Welcome
Please note: This edition of the bulletin was published by MEDFASH. Click here to view the original format.
Welcome the fourth issue of the MEDFASH Sexual Health & HIV Policy EUROBulletin. The eFeature interview this issue is with Dr Duarte Vilar from the Portuguese Family Planning Association, who considers the many challenges facing small NGOs working to advance sexual and reproductive health and rights in Southern European countries today.
There are lots of developments to report in the round-up section this issue, but look out for: the new CONCORD report on the EU funding landscape and funding delivery mechanisms available to support the work of civil society organisations; WHO updated hepatitis C treatment guidelines providing evidence-based recommendations for the use of new direct-acting antivirals (DAAs); new 2016 European guidelines from IUSTI Europe; ECDC policy guidance on TB control in vulnerable groups and BzgA/WHO Europe/UNFPA policy briefs on sexuality education in Europe and Central Asia.
The EUROBulletin was launched in July 2015 and after four issues we feel it would be timely to get some feedback from you so we can use it improve the bulletin and ensure it is as relevant as possible to the work you do. The reader survey will take no more than 5 minutes of your time to complete and we will share the results with you in a future issue. The survey can be accessed here or in the MEDFASH section at the end of the bulletin. Many thanks!
eFeature
Dr Duarte Vilar has been Executive Director of the Portuguese Family Planning Association since 1988. He is also Associate Professor at Lusiada University of Lisbon. In his eFeature interview Duarte talks about the sexual health and reproductive health challenges facing Portugal and considers how these might resonate across parts of Europe. He also highlights the need for small NGOs like his to continue to be innovative and to forge partnerships to ensure the work of advancing sexual health and reproductive health and rights continues in the face of ever-dwindling resources.
>Dr Duarte Vilar interview (PDF)
Policy development & guidance
Update on new European action plans on HIV/AIDS and viral hepatitis
Expert meetings were convened in Copenhagen at the beginning of April to guide and further develop new action plans on HIV/AIDS and viral hepatitis for the WHO European Region 2016-21. Next steps include an online public consultation and further consultation with all countries in the Region to provide input to the final versions of both plans, which will be presented for endorsement at the 66th session of the WHO Regional Committee for Europe in September this year.
>WHO Europe - news - April 2016
Towards a European strategy for women’s health
WHO Europe is in the process of developing a European strategy for women’s health through a series of consultations and with guidance from Member States. The strategy will focus on improving women's and girls' health and well-being beyond issues of reproductive, maternal and child health, and will encourage taking action to reduce health inequities for women throughout the life-course. The strategy will be presented for adoption by countries in the Region at the 66th session of the WHO Regional Committee for Europe in September 2016.
>WHO Europe - news - March 2016
Prevention of potential sexual transmission of Zika virus: interim guidance
This WHO guidance has been developed to provide advice on the prevention of potential sexual transmission of Zika virus. The primary transmission route of Zika virus is via the Aedes mosquito. However, sexual transmission of Zika virus may also be possible, with limited evidence recorded in a few cases. This guidance will be reviewed and the recommendations updated as new evidence emerges.
ECDC guidance on tuberculosis control in vulnerable hard-to-reach populations
This guidance provides support to those working towards strengthening tuberculosis prevention and control among vulnerable populations. It provides an overview of interventions to improve early diagnosis of tuberculosis and treatment completion in these populations, as well as factors to consider when developing programmes for health communication, awareness and education, and programme monitoring and evaluation. Also see the recently published ECDC TB surveillance and monitoring report in the data section below. Click the link to download the guidance document.
>ECDC - Guidance document - March 2016
ECDC Policy Briefing: Interventions in vulnerable groups are key to eliminating tuberculosis in Europe
This shorter document gives an overview of why interventions among vulnerable groups are necessary and what can be done, with examples and data to give evidence of the points raised. It is intended to address policy makers when needing political commitment or funding for TB programmes. Design files are also available so that the document can be adapted for use at national level, for example by translating the text into other languages. Click the link to access both.
>ECDC - briefing and design files - March 2016
Integrating collaborative TB and HIV services within a comprehensive package of care for people who inject drugs: consolidated guidelines
These WHO guidelines aim to reduce morbidity and mortality related to TB and HIV-associated TB among people who inject drugs (PWID) through the integrated delivery of a comprehensive and holistic package of care. The guidelines provide an update of the 2008 Policy guidelines for collaborative TB and HIV services for injecting and other drug users: an integrated approach. They consolidate the latest recommendations relating to the management of TB, HIV-associated TB, HIV, hepatitis B and hepatitis C, and drug dependence, as well as of alcohol dependence, malnutrition, mental illness and psychosocial needs.
