The path that ends AIDS

From the UNAIDS press release

A new report released today by UNAIDS shows that there is a clear path that ends AIDS. This path will also help prepare for and tackle future pandemics and advance progress towards achieving the Sustainable Development Goals. The report, ‘The Path that Ends AIDS’, contains data and case studies which highlight that ending AIDS is a political and financial choice, and that the countries and leaders who are already following the path are achieving extraordinary results.

The report highlights that HIV responses succeed when they are anchored in strong political leadership. This means following the data, science, and evidence; tackling the inequalities holding back progress; enabling communities and civil society organizations in their vital role in the response; and ensuring sufficient and sustainable funding.

Progress has been strongest in the countries and regions that have the most financial investments, such as in eastern and southern Africa where new HIV infections have been reduced by 57% since 2010.

Thanks to support for and investment in ending AIDS among children, 82% of pregnant and breastfeeding women living with HIV globally were accessing antiretroviral treatment in 2022, up from 46% in 2010. This has led to a 58% reduction in new HIV infections among children from 2010 to 2022, the lowest number since the 1980’s.

Progress in the HIV response has been strengthened by ensuring that legal and policy frameworks do not undermine human rights, but enable and protect them. Several countries removed harmful laws in 2022 and 2023, including five (Antigua and Barbuda, the Cook Islands, Barbados, Saint Kitts and Nevis, and Singapore) that have decriminalized same-sex sexual relations.

The number of people on antiretroviral treatment worldwide rose almost fourfold, from 7.7 million in 2010 to 29.8 million in 2022.

However, the report also sets out that ending AIDS will not come automatically. AIDS claimed a life every minute in 2022. Around 9.2 million people still miss out on treatment, including 660 000 children living with HIV.

Women and girls are still disproportionately affected, particularly in sub-Saharan Africa. Globally, 4,000 young women and girls became infected with HIV every week in 2022. Only 42% of districts with HIV incidence over 0.3% in sub-Saharan Africa are currently covered with dedicated HIV prevention programmes for adolescent girls and young women.

Almost one quarter (23%) of new HIV infections were in Asia and the Pacific where new infections are rising alarmingly in some countries. Steep increases in new infections are continuing in eastern Europe and central Asia (a rise of 49% since 2010) and in the Middle East and North Africa (a rise of 61% since 2010). These trends are due primarily to a lack of HIV prevention services for marginalized and key populations and the barriers posed by punitive laws and social discrimination.

Funding for HIV also declined in 2022 from both international and domestic sources, falling back to the same level as in 2013. Funding amounted to US$ 20.8 billion in 2022, far short of the US$ 29.3 billion needed by 2025.

There is an opportunity now to end AIDS by increasing political will by investing in a sustainable response to HIV through financing what matters most: evidence-based HIV prevention and treatment, health systems integration, non- discriminatory laws, gender equality, and empowered community networks.

In 2022, an estimated:

  • 39,0 million people globally were living with HIV
  • 29,8 million people were accessing antiretroviral therapy
  • 1,3 million people became newly infected with HIV
  • 630.000 people died from AIDS-related illnesses

To access the report, follow this link>>>.

 

Online dialogue meetings

The Drug Policy Network South East Europe (DPNSEE) organised two regional online dialogues as part of the BOOST project. The aim was to assess the needs and challenges for the implementation of community-based good practices in the field of HIV/HCV/HBV prevention, treatment, and care for people who use drugs (PWUD). The two online dialogue meetings held in South East Europe gathered 30+ participants from 17 organisations in 9 countries

As the situation in the region is far from good, most of the dialogue was on the problems that people from key affected populations, their community organisations, service-providing organisations, and institutions face. In the context of our region’s challenging situation, discussions primarily revolved around the issues confronting key affected populations and organisations providing support to communities facing elevated risks.

Problems are common across the region. These include the pervasive stigma and discrimination directed at nearly all at-risk communities, particularly within institutional sectors where understanding should be most prominent. The public discourse surrounding these communities often employs disrespectful and discriminatory language, despite the efforts of NGOs to promote appropriate terminology.

