WHO strategy on HIV/AIDS 2011-2015 “Getting to Zero” Presenter : Armin Hirbod-Mobarakeh Armin Hirbod-Mobarakeh

Introduction to HIV/AIDS Causative agent : Human Immunodeficiency Virus (HIV), an RNA virus from the retrovirus family Pathogenesis: main target is the immune system and consequently impairs the surveillance and defense systems against infections and some types of cancer Armin Hirbod-Mobarakeh

Armin Hirbod-Mobarakeh

Presentation 1. The early, acute phase Initial response of an immunocompetent adult to HIV infection High level of virus production and viraemia Clinically, this stage is characterized by infectious mononucleosis-like features of sore throat, myalgias, fever, weight loss, and fatigue all of which are self-limiting 2. The middle, chronic phase Relative containment of the virus and clinical latency Virus replication continues for several years, predominantly in the lymphoid tissues Clinically, patients are either asymptomatic or develop persistent generalized lymphadenopathy 3. The final, crisis phase breakdown of host defense CD4 count usually < 200 cells/mm3 Clinically, the patient presents with marked weight loss, chronic diarrhea, and fever lasting more than 1 month and Opportunistic infections occur Armin Hirbod-Mobarakeh

Diagnosis: blood tests detecting presence or absence of antibodies and antigens; “window period" of 3 to 12 weeks Treatment: no cure; combination antiretroviral therapy (ART) to control the virus Armin Hirbod-Mobarakeh

“Know your epidemic, know your response” One of the world's leading infectious killers more than 25 million deaths over the past three decades 34 million people living with HIV in 2010. less than 40% of people living with HIV know their HIV status 2.6 million new infections in 2009 In 2010, around 6.6 million people living with HIV were receiving antiretroviral therapy in low- and middle-income countries, but over 7 million others are waiting for access to treatment. Armin Hirbod-Mobarakeh

Armin Hirbod-Mobarakeh

Global vision, goals, targets and strategic directions Zero new HIV infections, zero AIDS-related deaths and zero discrimination in a world where people living with HIV are able to live long, healthy lives. Global goals and targets reduce new infections: reduce by 50% the percentage of young people aged 15–24 years who are infected (compared with a 2009 baseline) eliminate new HIV infections in children: reduce new HIV infections in children by 90% (compared with a 2009 baseline) reduce HIV-related mortality: reduce HIV-related deaths by 25% (compared with a 2009 baseline) reduce tuberculosis-related mortality: reduce tuberculosis deaths by 50% (compared with a 2004 baseline). Armin Hirbod-Mobarakeh

Strategic directions Strategic direction 1: Optimize HIV prevention, diagnosis, treatment and care outcomes. Integrate and improve the quality, effectiveness and coverage of HIV-specific interventions and approaches, and identify new HIV interventions as evidence emerges. Strategic direction 2: Leverage broader health outcomes through HIV responses. Strengthen linkages and synergies between HIV and other related health programs, notably for sexual and reproductive health, maternal, newborn and child health, tuberculosis, drug dependence and harm reduction, emergency and surgical care and nutrition. Strategic direction 3: Build strong and sustainable systems. Build effective, efficient and comprehensive health systems in which HIV and other essential services are available, accessible, affordable and sustainable. Strategic direction 4: remove structural barriers to access services. The health sector must remove structural barriers to achieve equitable access to HIV services and protecting and promoting the human rights of key populations Armin Hirbod-Mobarakeh

Armin Hirbod-Mobarakeh

Strategic direction 1: Optimize HIV prevention, diagnosis, treatment and care outcomes Revolutionize HIV prevention Prevent sexual transmission of HIV: behavior change counseling, male and female condom programming, early initiation of antiretroviral therapy, safe male circumcision (in high HIV-prevalence settings), post-exposure prophylaxis, and quality-assured HIV testing Eliminate HIV transmission in health-care settings: standard precautions, injection and surgical safety, blood safety, safe waste disposal and post-exposure prophylaxis for occupational exposure to HIV Eliminate new HIV infections in children: preventing HIV infection in women of child-bearing age, preventing unintended pregnancies among women living with HIV, reducing HIV transmission from women living with HIV to their infants, and providing appropriate early treatment and care for women living with HIV, their children and families. Catalyze the next phase of treatment, care and support Expand and optimize HIV treatment and care for children, adolescents and adults Reduce co-infections and co-morbidities among people living with HIV. Decrease the burden of tuberculosis for people living with HIV Provide comprehensive and integrated services for key populations Implement a comprehensive package of interventions to meet the needs of vulnerable populations Ensure access to comprehensive services for sex workers, men who have sex with men and transgender people Provide harm-reduction services for people who use drugs Armin Hirbod-Mobarakeh

Strategic direction 2: Leverage broader health outcomes through HIV responses. Strengthen links between HIV programs and other health programs Strengthen HIV/tuberculosis collaborative activities Strengthen linkages between HIV and maternal, newborn and child health services Address sexual and reproductive health and rights Link HIV and blood and injection safety programs Armin Hirbod-Mobarakeh

Strategic direction 3: Build strong and sustainable systems. Strengthen the six building blocks of health systems Armin Hirbod-Mobarakeh

Strategic direction 4: Reduce vulnerability and remove structural barriers to access services Promote gender equality and remove harmful gender norms Collect gender-based health information Include gender issues in the design, delivery and monitoring of health services. Advance human rights and promote health equity Ensure health in all policies, laws and regulations: Health-related aspects of HIV should be considered in the development and review of policies, laws and regulations in other sectors Armin Hirbod-Mobarakeh

Armin Hirbod-Mobarakeh

Armin Hirbod-Mobarakeh

Armin Hirbod-Mobarakeh

Thank you for your attention Armin Hirbod-Mobarakeh