July 2015

Almost 20 years after the 1996 International AIDS Conference in Vancouver and its “hit hard and early” discussions, many of us will soon travel to Vancouver again for the 8th International AIDS Society Conference (IAS 2015) on HIV Pathogenesis, Treatment and Prevention. As was the case 20 years ago, much discussion will focus on the potential and timing of antiretroviral (ARV) therapy – but this time from the perspective of a prevention-testing-treatment continuum towards ending the AIDS epidemic by 2030.

At the conference, WHO will engage with the HIV community in multiple sessions – starting with a satellite on Sunday, 19 July 2015 (12:30-14:30, Room 211) in which we will present new directions in ARV guidelines and launch the “WHO consolidated guidance on HIV testing services”. A detailed pro-gramme for WHO’s key events at IAS 2015 is attached to this message.

At the Sixty-ninth World Health Assembly last month, we hosted a special technical briefing with the Member States to discuss the key directions of the next global health sector strategies for HIV, hepatitis and sexually transmitted infections. WHO Director-General, Dr Margaret Chan, attended the briefing and called for global action to ensure a people-centred response to these issues. We are continuing with the consultations in the regions, and the strategies will be discussed at the Regional Committees from September.

We will observe the fifth World Hepatitis Day annual campaign on 28 July 2015. This year the focus is on the prevention of hepatitis B and C, and on linkage to testing and treatment. We hope all our part-ners, friends and colleagues will join in the campaign to spread messages and ideas on how to move the important hepatitis agenda forward.

Dr Gottfried Hirnschall

Director

Department of HIV/AIDS, the Global Hepatitis Programme

World Health Organization

DIRECTOR’S MESSAGE

Sneak peek: WHO at IAS 2015

WHO plans to

release new

guidelines on

HIV testing

services, as well

as latest recom-

mendations on ARV use and strategic information,

at the IAS 2015 Conference taking place in Vancou-

ver, Canada on 18–22 July. The launch event will

take place at a satellite on Sunday, 19 July. WHO

will also participate in other key events with part-

ners, including the 2nd International HIV/Viral Hep-

atitis Co-infection Meeting on 17–18 July, and side

events on HIV drug resistance and tuberculosis/HIV

coinfection. More at: www.who.int/hiv

Sneak peek: World Hepatitis Day 2015 The fifth

World Hepati-

tis Day, to be

observed on

28 July ,will

focus on the prevention of hepatitis B and C. World-

wide, these viruses affect close to 400 million people.

Every year, approximately 1.39 million people die

mostly from liver cirrhosis and cancer caused by these

infections. By highlighting the prevention of hepatitis

B and C, WHO aims to draw global attention to the

need to prevent hepatitis epidemics, and to urge poli-

cymakers to initiate bold actions to combat hepatitis.

More at www.who.int/hiv/topics/hepatitis

HIV NEWS

WHO and partners to catalyse access to HIV self-testing in Africa with UNITAID

grant

A team of partners, including WHO, has received an investment of US$ 23 million from UNITAID to devel-

op and improve access to HIV self-testing services in three high-burden African countries over the next

two years. The team comprises WHO, Population Services Inter-

national and its partners, the London School of Hygiene & Trop-

ical Medicine, the Liverpool School of Tropical Medicine, and

University College London. With support from UNITAID, these

partners will deliver approximately 800 000 rapid diagnostic tests

adapted for HIV self-testing across Malawi, Zambia and Zimba-

bwe, making this the world’s largest evaluation of HIV self-

testing to date. During this initiative, WHO will be synthesizing

evidence to develop normative guidelines and implementation

guidance to support the establishment of appropriate policies, at

both the international and country levels, and encourage new manufacturers to enter the self-test market

to supply country demands. It is hoped that the two-year project will help stimulate the HIV self-test mar-

ket, increase access to HIV testing, and help achieve goals around HIV prevention, care and treatment.

Read more

WHO to assess START trial findings

Interim results from the Strategic Timing of AntiRetroviral Treatment (START) study, by the National Insti-

tute of Allergy and Infectious Diseases in the United States, concluded that people living with HIV should

start taking ARV drugs as soon as they are diagnosed with HIV. The trial measured a composite outcome,

which included death, AIDS and severe non-AIDS events, among 4 685 healthy adults living with HIV in 35

countries. The study showed a 53% reduction in death, AIDS and severe non-AIDS events among those

who started treatment early. WHO has been assessing these findings to update its ARV recommenda-

tions. The 2015 interim ARV guidelines are now being released at the IAS2015 Conference, and full guide-

lines will be published later in the year. They include new clinical recommendations, as well as guidance

on how to implement new policies in support of the 'Fast Track' initiative and the 90-90-90 targets to end

AIDS by 2030. Read more

WHO ranked on technical support for countries

Since 2014, WHO has worked to provide technical support to more than 50 countries in developing pro-

posals for Global Fund grants under the new funding model. To evaluate this initiative, consulting agency

BigThink Partners conducted a study earlier this year focused on how countries and partners view the

quality of WHO’s technical support, and the effectiveness of its coordination and communication during

the technical support initiative. The survey was conducted in three languages, and received responses

from 152 individuals in 73 countries situated across WHO's six regions. In addition, 59 individuals, includ-

ing stakeholders and national programme leaders who acted in the Country Coordinating Committees,

were interviewed as part of the study. Final results showed that WHO’s technical support and communi-

cation were ranked highly by country representatives and partners. Over 90% of responses ranked the

relevance and quality of WHO’s technical support and communication “excellent” or “very good”.

