Africa is not the most rapidly growing HIV epidemic region: it is Eastern Europe. Out of a total 2.2 millions people living with HIV in Europe, more than 60% of them are living in the East. Before 2002 this figure was stable, but in just seven years it has increased by two thirds.
In 2011, a Report by the World Health Organization (WHO) has found out that over 60% of the new infected people in the geographical region from Belarus to Russia are people who inject drugs. But WHO defines “key population at higher risk” as “people who inject drugs and their sexual partners, men who have sex with men, transgender people, sex workers, prisoners and migrants”. In order to face this alarming situation, both the WHO and the European Union activated themselves.
The WHO Action Plan
The WHO launched an “European Action Plan for HIV/AIDS 2012-2015”, based on four guiding principles: equity in health (in the European Region, key populations at higher risk have the poorest access to health services), community participation, human rights, evidence-informed policies and ethical public health approaches. With this background, the European Regional WHO offices aimed to halt and begin to reverse the spread of HIV in Europe by 2015 by achieving universal access to comprehensive HIV prevention, treatment, care and support by 2015. Further WHO's goals are to contribute to the attainment of Millennium Development Goal 6 and other health-related Millennium Development Goals (3, 4, 5 and 8), particularly those referring to the incidence of tuberculosis in Europe.
The European Union Action Plan
Due to the proximity, the migration from East and the free movement of people within the Union, also the EU took action against HIV/AIDS epidemic in Eastern Europe. In March 14th 2014, the European Commission put forward an enhancement of the 2009-2013 Action Plan against HIV/AIDS (here a 2012 interim report of this Action Plan). The enhancement will be valid through 2016. Tonio Borg, Commissioner for Health, said that “the fight against HIV/Aids remains a priority for EU health policy. We must reach out to the citizens who are most at risk, fight all forms of discrimination, and foster access to diagnosis and treatment”. Generally speaking, the 2014-2016 plan (as the previous one) is meant as a policy instrument to complement Member States' policies. In particular, through this decision, the EU fosters and coordinates different funding mechanisms and instruments such as the EU Health Program, Horizon 2020 (funding for HIV and Tuberculosis research had been in H2020 first calls) and the Global Fund to Fights AIDS.
Italian successful researches to fight HIV/TB
Italy has been one of the leading country in the effort to fight HIV/AIDS epidemic in Eastern Europe, as showed by the database of EU funded projects against sexually transmitted deseases.
Some EU funded projects run by Italian entities became a world-leading standard, such as, in particular, the Sialon I and II. The project is run by Dr. Pier Paolo Benetollo of the Azienda Ospedaliera Universitaria Integrata Verona (Verona's University Hospital) with partners from 13 different countries. Funded through the EU Health program, it is backed by the WHO, UNAIDS and the Italian National Institute of Health.
The Sialon II project is aimed to enhance the previous Sialon I, by fostering “the capacity building in combining targeted prevention with meaningful surveillance among men who have sex with men (MSM)”. In addition, the project aims to create a network of institutions working with the ECDC to implement new tools for sexually transmitted diseases surveillance with integrated HIV prevention strategies. Technically, this means to develop and disseminate innovative surveillance methodologies for hard to reach populations like MSM (time and location sampling, respondent driven sampling, HIV testing). The project, thanks to the participation of UNAIDS and WHO, will be implemented, using the same methodologies and prevention strategies, in both EU (Italy, Belgium, Bulgaria, Germany, Slovak Republic, Spain, Lithuania, Poland, Sweden, Slovenia, Romania, United Kingdom) and neighboring countries (Russia, Armenia, Belarus, Moldova).
Other relevant projects run by Italian entities have been the Im.pac.T by the Ngo Fondazione Villa Maraini, aimed to improve the access to HIV/TB tests in marginalized groups and finalized in 2012; the H-Cube by University of Sassari, focused on adolescents in Eastern Europe; Sunflower by ANLAIDS, aimed to collect the best practices on HIV prevention among young people.