1. Outline of Current Situation Survey on HIV/AIDS (Proposal) Ms. Keiko Dozono Director for AIDS and Emerging Infectious Disease Control Health and Safety Division Bureau of Social Welfare and Public Health Tokyo Metropolitan Government February 5, 2014

2. 1 Conducting a Current Situation Survey Background (1) As five years have passed since the compilation of the 2009 Infectious Diseases Situation Survey, an update is needed. (2) While information on the current situation of HIV/AIDS for each country as a whole is available, there is little information regarding individual cities.

3. 2 Conducting a Current Situation Survey Objectives (1) To update the 2009 Infectious Diseases Situation Survey in order to share the current situation regarding infectious diseases in the member cities. (2) To share the current situation and measures against HIV/AIDS in each city in order to consider what exactly to implement for Joint Research and Survey starting from 2015.

4. 3 Infectious Diseases Situation Survey (Draft) Implementation Details (1) Update information of the 2009 Infectious Diseases Situation Survey. (Four Contents) (2) For the matters related to HIV/AIDS, conduct a detailed survey in preparation for Joint Research and Survey. Also, conduct particularly detailed surveys on healthcare service systems and activities for public awareness.

5. 4 Infectious Diseases Situation Survey (Draft) Method: (1) The Infectious Diseases Situation Survey will be conducted by a questionnaire method. (2) Tokyo will send a questionnaire to the member cities by e-mail. (3) The member cities will reply the questionnaire to Tokyo. (4) Based on the collected replies, Tokyo will compile a report on the current situation and measures against infectious diseases. (5) The findings of the survey will be shared at the conference, while the report will be distributed to the member cities.

6. 5 Four Contents (Draft) A. Outline of Healthcare Basic Demographic Feature Areas and Population Fertility profile Mortality profile System of Health Governance and Health Resources Health service system in your country including your city Health Insurance Organizational chart of your city Health-related administrative organization of your city Health infrastructure Overall of Infectious Diseases Control Mortality and morbidity of communicable diseases (per year) Immunization Coverage (%) Surveillance system for infectious diseases given by law(s) *For the overview of healthcare, the survey will contain the same items as that of 2009.

7. 6 B. HIV/AIDS Administration Morbidity and Mortality Counseling and Testing Number of special hospitals for HIV/AIDS treatment The number of questions related to HIV/AIDS will be increased. 1. Surveillance for HIV/AIDS 2. Situation of Infection and patient trends 3. Roles and responsibilities of relevant agencies regarding HIV/AIDS 4. Counseling and Testing 5. Healthcare service system 6. Activities for public awareness Four Contents (Draft)

8. 7 C. Tuberculosis (TB) Administration Administrative response at detecting TB cases Records and reporting system for health administration BCG Age or month for BCG vaccination BCG coverage Number of TB cases and rate (per 100,000 population) Number of notification, incidence, prevalence, deaths, successfully treated (country, city) DOTS Strategy Compliance of DOTS strategy Target patients for implementing DOTS Percent of population covered by DOTS Resources for diagnostic services by laboratories 1) sputum smear, 2) culture, 3) drug susceptibility test, 4) QFT, 5) RFLP, 6) VNTR Surveillance for MDR/XDR-TB Number of MDR-Tb patients, the number of treated in DOTS-Plus programs * For TB, the survey will contain the same items as that of 2009. Four Contents (Draft)

9. 8 D. Pandemic Influenza Pandemic preparedness plan Expectations on availability of pandemic vaccine Expectations on availability of antivirals Status of planning for antivirals and pandemic vaccine 1) Monitoring antiviral use & adverse events 2) Strategies for antiviral drug delivery 3) Priority groups for antiviral treatment 4) Monitoring use & adverse events of pandemic vaccine 5) Strategies for vaccine delivery 6) Priority groups for vaccination Resources on testing and surveillance Types of laboratory which can detect a novel influenza subtype Data sources of syndromic surveillance for early detection of outbreak *For pandemic influenza, the survey will contain the same items as that of 2009. Four Contents (Draft)

10. 9 1. Surveillance for HIV/AIDS ・ Types of surveillance (1) notifiable (2) sentinel (3) pathogens B. HIV/AIDS (Draft)

11. 10 2. Situation of infection and patient trends (Both national and city statistics) (1) Cumulative number of HIV/AIDS reported (2) Annual trend in numbers of newly infected HIV/AIDS cases (3) Number of newly infected HIV/AIDS cases (total, by sex, by age, by infection route) (4) Number of deaths due to AIDS B. HIV/AIDS (Draft)

12. 11 B. HIV/AIDS (Draft) 3. Roles and responsibilities of relevant agencies regarding HIV/AIDS (1) Public health organizations (2) Healthcare providers (3) NGOs (4) Others

13. 12 B. HIV/AIDS (Draft) 4. Counseling and Testing (1) HIV testing facilities (types, number) (2) Testing available at each facility (types) (3) Number of testing conducted at each facility (per year) (4) Number of HIV positive results (5) Fees for receiving HIV testing

14. 13 B. HIV/AIDS (Draft) 5. Healthcare service system (1) Public agencies in charge of HIV/AIDS (number, types) (2) NGOs related to HIV/AIDS number, types: (a) activities for public awareness (b) testing (c) support (3) Regional plan or guideline on HIV/AIDS

15. 14 B. HIV/AIDS (Draft) (4) Medical care (a) Number of specialized healthcare providers (b) HIV/AIDS treatment fees (public assistance, health insurance) (c) Flow chart of testing  examination at a healthcare provider  medical prescription  treatment support and consultation (5) Treatment support (a) By public agencies (b) Healthcare providers (c) NGOs

16. 15 B. HIV/AIDS (Draft) 6. Activities for Public Awareness (1) For general population (2) For specific groups Each city selects two or more of the following groups, on which it is focusing most: (a) MSM (b) CSW (c) youths (d) mother-to-child transmission (e) drug users

17. 16 Infectious Diseases Situation Survey (Draft) Questionnaire (March) Submit (B. HIV/AIDS) (May) Submit (A,C and D) (November) Report (Early in 2015) Implementation Schedule in 2014 Tokyo The member cities

18. 17 (1) In 2009, Infectious Diseases Situation Survey was conducted in order to understand and share the current situation regarding infectious diseases in the member cities. (2) Participating cities: Bangkok, Hanoi, Seoul, Singapore, Taipei, Tokyo 2009 Infectious Diseases Situation Survey

19. 18 2009 Infectious Diseases Situation Survey (3) Method Questionnaire method (4) Survey period From March to April in 2008

20. 19 2009 Infectious Diseases Situation Survey (5) Survey Items ・ Outline of Healthcare ・ Administrative summary ・ HIV/AIDS ・ Tuberculosis ・ Pandemic influenza ・ Expecting themes on the joint research

21. 20 Thank you!