ECDC guidance on chlamydia control in Europe
This evidence-based guidance from the European Centre for Disease Prevention and Control (ECDC) updates the 2009 guidance. The aim of this updated guidance is to support Member States to develop, implement or improve national or local strategies for chlamydia control. It sets out the current evidence base behind the proposed options, highlights key gaps in knowledge, and suggests effective options for national chlamydia control strategies. It is directed primarily at policy advisors but should be useful for programme managers and experts in sexual health, especially those at the European or national levels. Click the link for more information and to access the updated guidance document.
>ECDC guidance for Europe - Mar 2016
Parliament & other European institutions
EP resolution on refugees and asylum seekers in the EU
In March the European Parliament (EP) adopted a resolution calling for a reform of EU migration and asylum policies and procedures to include gender-sensitive measures to ensure the safety of women seeking asylum and to protect their sexual and reproductive health and rights. Click the links below to access the resolution and to see an overview report on the gender aspects of migration and asylum in the EU.
Commission proposes EU accession to international Convention to fight violence against women
Back in March the European Commission put forward a proposal for the EU to ratify the Council of Europe’s Istanbul Convention, a comprehensive international treaty on combatting violence against women. It also called on Member States who have not yet ratified the Convention to do so swiftly to ensure a coherent approach to gender-based violence. Click the links for more information on the proposal as well as a factsheets on the Istanbul Convention and the European Commission actions to combat violence against women.
>Factsheet - Istanbul Convention - March 2016
>Factsheet - EC actions to combat violence against women and girls - March 2016
EP policy study: The issue of violence against women in the EU (2016)
This study provides an overview of the current international and European political and legal framework on violence against women, including sexual violence. It updates findings from an earlier study in 2011.
>EP - policy study - March 2016
Reproductive health and women’s rights in Poland
The European Parliamentary Forum on Population and Development (EPF) has published an open letter to the Speaker of the Polish Parliament voicing concerns over a draft law that would introduce a complete ban on abortion and plans to reinstate a prescription requirement for emergency contraceptive pills. Parliamentarians from the Council of Europe Assembly have also made a written declaration expressing concerns about the current developments in reproductive health rights in Poland.
>EPF letter to Polish Parliament
>Council of Europe Assembly declaration – 20 April 2016
Health: Commission work programme for 2016
The European Commission adopted its public health work programme earlier this year. The overall amount of EU funding available in 2016 is 58 million. Calls for proposals for projects are now live and can be found by clicking the link below.
>Call for proposals for projects 2016
Commission announces €470m for Global Fund
In March the European Commission announced a pledge of €470 million for the Global Fund to Fight AIDS, Tuberculosis and Malaria for a three year period starting in 2017-2019. This represents an increase in the EU’s contribution compared with previous years.
>EC – press release – March 2016
EU Funding delivery mechanisms
This publication by the European NGO Confederation for Relief & Development (CONCORD) looks at the different EU funding delivery mechanisms available to support the work of civil society organisations (CSOs). New types of agreements and procedures have been recently introduced and this report aims to help CSOs better navigate the funding landscape.
>CONCORD - publication - March 2016
Treatment & service guidelines
Guidelines for the screening, care and treatment of persons with chronic hepatitis C infection
WHO has updated its hepatitis C (HCV) treatment guidelines to provide recommendations for the use of new direct-acting antivirals (DAAs), which are transforming the treatment of HCV. The guidelines provide updated evidence-based recommendations for treatment and also include existing recommendations on screening and care. A recent WHO-commissioned study published online in The Lancet Infectious Diseases in February looks at the epidemiology and burden of HCV co-infection in people living with HIV. Click the links to get the new guidelines and information about the study, and to access the Lancet article.
>WHO - publication - April 2016
>WHO - news - study on HIV/HCV co-infection
>Lancet article - February 2016
IUSTI 2016 Guidelines
These 2016 guidelines have been produced by the European branch of the International Union against Sexually Transmitted Infections (IUSTI- Europe). All current guidelines and patient information are accessible via the IUSTI website.