Financing and sustainability of support services pose significant challenges, and the civil sector’s operational space is limited, reflecting a lack of motivation among institutions and decision-makers to enhance the quality of life for these communities. Existing laws related to these communities are problematic, as is the complex and exclusionary nature of accessing healthcare services and treatment programs. Official registers or record-keeping mechanisms are often lacking, and strategies are frequently rewritten without effective implementation.

The recommendations and conclusions from our open dialogue emphasise the need to focus on these issues. Through lobbying, public awareness campaigns, collaboration agreements, participation in working groups, and partnerships, we aim to improve the current situation. Our goal is to raise public awareness about these critical issues faced by at-risk communities and advocate for improvements in services, policies, and laws. Ultimately, we strive to ensure that members of these communities, who are at an elevated risk of social exclusion, can fully integrate into our society.

The report from the dialogues is available following this link>>>.

 

Positive Voice naimed “European Citizen of the Year”

The European Parliament declared the Greek Association of people living with HIV/AIDS Positive Voice 2023 “European Citizen of the Year” for the Ref Checkpoint initiative, by decision of the Chancellery of the European Citizen Award.

The European Citizen’s Prize was established by the European Parliament in 2008 and is a reward for outstanding achievements, activities or actions of citizens and organizations that promote European values: human dignity, freedom, democracy, equality, the rule of law and human rights rights.

Ref Checkpoint is a prevention and sexual health center for refugees, asylum seekers and immigrants in Athens and provides free information, counseling on sexual health issues in the native language of the beneficiaries (English, French, Spanish, Portuguese, Russian, Arabic, Urdu or Farsi), anonymous testing for HIV and viral hepatitis, and linking the beneficiaries with the National Health System or with other agencies and services.

The idea of ​​this initiative, which began in 2022 with the support and assistance of the AIDS Healthcare Foundation Europe and the Municipality of Athens, arose from the identification of the significant obstacles faced by mobile populations in their access to health services and the lack of modern, inclusive sexual health information materials.

Ref Checkpoint, adapted to the needs of this community and implemented by the people of the target community themselves, was and is intended to provide access to targeted, inclusive sexual health services without stigma and discrimination.

We congratulate our colleagues from Positive Voice for this great achievemtn and recognition of their work.

President of Montenegro supported LGBTI community

Jakov Milatović, newly elected President of Montenegro, met on 28 June 2023 with representatives of the LGBTI community and organisations that support them on the occasion of International Day and Pride Month. That was an opportunity to gain insight into the challenges these communities face.

Mr. Milatović clearly stated that Montenegro is a country of equal rights for every citizen and that there shouldn’t be any kind of discrimination. To achieve that, institutional and legal support have to be ensured for every person.

Our colleagues from Juventas, Queer Montenegro, and Stana were among those who met with the President and presented their work.

Global day FOR action

Statement from our Board member Marios Atzemis

This text is not an “anniversary” piece, nor is it a kind of report. Anniversary approaches do not suit us, nor does the cynicism that accompanies them in some cases, and an account would be too long for this occasion.

Every such day, officially called “against drugs” but those of us who are active in peer-led harm reduction call it “Global Day for Action” and for us it is a daily routine, we are given the opportunity to talk about what is of concern to us and to acknowledge the positive developments and future challenges in the field – not as self-appointed saviors, but as people who have experienced our country’s drug policies and therapeutic (or in some cases anti-therapeutic) approaches under our own skin. We also now have the appropriate peer led education, field experience and an ongoing communication, collaboration and osmosis with major civil society organizations abroad on HIV, harm reduction and drug policies.

Yet, in many cases, we are considered the most unqualified to express an opinion on the thorny field of “addictions”, and there are many times when we are tried to be displaced by people without clinical experience and lived experience or any kind of theoretical background, who think they can speak and decide for us without us. All of the above are manifestations of the multiple and multidimensional stigma that we harbour, and which at the first opportunity are indirectly emphasized by the ‘professional saviours’ to remind us that they know better than we do, and that the field of advocacy and politics is not our domain.

As far as the situation in Greece is concerned, significant breakthroughs have been made in recent years with the development of a multitude of services that have solved problems that we used to face, such as housing and having a safe place to use. We have also reached a high level of cooperation with the people who staff these serorganisation sanisations, which is to the benefit of the affected community.

