Mena research priorities

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  • The figure for new diagnosed cases I took from the ASD surveillance report
  • I have added 2011 data on the graph from this years’ country reports , however clarification is till underway
  • Mena research priorities

    1. 1. Research Needs in the MENA Region Gabriele Riedner, WHO AIDS 2012|
    2. 2. OutlineFocus on 2 thematic research areas: 1. epidemiology 2. prevention, care, treatment continuumWhat we know and what we do not knowConclusion|
    3. 3. RESEARCH AREA: EPIDEMIOLOGY|
    4. 4. Epidemiological research informs aboutthe distribution and risk factors for HIVWho? Where? How and how much? (Why?) |
    5. 5. Status of the HIV epidemic (2011) - What do we know? MSM ? ? IDU IDU IDU ? IDU MSM? IDU MSM? IDU SW? HIJRA SW SW MSM ? ? MSM? IDU! IDU! MSM, SW ? SW SW Low level Concentrated ≥ 5% Generalized| 5
    6. 6. Epidemiology – what we do not know Correct HIV estimates (# PLHIV; # new infections etc.) HIV prevalence in key populations (KP) at higher risk (mainly in GCC) Trends in HIV prevalence in KP (in most countries) Sizes of key populations at higher risk HIV incidence rates Proportions of new infections attributable to different modes of transmission (MoT analysis) |
    7. 7. Mode of Transmission Analysis Morocco
    8. 8. Regional Guide on HIV surveillance in low and concentrated epidemics4 HIV Surveillance Training Modules
    9. 9. RESEARCH AREA:PUBLIC HEALTHINTERVENTIONS FOR HIV|
    10. 10. Interventions and operational researchSeeks information about: Which bio-medical / behavioural interventions are effective? What are the most cost-effective ways to achieve coverage of beneficiaries? – E.g. Facilitating factors and obstacles to access and utilization – Comparison of different service delivery models What impact do interventions achieve on the epidemic and on the health/wellbeing of PLHIV? |
    11. 11. Prevention Effective prevention tools are available: e.g. behaviour change communication, testing/counselling, condom, STI treatment, IDU harm reduction, pre-exposure prophylaxis (e.g.PMTCT), ART Coverage of people in need of prevention services very low Impact of interventions at population level is mostly unknown |
    12. 12. Prevention: priority research questions Barriers to access to effective prevention interventions from perspective of people at risk Most cost-effective, feasible and acceptable modes of service delivery (how to reach people most at risk and link them to services? How to engage communities? Best mix or service providers: NGO, public, private providers) Stigma reduction interventions – what works in regional context? |
    13. 13. Diagnosis – Care – Treatment Cascade ( drawing not to scale )Estimated number of PLHIV with HIV in 2010: 560 000Estimated in need of ART: 200 000# known ??? Main bottleneck:PLHIV:# in HIV diagnosis ???care:# 19 500ART *WHO, UNAIDS, UNICEF. Towards universal access: scaling up priority interventions in the health sector : Progress report 2011.WHO. | New Diagnosis data from ASD surveillance report 2011
    14. 14. Operational Research Priorities: Care and Treatment|
    15. 15. Conclusion: Suggestions for focus of research Epidemiological studies to determine where most new infections occur Interventions and operational research to determine – Most effective approaches to reach people at higher risk with prevention and HIV testing – Best service delivery models to enrol and keep PLHIV in life-long care and treatment |
    16. 16. Thank you|
    17. 17. |
    18. 18. Number of PLHIV on ART 2006-2011 in the EM Region 247552500020000 19050 Regional ART15000 11215 15473 coverage10000 7150 (2011): 13%* 5209 5000 0 2006 2007 2008 2009 2010 2011 Latest estimated of ART need (2010): 200,000WHO, UNAIDS, UNICEF. Towards universal access: scaling up priority interventions . in the . ,health sector:progress report. WHO, 2007-2011 .Survey on ARV use .WHO 2011. |* UNAIDS: Together we will end AIDS, 2012
    19. 19. Distribution of (gu)estimated HIV burden Estimated number of PLHIV (% of regional burden) Other Sudan 21% 18% Iran South Sudan 17% 27% Pakistan 17% |

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