1. NDPHS HIV Expert Group/Gdansk April 2009 HIV Expert Group Report for CSR Gdansk April 2009 P.Leinikki

2. NDPHS HIV Expert Group/Gdansk April 2009 HIV is still a major public health threat made worse by the emerging link with MDR TB! TB/HIV co-morbidity is rapidly increasing: (Panteleeva, 2008) Course of the epidemic different in different countries of the region: (Leinikki 2009)

3. NDPHS HIV Expert Group/Gdansk April 2009 HIV is “curable” but cure needs extremely good service that can provide uninterrupted uptake of medicine and unflawed vigilance Lifetime costs enormous; cannot be covered by private funds Number of people needing ARV steadily increasing and will reach about 30% of the number of PLWHA

4. NDPHS HIV Expert Group/Gdansk April 2009 Public health interventions have been shown to be effective: Services are provided with “low-treshold”-principle indicating that anybody is welcome to use the services free of charge and anonymously, if desired. The centre provides condoms and clean needles and syringes, and on-site HIV and HCV tests. Low-treshold service centers:

5. NDPHS HIV Expert Group/Gdansk April 2009 Confirmed Determine HIV-1/2-antibody positive samples 1999-2004

6. NDPHS HIV Expert Group/Gdansk April 2009 Discrimination is still an issue: Infected people are often from the worst-off part of the population, (gypsies, prisoners, ex-prisoners, socially marginalised addicts etc) fueling de- facto discrimination While the disease itself has lost much of its stigma,

7. NDPHS HIV Expert Group/Gdansk April 2009 Regional collaboration is needed because: The countries share IDU as a major risk factor Cross-border travelling and immigration are very common Resources are distributed unevenly Different countries have encountered different “aspects” of the epidemic and collected different information

8. NDPHS HIV Expert Group/Gdansk April 2009 The HIV EG should focus on: Reliable surveillance providing sound base for proposals for interventions Identification of best practices that are applicable within the region Providing and using properly research- based evidence

9. NDPHS HIV Expert Group/Gdansk April 2009 Current working format: NDPHS provides a unique opportunity to national experts on HIV to meet and discuss about HIV- related problems and find solutions The main outcome is a stabile network where numerous projects can been initiated and implemented The group is a proper forum for commenting and making suggestions concerning national AIDS policies and defining priorities for regional collaboration The expertice can be exploited in project planning and evaluation

10. NDPHS HIV Expert Group/Gdansk April 2009 HIV EG in the context of NDPHS: The EG can work at a regular basis in an organised way. ITA brings in important support by personal expertice, serving as a link between project implementation and the EG and communicating the outcomes to appropriate fora and with the secretariat. The main role of the secretariat should be to support the creativity of the EG:s

11. NDPHS HIV Expert Group/Gdansk April 2009 HIV EG in an alternative role The EG is given defined tasks to implement projects with short-term objectives Problems: –How to identify the right topics? –How to secure financing? –How to get committment? –How to get impact? –How to bring added value to the regional collaboration? –How to evaluate the work? By a new EG??

12. NDPHS HIV Expert Group/Gdansk April 2009 Mid-term priorities/goals Enhancing of regional collaboration Integration of social and health care for HIV-infected individuals Prevention of HIV among drug users Enhancing cross-border bilateral activities Promoting harm reduction policies among drug users Prevention of HIV/TB dual infections Prevention of HIV among MSM Prevention of MTCT Enhancing implementation of common best practices

13. NDPHS HIV Expert Group/Gdansk April 2009 Work plan, 2009: Planned outputs Policy issues: –Epidemiological update and analysis –Post-exposure prophylaxis: analysis of situation and recommendations –Current trends in MSM – related HIV in the region Meetings Projects: planning, implementation and support

14. NDPHS HIV Expert Group/Gdansk April 2009 Future When should we start dreaming about HIV-free society? (no new infections) Is it ever feasible? Should it be defined as a long term objective in selected countries??

15. NDPHS HIV Expert Group/Gdansk April 2009 8th NORDIC – BALTIC CONGRESS ON INFECTIOUS DISEASES FIRST ANNOUNCEMENT September 23–26, 2009 Saint Petersburg, Russia CONGRESS CHAIRMEN Alexei Yakovlev (Russia) Niels FrimodtMoller (Denmark) INTERNATIONAL ORGANIZING COMMITTEE Svein Gunnar Gundersen (Norway) Are Naess (Norway) Goran Friman (Sweden) Niels FrimodtMoller (Denmark) Peter Skinhoj (Denmark) Jukka Lumio (Finland) Baiba Rozentale (Latvia) Uga Dumpis (Latvia) Matti Maimets (Estonia) Kai Zilmer (Estonia) Alryda Laiskonis (Lithuania) Arvydas Ambrozaitis (Lithuania) Sergey Mukomolov (Russia) Victor Maleyev (Russia) Tatiana Smolskaya (Russia) Will this survive?