>2016 European guideline on Mycoplasma genitalium infections
>2016 European guideline on the management of non-gonococcal urethritis
>2016 European guideline for the management of vulval conditions
>IUSTI website - current European guidelines
Implementing Comprehensive HIV and STI Programmes with Transgender People: Practical Guidance for Collaborative Interventions
This new UN tool contains practical advice on implementing HIV and sexually transmitted infection (STI) programmes with transgender people. It is based on recommendations in the Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations, published by the World Health Organization. Topics covered include community empowerment and human rights, addressing violence, stigma and discrimination, and delivering trans-competent services, especially for HIV and STI prevention, diagnosis, treatment and care. Click the link for more information and to download the tool.
European Commission Marketing Authorisation for Gilead’s Fixed-Dose Combination Descovy® (Emtricitabine, Tenofovir Alafenamide) for Treatment of HIV
Last month (25 April) the European Commission granted marketing authorisation for Gilead’s fixed-dose combination Descovy. The authorisation allows for the marketing of Descovy in all 28 countries of the European Union.
>Gilead announcement – April 2016
ViiV Healthcare extends MPP licence agreement for dolutegravir to cover all lower middle-income countries
ViiV Healthcare has announced an extension of overall country coverage of its existing licence agreement for the adult formulation of dolutegravir to the Medicines Patent Pool (MPP) to cover all lower middle income countries (LMICs). This includes Armenia, Moldova, Morocco and Ukraine, where ViiV Healthcare has a registered patent for dolutegravir. The revised agreement means that dolutegravir and dolutegravir-based fixed-dose combinations could now be made available through generic manufacturers subject to the necessary regulatory approval.
>ViiV announcement - April 2016
Data, evidence & research
ECDC: Tuberculosis surveillance and monitoring in Europe 2016
This report jointly published by ECDC and WHO Regional Office for Europe gives a detailed picture of tuberculosis in Europe. Despite notable progress in the past decade, tuberculosis (TB) is still a public health concern in many countries across Europe. An estimated 340,000 Europeans had TB in 2014. Presentation slides and individual country profiles are also available.
>WHO/ECDC – press release – 17 March 2016
>TB in the European Region fact sheet
>ECDC report – slides & country profiles
ECDC: Antenatal screening for HIV, hepatitis B, syphilis and rubella susceptibility in the EU/EEA
This technical report from ECDC presents the findings of an online survey undertaken in summer 2013 with national experts on antenatal screening programmes in Member States. The results indicate that limited access to antenatal care services, combined with low testing uptake among pregnant women in certain subpopulations, often leads to low screening coverage for HIV, hepatitis B, syphilis and rubella susceptibility, especially in vulnerable groups. Click the link to download the report.
WHO European Health Information Gateway
This new WHO European Health Information Gateway brings together information, data and evidence from all Member States, from trusted international organisations and academic institutions. The Gateway, available also to the public, makes it easier to access Region-wide evidence on health (including for example reproductive and adolescent health and migrant health) and provides a forum for exchange of expertise and good practice. A mobile app is also available making the latest health information accessible via phones and tablet devices. Click the links below for more information.
>WHO Europe – news – 15 April 2016
WHO Health Behaviour in School-aged Children (HBSC) study
The latest update of this WHO collaborative, cross-national study - Growing up unequal: gender and socio-economic differences in young people’s health and wellbeing - has been recently published. It is based on a survey of over 200,000 young people in 42 countries in Europe and North America. The new report presents data from the 2013 and 2014 surveys, including on key risk behaviours such as sexual activity, alcohol consumption and cannabis use.
Knowledge of HPV and the HPV vaccine in European adolescents
The results of a systematic review to ascertain the level of human papillomavirus (HPV) and HPV vaccine knowledge among European adolescents was published in Sexually Transmitted Infections at the beginning of 2016. The review concluded that the delivery of HPV education to European adolescents needs to be re-evaluated as there appear to be significant deficiencies in basic knowledge and understanding of the subject. Click the link to access the article abstract. The full text requires subscription or payment.
>Sex Transm Infect doi:10.1136/sextrans-2015-052341
Reports & resources
From innovation to implementation: eHealth in the WHO European Region
This report describes the development of, and emerging trends in, electronic health (e-health) in the WHO European Region in 2016. It gives case examples to illustrate success stories in countries and the practical application of e-health in various settings. The key outcomes given provide evidence of an increasing appetite for e-health and indicate tangible progress in the mainstreaming of technology solutions across the European Region to improve public health and health service delivery.
