1. WHO strategy on HIV/AIDS 2011-2015 “Getting to Zero”
Presenter : Armin Hirbod-Mobarakeh
Armin Hirbod-Mobarakeh

2. Introduction to HIV/AIDS
Causative agent : Human Immunodeficiency Virus (HIV), an RNA virus from the retrovirus family
Pathogenesis: main target is the immune system and consequently impairs the surveillance and defense systems against infections and some types of cancer
Armin Hirbod-Mobarakeh

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4. Presentation 1. The early, acute phase
Initial response of an immunocompetent adult to HIV infection
High level of virus production and viraemia
Clinically, this stage is characterized by infectious mononucleosis-like features of sore throat, myalgias, fever, weight loss, and fatigue all of which are self-limiting
2. The middle, chronic phase
Relative containment of the virus and clinical latency
Virus replication continues for several years, predominantly in the lymphoid tissues
Clinically, patients are either asymptomatic or develop persistent generalized lymphadenopathy
3. The final, crisis phase
breakdown of host defense
CD4 count usually < 200 cells/mm3
Clinically, the patient presents with marked weight loss, chronic diarrhea, and fever lasting more than 1 month and Opportunistic infections occur
Armin Hirbod-Mobarakeh

5. Diagnosis: blood tests detecting presence or absence of antibodies and antigens; “window period" of 3 to 12 weeks
Treatment: no cure; combination antiretroviral therapy (ART) to control the virus
Armin Hirbod-Mobarakeh

6. “Know your epidemic, know your response”
One of the world's leading infectious killers
more than 25 million deaths over the past three decades
34 million people living with HIV in 2010.
less than 40% of people living with HIV know their HIV status
2.6 million new infections in 2009
In 2010, around 6.6 million people living with HIV were receiving antiretroviral therapy in low- and middle-income countries, but over 7 million others are waiting for access to treatment.
Armin Hirbod-Mobarakeh

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8. Global vision, goals, targets and strategic directions
Zero new HIV infections, zero AIDS-related deaths and zero discrimination in a world where people living with HIV are able to live long, healthy lives.
Global goals and targets
reduce new infections: reduce by 50% the percentage of young people aged 15–24 years who are infected (compared with a 2009 baseline)
eliminate new HIV infections in children: reduce new HIV infections in children by 90% (compared with a 2009 baseline)
reduce HIV-related mortality: reduce HIV-related deaths by 25% (compared with a 2009 baseline)
reduce tuberculosis-related mortality: reduce tuberculosis deaths by 50% (compared with a 2004 baseline).
Armin Hirbod-Mobarakeh

9. Strategic directions
Strategic direction 1: Optimize HIV prevention, diagnosis, treatment and care outcomes. Integrate and improve the quality, effectiveness and coverage of HIV-specific interventions and approaches, and identify new HIV interventions as evidence emerges.
Strategic direction 2: Leverage broader health outcomes through HIV responses. Strengthen linkages and synergies between HIV and other related health programs, notably for sexual and reproductive health, maternal, newborn and child health, tuberculosis, drug dependence and harm reduction, emergency and surgical care and nutrition.
Strategic direction 3: Build strong and sustainable systems. Build effective, efficient and comprehensive health systems in which HIV and other essential services are available, accessible, affordable and sustainable.
Strategic direction 4: remove structural barriers to access services. The health sector must remove structural barriers to achieve equitable access to HIV services and protecting and promoting the human rights of key populations
Armin Hirbod-Mobarakeh

10. Armin Hirbod-Mobarakeh

11. Strategic direction 1: Optimize HIV prevention, diagnosis, treatment and care outcomes
Revolutionize HIV prevention
Prevent sexual transmission of HIV: behavior change counseling, male and female condom programming, early initiation of antiretroviral therapy, safe male circumcision (in high HIV-prevalence settings), post-exposure prophylaxis, and quality-assured HIV testing
Eliminate HIV transmission in health-care settings: standard precautions, injection and surgical safety, blood safety, safe waste disposal and post-exposure prophylaxis for occupational exposure to HIV
Eliminate new HIV infections in children: preventing HIV infection in women of child-bearing age, preventing unintended pregnancies among women living with HIV, reducing HIV transmission from women living with HIV to their infants, and providing appropriate early treatment and care for women living with HIV, their children and families.
Catalyze the next phase of treatment, care and support
Expand and optimize HIV treatment and care for children, adolescents and adults
Reduce co-infections and co-morbidities among people living with HIV.
Decrease the burden of tuberculosis for people living with HIV
Provide comprehensive and integrated services for key populations
Implement a comprehensive package of interventions to meet the needs of vulnerable populations
Ensure access to comprehensive services for sex workers, men who have sex with men and transgender people
Provide harm-reduction services for people who use drugs
Armin Hirbod-Mobarakeh

12. Strategic direction 2: Leverage broader health outcomes through HIV responses.
Strengthen links between HIV programs and other health programs
Strengthen HIV/tuberculosis collaborative activities
Strengthen linkages between HIV and maternal, newborn and child health services
Address sexual and reproductive health and rights
Link HIV and blood and injection safety programs
Armin Hirbod-Mobarakeh

13. Strategic direction 3: Build strong and sustainable systems.
Strengthen the six building blocks of health systems
Armin Hirbod-Mobarakeh

14. Strategic direction 4: Reduce vulnerability and remove structural barriers to access services
Promote gender equality and remove harmful gender norms
Collect gender-based health information
Include gender issues in the design, delivery and monitoring of health services.
Advance human rights and promote health equity
Ensure health in all policies, laws and regulations:
Health-related aspects of HIV should be considered in the development and review of policies, laws and regulations in other sectors
Armin Hirbod-Mobarakeh

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18. Thank you for your attention
Armin Hirbod-Mobarakeh