HIV NEWS

Spotlight: For a new generation free from HIV and syphilis

Cuba has been declared the first WHO-validated country to achieve the elimination of mother-to-child transmission (EMTCT) of HIV and syphilis. In 2014, the HIV/AIDS Department released the WHO guid-ance on the global validation process for the elimination of HIV and syphilis, which was featured in this newsletter. We spoke with WHO Technical Officer for HIV Strategic Information and Planning, Ms Chika Hayashi, to find out what the overall validation process means for the global response.

Q: Can you please explain the validation process WHO is under-taking for HIV and syphilis?

News about Cuba has been welcomed around the world. Leading to this announcement, there was a systematic process to evaluate

the established criteria set up by WHO based on the global guidance you mentioned. A regional validation committee was established in the Americas, and once Cuba requested validation, PAHO worked with Cuba to prepare a country report and conduct a pre-validation visit. Then in March 2015, a validation team was sent to review Cuba’s programme. Four tools were used to assess Cuba’s programme in the areas of data systems; laboratory systems; human rights, gender and community engagement; and programme service delivery. The team visited facilities and interviewed providers, government officials, and representatives of civil society. The findings of the visit were reviewed by the full regional validation committee, as well as the global validation advisory committee.

Q: How many countries have requested to be validated as HIV- and syphilis-free among their newborns?

There are already 10–20 countries (at least one from each region) that have expressed interest, through either requests to start a readiness assessment, or requests for official validation of EMTCT of HIV and/or syphilis in the near future. Including both official re-quests and requests for preparatory activi-ties, there are at least 6 to 8 countries from the Americas, 8 from the EURO Region, 3 from WPRO, 1 from the EMRO Region, and 1 from the AFRO Region. So we will hopefully be hearing about the next countries validated for EMTCT soon.

Q: What does EMTCT validation mean for the course of the two diseases globally?

Achieving validation is great news for the health sectors in the validated countries and, of course, the affected communities, as it demonstrates a strong underlying antenatal-care platform and the ability to follow up on exposed children. Hopefully it can also help countries track their progress for EMTCT better in general, by improving data collection. Due to the need to bring down the case rate, it may be difficult to achieve in very high-burden countries. One of the outcomes of the first global validation committee meeting was to develop a staged system with benchmarks so we can measure and celebrate the tremen-dous progress being made towards validation of EMTCT. The validation of Cuba is one of the first early steps towards ending AIDS.

Photos: by WHO/PAHO staff, taken during the regional validation team visit to Havana, Cuba.

Read more about validation process

HEPATITIS NEWS

More 'first' guidelines on hepatitis expected in 2015

Following the 2014 launch of the guidelines for the screening, care and treatment of persons with hepati-

tis C, several new medicines have been approved for the treatment of chronic hepatitis C. The WHO

Global Hepatitis Programme (GHP) is now updating its recommendations on hepatitis C treatments to

include these medicines. This update is due to be released at the end of 2015. The GHP is also working to

publish the first-ever WHO guidelines on testing for chronic hepatitis B and C infections by early

2016. These guidelines will be the first hepatitis testing recommendations for low- and middle-income

countries. They will include guidance on testing strategies (diagnostic algorithms) for hepatitis B and C;

strategies on who to screen among high-risk groups and the general population; the provision of appropri-

ate pre- and post-test counselling; and linkage to care and treatment.

First meeting of the WHO Hepatitis Civil Society Reference Group

In May 2015, the GHP welcomed members of the WHO Hepatitis Civil Society Reference Group at the first

face-to-face meeting to discuss and provide insight on WHO’s hepatitis programme and activities. The

animated and engaging two-day meeting covered topics such as normative guidance, global advocacy, in-

tegration and scale-up, the development of global indicators for viral hepatitis, and access to medicines.

There was also substantial discussion and review of the draft Global Health Sector Strategy for Viral Hepa-

titis, with many valuable insights and recommendations made. The meeting participants agreed that civil

society will play a critical role in raising awareness and advocating for resources, so that countries and

partners are supported in their achievement of the bold and aspirational targets laid out in the draft strat-

egy. The first global health sector strategy on viral hepatitis for 2016-2021 is currently under develop-

ment. Read more

WHO hepatitis website to be launched

The WHO websites are the key communication platforms for the public to access information on the global

state of the hepatitis epidemic, and actions taken by WHO and its partners. In July 2015, WHO will intro-

duce a comprehensive new website for hepatitis. This website to be located at www.who.int/hepatitis will

be live before World Hepatitis Day 2015. You can also stay tuned to WHO’s action on hepatitis on Twitter

by following HIV-HEP @INF0channel and the hashtag #whohep.

IN 58 DAYS www.worldhepatitissummit.com

Make history happen

At the first inaugural summit

on global hepatitis

SEE YOU THERE

Something new

Want to know more about us?

On the web: www.who.int/hiv. Tweet with us: HIV-HEP@INF0channel and use the hashtags

#whohiv and #whohep

If you are a WHO staff member, there is more info for you on the Intranet: http://intranet.who.int/

homes/hiv/

If you wish to receive our regular newsletters and other information, please email: hiv-aids@who.int

WHO Department of HIV/AIDS, Global Hepatitis Programme

20, Avenue Appia

1211 Geneva 27 Switzerland

Here are some of the new publications released by us lately:

Supplement to the 2014 Consolidated guidelines for HIV prevention,

diagnosis, treatment and care for key populations: Tool to set and monitor

targets for HIV prevention, diagnosis, treatment and care for key populations

Article in AIDS and Behavior : Attitudes and acceptability on HIV self-

testing among key populations: a literature review

WHO supplement on HIV postexposure prophylaxis for Clinical

Infectious Diseases

Meeting report: Paediatric ARV Drug Optimization 2

Consolidated strategic information guidelines for HIV in the health

sector

Infographic for the Consolidated strategic information guidelines for HIV

in the health sector

For full repository of WHO HIV and hepatitis publications, by topic, and by

date, please visit our website.