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Dr Laura Gillini WHO

Adults and children estimated to be living with HIV/AIDS as of end 2003. Total: 40 (34 46) million . Western Europe520 000 680 000. North Africa

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Dr Laura Gillini WHO

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    1. TB/HIV in EMR: State of the Art and the way forward Dr Laura Gillini WHO/EMRO

    2. Adults and children estimated to be living with HIV/AIDS as of end 2003 It is estimated tha in 2003 we have 40 million adults and children lliving with HIV/AIDS It is estimated tha in 2003 we have 40 million adults and children lliving with HIV/AIDS

    3. TB/HIV in EMR: State of the Art and the way forward 3

    4. TB/HIV in EMR: State of the Art and the way forward 4 Estimated PLWHA in EMR

    5. TB/HIV in EMR: State of the Art and the way forward 5 TB estimated cases in EMR

    6. TB/HIV in EMR: State of the Art and the way forward 6 Reported AIDS cases per 100000 people in selected MENA/East Africa countries

    7. TB/HIV in EMR: State of the Art and the way forward 7

    8. TB/HIV in EMR: State of the Art and the way forward 8 Trend of TB (Kenya and Djibouti)

    9. TB/HIV in EMR: State of the Art and the way forward 9 TB is the main killer among the HIV(+)

    10. TB/HIV in EMR: State of the Art and the way forward 10 Effect of Highly Active Antiretroviral Therapy on Incidence of Tuberculosis in South Africa

    11. TB/HIV in EMR: State of the Art and the way forward 11 WHO 3 x 5 Initiative: what is it? The goal: to advance towards universal access to ART as human right and within a comprehensive response to HIV/AIDS The target: By end 2005, provide ART to 3 M of eligible people in developing countries

    12. TB/HIV in EMR: State of the Art and the way forward 12 STAG Recommendation, Rabat 2003 Design a clear plan for TB/HIV (at minimum, HIV surveillance among TB patients), by end 2003 however, surveillance it is not enough if services and care are not available

    13. TB/HIV in EMR: State of the Art and the way forward 13 Actions taken Submitted a questionnaire to the National AIDS Programmes Managers querying on AIDS care services availability and TBHIV joint activities Response: 16/22 (72%) missing Iraq, Libya, Palestine, Saudi Arabia, Syria, Tunisia

    14. TB/HIV in EMR: State of the Art and the way forward 14 Care for PLWHA in EMR VCT: Morocco, Bahrain, Djibouti (only one center), Egypt, Oman, Iran (high risk groups), Lebanon, Jordan, Sudan, Pakistan CTX: Bahrain, Egypt, Kuwait, Qatar, Oman, Morocco, Iran, Lebanon, Jordan, Sudan (limited scale) ARV: Bahrain, Morocco, Oman, Qatar, Jordan, Lebanon, Iran (AZT/3TC/NFV), Djibouti and Sudan (only in one hospital), Pakistan (not yet, on GFATM funds), Kuwait, UAE VCT+CTX+ARV: Morocco, Oman, Bahrain, Iran, Lebanon, Jordan�

    15. TB/HIV in EMR: State of the Art and the way forward 15 HIV surveillance among TB patients No current nationwide routine system in Afghanistan, Iran, Lebanon, Kuwait, Somalia, Yemen Sentinel surveillance in Djibouti (January 2004), Egypt, Morocco, Sudan, Pakistan All TB patients routinely tested in Bahrain, Jordan, Oman, Qatar, UAE

    16. TB/HIV in EMR: State of the Art and the way forward 16 Collaboration between NAP and NTP in EMR 50% of the countries has some sort of formal body for collaboration between NAP and NTP . In Oman and Qatar both programmes have the same manager, in Bahrain and Jordan there is a focal point for TB/HIV issues within the NAP

    17. TB/HIV in EMR: State of the Art and the way forward 17 GFATM granted countries for TB and/or HIV

    18. TB/HIV in EMR: State of the Art and the way forward 18 Summary: EMR Countries profile ARV not available, No formal routine forms of collaboration between NAP/NTP: Afg, Pak, Som, Yem ARV not available but stable collaboration between NAP/NTP: Egy, Dji (ARV still limited) ARV available but No formal routine forms of collaboration between NAP/NTP: Leb, Kuw, UAE ARV available and stable collaboration between NAP and NTP Bah, Irn, Jor, Mor, Omn, Qat, Sud

    19. TB/HIV in EMR: State of the Art and the way forward 19 The way forward 1 Ensure follow-up on TB/HIV related matters in EMRO, closely being involved in the regional activities for 3X5 initiative Support establishing a good routine surveillance system for TB/HIV in all EMR countries where it is not in place yet (preferably sentinel surveillance) Support fellowships of the NTP officers to develop expertise on TB/HIV management & care

    20. TB/HIV in EMR: State of the Art and the way forward 20 The way forward 2 Develop, with the support of HQ, a routine tool for collecting information on progresses on cooperation between NAPs and NTPs Design a interventional multi-country study for integrated TB/HIV care, at least for countries with generalized HIV epidemic namely Sudan, Somalia, Djibouti but also for Iran, Pakistan, Morocco that, despite of being low prevalence countries or with epidemics concentrated in specific groups, have considerable number of PLWHA cases due to big population

    21. Thanks very much for your attention

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