, infrastructure and health care system capacities. Consequently, the WHO Regional Office for Europe had initiated the revision of its 2007 clinical protocols on HIV/AIDS treatment and care.

Two clinical protocols have been revised:

• Protocol 1: Patient Evaluation and Antiretroviral Treatment for Adults and Adolescents
• Protocol 7: Management of Hepatitis B and HIV Co infection

These are now available in both English and Russian languages.

It is planned to release three more protocols in 2012: 

• Protocol 4: Management of Tuberculosis and HIV Coinfection, 
• Protocol 10: Prevention of HIV Transmission from HIV-infected Mothers to Their Infants. and 
• Protocol 11: Paediatric HIV & AIDS Treatment and Care.

The revised European protocols are the cornerstone of the strategic WHO Europe contribution to universal access to treatment and care - one of the six priority areas of the European Action Plan for HIV/AIDS 2012-2015. They should serve as a basis for adaptation of national HIV/AIDS treatment guidelines. Reflecting the diverse implementation capacity of the countries in the WHO European Region, the revised protocols contain preferable, alternative and acceptable options. This approach allows countries to choose appropriate recommendations depending on available national resources.

WHO highly appreciates participation of all partners who contributed to the development of the protocols.

AIHA/KH C&T launched a new initiative - Capacity Building of HIV Medical Specialists in Turkmenistan - in response to a request from the UNFPA and WHO offices in country.

This meeting brought together the national working group with Russian HIV/AIDS expert from the Federal AIDS Center in Moscow, who are currently assisting with the development of national HIV/AIDS clinical, diagnostic, and treatment guidelines based on WHO's revised recommendations on ART for adults and adolescents. At the same time, 24 Turkmen specialists: ID physicians, epidemiologist, TB-specialists, laboratory specialists, gynecologists and faculty from the State Medical University were trained in diagnostic, treatment and management of HIV-infection.

This 3.5-day training was conducted by AIHA/KH C&T with support from the EU-BLR WHO Country Office.

Using a multidisciplinary approach, experienced faculty from St. Petersburg and Minsk taught 31 physicians, nurses, psychologists, and social workers from Belarus advanced adult ART and management of opportunistic infections with the goal of improving provision of comprehensive care and treatment to PLHIV, as well as increasing adherence to treatment.

With financial support from USAID through the Strategic Health Partnership Initiative, AIHA conducted a ToT on new HIV and TB courses for postgraduate and undergraduate education developed with leading Russian medical universities in 2011. AIHA also conducted a session and on innovative educational methodologies for 38 heads of the infectious diseases and pulmonology departments of most medical schools of Russia and the CIS. The following three courses were presented:

• "Issues of Specialized Medical Care for Patients with HIV-infection and Sexually Transmitted Diseases," a postgraduate course developed with Moscow State University of Medicine and Dentistry and Bashkir State Medical University;
• "Issues of Specialized Medical Care for HIV/TB Co-infection," a postgraduate distance learning course developed with the St. Petersburg Medical Academy of Post Graduate Studies; and
• "TB Epidemiology and Prevention," an undergraduate course developed by the I.M. Sechenov First Moscow State Medical University.

AIHA representatives took part in the International MDG-6 Forum, participating in a number of events, debates, and discussions. AIHA presented key program results at the Strategic Health Partnership Initiative session.

At the exhibition, AIHA organized a number of activities, including the presentation of AIHA programs to the high-level US delegation that included Ambassador E. Goosby, US Global AIDS Coordinator and USAID/Russia representatives. AIHA also distributed HIV/AIDS and TB products developed by AIHA/KH C&T, along with major translated materials, CDs, and other educational tools.

In response to a request from Center PAS in Moldova, AIHA conducted a 5-day training titled "Integrated Medical HIV Case Management" for multidisciplinary teams consisting of coordinators of services who provide care and treatment to PLHIV in Moldova.

The faculty team of Russian and Ukrainian experts in HIV/AIDS and substance abuse treatment shared international best practices in the field of integrated medical HIV case management with 25 participants, who were also trained in mechanisms of coordination and integration of services and developing possible algorithms for building the system of comprehensive care and treatment to PLHIV in Moldova.

This three and a half day training took place in Minsk, Belarus, on June 7 through 10, 2011. It was conducted by AIHA and the Knowledge Hub with support from the EU-BLR WHO Country Office.

Through a multidisciplinary approach, experienced faculty from St. Petersburg, Russia, trained 21 specialists (physicians, nurses, psychologists and social workers) from Belarus advanced adult ART, management of opportunistic infections for provision of comprehensive care and treatment to PLHIV, as well as improvement of adherence to treatment.