>WHO Europe – press release – March 2016
>Fact sheet – status of e-health in European Region
EMCDDA: EU Drug Markets Report
This report from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) analyses what is known about the European drugs market today. It reviews the markets for different drugs and provides action points to inform policy development at EU and national level. A summary document offering easy access to the key findings is available in English French, German, Portuguese and Spanish.
>Access to the new report – full analysis and summary versions
HIV, HCV, TB and harm reduction in prisons: human rights, minimum standards and monitoring at the European and international levels
This report is part of the European Union co-funded project Improving Prison Conditions by Strengthening Infectious Disease Monitoring, led by Harm Reduction International. The project aims to reduce ill treatment of people in detention and improve prison conditions through more comprehensive and standardised monitoring of HIV, hepatitis C virus (HCV), tuberculosis and harm reduction.
IPPF: Access to Modern Contraceptive Choice in Eastern Europe and Central Asia
This factsheet from IPPF presents data and trends in the use of contraceptives in Eastern Europe and Central Asian (EECA), highlighting major factors influencing contraceptive behaviour, demand and access. It explains what role donors can play to enable women in EECA to access modern contraceptive methods.
Emerging evidence, lessons and practice in comprehensive sexuality education: a global review
This UNESCO report provides an overview of the status of comprehensive sexuality education (CSE) implementation and coverage on a global level. It draws on specific information about the status of CSE in 48 countries, generated through analysis of existing resources and studies. The report examines the evidence base for CSE and its positive impact on health outcomes, takes stock of political support for it, and examines how the various global and regional commitments have had an impact at national level on the delivery of CSE in practice.
>UNESCO review on CSE - press release - March 2016
Policy briefs on sexuality education
The Federal Centre for Health Education BZgA in Germany, the United Nations Population Fund (UNFPA Regional Office for Eastern Europe and Central Asia), and the World Health Organisation (WHO Regional Office for Europe) have jointly developed two policy briefs on sexuality education. The first provides an overview of the key issues and the second considers the impact of good quality sexuality education on the health and wellbeing of children and young people. Both focus primarily on Europe and Central Asia.
Sexual health rights & advocacy
UN - Right to sexual and reproductive health indivisible from other human rights
In March the UN’s Committee on Economic, Social and Cultural Rights (CESCR) published a General Comment on the right to sexual and reproductive health (SRH). It highlights the numerous legal, procedural and social barriers people face in accessing sexual and reproductive healthcare and information, and the resulting human rights violations. It also details the importance of SRH for women and girls but also gives attention to the needs of men and boys as well as other groups of individuals who face particular challenges and multiple forms of discrimination, including LGBT people. Click the link below for the press release and to access the full General Comment text.
Persecution of people living with HIV in Czech Republic
A number of organisations representing European networks of communities of people living with and affected by HIV, doctors and scientists wrote to the Prague Public Health Authority back in February to raise concerns about the initiation of a police investigation into the sex lives of 30 men living with HIV on the sole grounds that these men had been diagnosed with a sexually transmitted infection (STI). The letter makes clear that these developments violate fundamental human rights and are counterproductive to effective public health. Click the link to view the letter.
>Open letter to Prague Public Health Authority
Campaigns & other news
ECDC call for tender: HIV testing guidance in the EU/EEA
ECDC has issued an open a call for the above tender on HIV testing guidance in the EU/EEA. The call has been published on the ECDC website and also through the e-tendering website. The deadline for submissions is 1 June 2016.
>e-tendering website – full details
ViiV: Positive Action for MSM and Transgender Small Grants Programme
ViiV’s Positive Action for MSM and Transgender Small Grants programme focusses on vulnerable communities and the stigma and discrimination they face on a daily basis due to sexual orientation, gender identity/expression and/or HIV status. This year the programme will focus on funding projects that are specifically led by members of the MSM and/or transgender communities. Applications can be made until 20 May 2016. Click the link for more information on the application process.
>MSM & transgender small grants programme 2016
European HIV-Hepatitis Testing Week 2015 evaluation
This two-page summary presents the topline results from the evaluation of the 2015 European HIV-Hepatitis Testing Week, which took place between 20-27 November last year.
BHIVA Conference 2016
The 22nd annual conference of the British HIV Association was held in April 2016. Click the link below to see aidsmap conference news and highlights, including the first data on uptake of HIV self-testing in the UK.
>NAM aidsmap – conference news
EASL 2016
The European Association for the Study of the Liver (EASL) held its annual conference last month (13-17 April). Click the link below for aidsmap conference news and highlights.