However, we must point out that when we talk about the field, we are talking about something that is constantly changing, as the disparate communities of people who make up the field are always one or more steps ahead of policies and agencies. Thus, we recognize as phenomena that we are called upon to address: The proliferation of shisha (crystal methamphetamine of poor quality) and the consequent changes it has brought about in the psyche of its problematic users; synthetic opioids (which are being decimating in North America); the chemsex phenomenon; the complete absence of LGBTQ+ inclusion in services aimed at users; and the gap between medicalised harm reduction and that on a peer basis. It also shows in some cases how strong the legacy of punitive degrading ‘tough love’ practices is in some cases, and the lack of up-to-date and evidence-based practices that are not based on outdated and ineffective approaches. We should also note the presence of so many private self-proclaimed rehabilitation centres of dubious efficacy and scientific training that are not audited and that trade on the human suffering and desperation of users and their closest support context.

In conclusion, we recognize the need for our country’s alignment with the European Drug Strategy and the corresponding Action Plan, which propose the active and meaningful participation of civil society and the affected community in the design and implementation of services and policies that directly affect their lives. We will continue our work, as it were, meeting people where they are but without leaving them there…

Marios Atzemis, Harm Reduction Officer of Positive Voice – Greek Association of PLHIV

 

Quality Assurance for Drug Use Disorder Treatment Systems

The Prevention, Treatment and Rehabilitation Section (PRTS) of the United Nations Office on Drugs and Crime (UNODC), with the support fom the Ministry of Health of Serbia, organised a three-day Training on Quality Assurance for Drug Use Disorder Treatment Systems. The aim of this training was to help stakeholders to review national drug use disorder treatment systems, identify gaps and develop plans that will enable the improvement and further development of the national treatment system.

25 participants came from specialised hospitals for treating addictions of pcychiatric hospitals from around the country, institute for public health, institute for mental health, centres for social work and ministry of health. DPNSEE Executive Director Milutin Milošević and representative from Izlazak represented the civil society organisations.

The program of the training was developed following the International standards for the treatment of drug use disorders, prepared by UNODC and the World Health Organisation. A translated version of the Standards was presented and shared during the training.

Trainers Victor Anthony Capoccia (USA) and Thomas Clausen (Norway) were supported by UNODC staff Christina Gamboa-Riano and Žana Glavendekić, Project Officer, UNODC South-Eastern Europe.

Support to unaccompanied and separated refugee children

Montenegro is sharing the same challenges as the rest of Western Balkan countries. Between January and December 2022, Montenegro registered 8,298 arrivals, including 463 children (285 boys, 178 girls) mainly from Afghanistan, Iran, and Bangladesh. This presented an increase of 161 % compared to arrivals in 2021. In addition, in 2022, after the outbreak of war in Ukraine, around 95 000 Ukrainian citizens entered Montenegro (8047 applied for temporary protection).

Our member organisation Juventas published the “Guide on referral system/social services delivery for UASC in Montenegro”. This practical tool is of use for those who work with unaccompanied or separated child, citizen of a third country, or a stateless person under the age of 18, who entered Montenegro unaccompanied by an adult who takes care of him or remained unaccompanied after entering Montenegro, until placed under guardianship in accordance with the regulations of Montenegro.

The Guide will be a multipliable model for the efficient provision of social services to the UASC to support the establishment of a protection-sensitive migration management system in the target countries. It will serve to assist the UASC who approached our services and ensure that the assistance in service provision is provided in a timely and professional manner.

This document is prepared within the project “Security for Human Beings and Borders – Combating Smuggling of Migrants in the Western Balkans”, financed by the Group 484 through the EU project and implemented by the Nisma për Ndryshim Shoqëror – ARSIS (Albania) and NGO Juventas (Montenegro).

The Guide is available following this link>>>.

 

Duga raises awareness about importance of testing and early discovery of HIV infection

Community-based and community-led testing services are crucial in the HIV/AIDS, viral hepatitis, and sexually transmitted infections response, particularly in reaching populations where diagnosis and linkage to care are lower than the national average. However, providing these services can be challenging, especially in environments that may be hostile towards community-based and -led service delivery, and where policy and legal barriers exist.

