Delivered by Dr Zsuzsanna Jakab, Regional Director, WHO Regional Office for Europe, Tbilisi, Georgia, 30 September 2015

1. © Carl Cordonnier © Maxim Dondiuk© Andrei Dadu
TB and HIV infection in the WHO European Region
Dr Zsuzsanna Jakab, Regional Director, WHO Regional Office for Europe
Tbilisi, Georgia, 30 September 2015
Regional high-level dialogue on successful transition to domestic funding of the response to HIV
infection and TB in eastern European and central Asian (EECA) countries: “Road to success”

2. 2
Fastest decrease in TB prevalence of all WHO regions
313
280
31 29
122 121
50
39
198
183
96 87
20
200
2009 2010 2011 2012 2013
per100000population(log)
6%
__
1.9%
2.4%
0.3%
2.0%
2.8% African
South-East Asia
Eastern Mediterranean
Western Pacific
European
The Americas

3. 3
TB and MDR-TB burden, 2013
41%
25%
21%
9%
4% 3%
30%
15%
24%
6%
25%
2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
S.E. Asia Africa W. Pacific E. Mediterranean Europe Americas
TB MDR-TB

4. 4
TB/HIV co-infection
2.8
7.8
0
1
2
3
4
5
6
7
8
9
2006 2007 2008 2009 2010 2011 2012 2013
%HIVinfectionamongTBcases

5. 5
Core achievements
Baseline 2015
Estimated prevalence of MDR-TB 9.1 per 100 000 8.4 per 100 000
MDR-TB detection rate 30% 50%
MDR-TB treatment coverage 63% 100%
Approach Small-scale pilot
projects
Nationwide integrated
programmes

6. 6
Stabilization of MDR-TB among previously treated
cases
38.3%
48.6% 48.0%
0%
10%
20%
30%
40%
50%
60%
2007 2008 2009 2010 2011 2012 2013
MDR among previously treated cases

7. 7
Key results
• 1 million TB patients cured, including 53 000 with MDR–TB
• 200 000 MDR–TB cases averted
• 2.6 million lives saved
• US$ 11 billion saved

8. 8
Regional response: “From Berlin, 2007,
to Vilnius, 2015”

9. 9
What is new in the new TB action plan?
• Scale-up of rapid diagnosis
• Expanded patient-centred care models
• Shorter, more effective treatment regimens and new
medicines
• Research for new tools
• Intersectoral approach to inequities

10. 10
TB action plan for the WHO European Region
2016–2020
• 3.1 million lives will have been saved
• 1.4 million TB patients will have been cured
• 1.7 million new cases of all forms of TB
will have been prevented
• US$ 48 billion will have been saved

11. 11
Less progress in prevention and control of HIV infection in
the WHO European Region
Despite progress in implementation
of the European action plan for
HIV/AIDS 2012–2015 and more
people on treatment, the HIV
epidemic in this Region is still
increasing.

12. 12
0
20
40
60
80
100
120
140
160
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Thousands
WHO European Region
East
West
Centre
WHO European Region
Centre
West
East
Newly diagnosed HIV infections, WHO European Region,
2004–2013

13. 13
Distribution of newly diagnosed HIV infections in 2013

14. 14
Populations disproportionately affected
• People who inject drugs (and their sexual
partners)
• Men who have sex with men
• Sex workers
• Transgender people
• Prisoners
• Migrants

15. 15
Late diagnoses in Europe
WHO European Region:
Percentages of new cases of HIV
infection with CD4 cell counts
< 350/mm3 and < 200/mm3 at
diagnosis, 2013
Source: ECDC/WHO (2014). HIV/AIDS Surveillance in Europe, 2013
49%
27%

16. 16
East:
Percentages of new cases of HIV infection
with CD4 cell count < 350/mm3 at
diagnosis, by transmission mode, 2013
Late diagnoses in eastern Europe

17. 17
Treatment gap
People with HIV infection receiving antiretroviral therapy (ART) in Europe, 2009–2013
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2009 2010 2011 2012 2013
Thousands
ART western and central Europe
ART eastern Europe
Cumulative HIV cases
26%↑
124%↑
41%↑

18. 18
Prevention of mother-to-child transmission
14%
37%
67%
75%
81%
92%
75%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Eastern Mediterranean Region
South-East Asia Region
Western Pacific Region
African Region
Region of the Americas
European Region
Global
Percentage of pregnant women living with HIV
infection in low- and middle-income countries who
received ART, globally and by WHO region, 2014

19. 19
Global health sector strategies on HIV infection, viral
hepatitis and STIs, 2016–2021
http://www.who.int/hiv/strategy2016-2021/en/
Strategic directions:
• Information for focus and accountability
• Interventions for impact
• Delivery for quality and equity
• Financing for sustainability
• Innovation for acceleration Regional
consultation
(33 countries),
June 2015

20. 20
Thank you very much for your attention