In 2022-2023, the COBATEST Network supported six member organizations in countries where the environment is particularly challenging for community-based and community-led service delivery. In the interview with Asocijacija DUGA, one of the 6 organisation supported, they asked the organisation to tell about their work, the challenges they face, and how they are working to improve community-based testing services for HIV/AIDS, viral hepatitis, and sexually transmitted infections in their communities.

Replying to the question about the role that CBVCT plays in reaching this community in Serbia, they said:

Community-based and community-led testing (CBVCT) centers have a crucial role in reaching of GBTMSM population in Serbia. This is mainly due to the fact that the population is still significantly stigmatized and discriminated. This is also noticeable within the system of public health institutions. The most of the VCCT centers exist only in bigger cities, and even not all of them have sufficiently sensitized staff in order to properly approach and address the needs of the community. Therefore, majority of the target population rather chooses CBVCT as a place they would like to get the information, counseling and testing services.

 Nowadays, as we are faced with the greater influx of the clients coming from the migrant population, CBVCT approach becomes even more important. No matter if they come from migrant, refugee or asylum seeker community, and belong to the GBTMSM population (which make significant share), they usually find information through the community based organizations and their social networks, as they are more accessible, so we are usually the first they approach to ask for services. Many of migrants belong to the population of PLHIV, and we were able to ensure they get linkage to care as well as to regulate their health insurance status, in order to continue using therapy in Serbia, which would be very difficult to achieve without support of CBVCT organizations.

You can read this interesting interview following this link>>>.

 

Regulating cannabis in EU: current policies and laws

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published document Cannabis laws in Europe: questions and answers for policymaking which provides an overview of current policies and laws at the EU level and in individual Member States. The speed and scale of cannabis policy change and the potential impact of these policies on public health and safety, has prompted the EMCDDA to publish this report

This publication answers some of the more frequently asked questions raised in discussions about cannabis legislation. While the primary focus is on the use of cannabis for recreational purposes, relevant legislation for other uses, including medical and commercial cannabis-derived products such as cosmetics, wellness products and foods, is included in order to provide the necessary context for various policy initiatives.

While the primary focus of this report is on the use of cannabis for recreational purposes, relevant legislation for other uses is included in order to provide the necessary context for various policy initiatives. Written for a broad audience, the report aims to give brief answers to some of the more frequently asked questions raised in discussions about cannabis legislation. These have been grouped into five parts:

  • Why is defining cannabis important?
  • What are countries’ international obligations to control cannabis?
  • How do EU countries respond to illegal use and supply of cannabis?
  • Is there a trend towards cannabis regulation — and if so why?
  • What laws cover medical and commercial cannabis-derived products?

This document is available at our Resource Centre following this link>>>, or at the EMCDDA website>>>.

 

HIV epidemic among injecting drug users in Greece

After the early HIV epidemics during the 1980s through the 1990s in Western Europe and North America, combined prevention and care interventions – such as needle and syringe (NSP) and opioid agonist treatment (OAT) programs, HIV testing and linkage to antiretroviral treatment (ART) – were introduced and scaled-up. This approach allowed to control the epidemics among PWID. Disruptions in service delivery due to economic crisis, complacency towards maintaining low HIV incidence in this population or other health threats, such as pandemics, may have a detrimental effect on what has been achieved so far in many countries. The largest of these recent epidemics occurred in Athens, Greece, where HIV prevalence in this population increased from less than 1% in 2010 to 16.5% in 2013.

During 2019–2021, and in the midst of the COVID-19 pandemic, a community-based intervention offering testing and linkage to care for HCV and HIV infections to PWID was implemented in Thessaloniki, the second largest city in Greece (ALEXANDROS program). During the intervention implemented in 2019–2021 in Thessaloniki, an increasing number of HIV cases was documented.

The article on the HIV epidemic among injecting drug users in Thessaloniki (second largest city of Greece) has just been published in the International Journal of Drug Policy. The aim of this analysis is to describe this new HIV outbreak among PWID (prevalence, incidence, risk factors for HIV seroconversion) that was documented through this intervention during the COVID-19 pandemic.

The research paper “A new outbreak of HIV infection among people who inject drugs during the COVID-19 pandemic in Greece” was published by the International Journal of Drug Policy, Volume 117. It is available following this link>>>.