Development of Community Action in Public Health

1. Drug use, Tuberculosis and HIV in the EU Public Health ProgrammeImp.Ac.T project Final conference22 November 2012,RomeCinthia Menel Lemoscinthia.menel-lemos@ec.europa.euExecutive Agency for Health and Consumers (EAHC)

2. Development of Community Action in Public Health Basis in Article 168 of the Treaty: incentive measures designed to protect and improve human health, in particular to combat the major cross-border health scourges, measures concerning monitoring, early warning of and combating serious cross-border threats, excluding any harmonisation of the laws and regulations of the Member States

3. Executive Agency Health Consumer (EAHC - Decision 2008/544/EC) Implements the EU Health Programme (2008-2013) - completion of the first programme (2003-2008) Management of the Programme Disseminates knowledge and best practices Fosters exchangeand co-ordination of the European communities of public health professionals The lifetime of the Agency has been extended for a period of 5 additional years until 31/12/2015 http://ec.europa.eu/eahc/health/index.html

4. Council Recommendation 2003/488/EC on the prevention and reduction of health-related harm associated with drug dependence • to set public health programmes for prevention of drug dependence and reduction of related risks and incidence of drug-related health damage • providing comprehensive substitution treatment • access for drug abusers in prison to services similar to those provided in the community (continuity of care); • promoting prevention and screening of HIV, hepatitis B and C, tuberculosis and sexually transmitted infections • provision of appropriate access to the distribution of condoms, needles and syringes and to exchange centres; • provision of emergency management of overdoses; http://europa.eu/legislation_summaries/justice_freedom_security/ combating_drugs/c11575_en.htm

5. Communication on combating HIV/AIDS in the EU and the neighbourhood - Second action plan (2009-2013) Priorities - Prevention • Evidence base and robust surveillance systems • Meaningful behavioural data to ensure that the key factors behind the epidemic are adequately addressed • Prevention linked to voluntary and counselled testing for HIV, universal access to treatment, care and support http://ec.europa.eu/health/ph_threats/com/aids/docs/com2009_en.pdf

6. Priorities - Most affected groups • Men who have sex with Men – MSM • Migrants from high prevalence countries • Injecting drug users- IDU IDU - Harm reduction • Unprejudiced treatment of drug users • Non criminalisation • Needle and syringe exchange in adequate settings including in prisons • Access and quality to HIV/AIDS care and co-infections (viral hepatitis and tuberculosis)

7. Priority regions - Eastern Europe and neighbourhood countries • development of specific programmes to improve the control of HIV/AIDS, particularly in Eastern Europe • use financial EU instruments to support health systems and to finance specific measures against the spread of HIV and associated infections • address HIV/AIDS in future negotiations on bi- and multilateral agreements with third countries where necessary • invite ENP countries to facilitate trans-national cooperation on all levels (Think tank and Civil Society Forum)

8. Priorityactions • Universal access to voluntary counselling and testing (VCT), treatment and care • Effective harm reduction • Prevention and integrated HIV, TB and co-infection treatment, including in prisons and other settings

9. TB and EU approach • The ECDC TB program work is guided by two key documents: • -Framework action plan to fight tuberculosis in the European Union-Progressing towards TB elimination: A follow-up to the framework action plan to fight tuberculosis in the European Union • Focus areas: • 1. Tuberculosis prevention and control • 2. Tuberculosis surveillance • 3. Tuberculosis laboratory • 4. New tools for tuberculosis • 5. Tuberculosis in vulnerable populations

10. Health Programme 2008 -2013 • 2008 WHO 2008 HR - Scaling-up access to high-quality harm reduction, treatment and care for injecting drug, WHO Europe Copenhagen (DK), http://www.euro.who.int/en/what-we-do/health-topics/communicable-diseases/hivaids/activities/ec-who-project-scaling-up-access-to-high-quality-harm-reduction/ec-who-grant-agreement-on-harm-reduction • 2008 MAIDS: Developing HIV/AIDS & Mental health Programs in the new EU countries (PL, EE, LV, LT, BU), AIDS Social AIDS Committee (PL), http://www.mentalhealthhiv.eu/en/index.html • 2008 Correlation II - European Network Social Inclusion and Health, Stichting De Regenboog MOC Inloophuizen AMOC (NL), www.correlation-net.org/ • HIV/AIDS and drug addiction prevention

11. 2006 - CONNECTIONS, Integrated responses to drugs and infections across European criminal justice systems, University of Kent (UK), http://www.connectionsproject.eu 2006 - Moretreat, Models of good practice in drug treatment in EC Strategic European Inventory on drugs, Univ. Medical Center Hamburg-Eppendorf (DE), http://www.gesundinhaft.eu/wp-content/uploads/2008/11/finalrep_moretreat081031.pdf 2006 - ACTIVATE, Capacity building and training in HIV/AIDS treatment and management across Europe, Fondazione PENTA (IT), http://www.eurocoord.net/collaborative_projects/activate.aspx 2007 - TCJP, Training Criminal Justice Professionals in Harm Reduction Services for Vulnerable Groups, implemented by Wissenschaftliches Institut der Ärzte Deutschlands (WIAD), http://www.tcjp.eu/LIVE/PAGES/project.html 2007 - European standards in evidence for drug prevention, Prevention Standards, by Liverpool John Moores University – LJMU (UK), http://www.cph.org.uk/drugprevention/ Health Programme 2003 -2008

12. 2009 - HIV-COBATEST, HIV Community based testing practices in Europe, Fundacion Institut d’Investigacion en Ciences de la Salut Germans Trias I Pujol (ES), http://www.cobatest.org/ • 2009 SRAP - Addiction prevention within ROMA and SINTI communities, Municipality of Bologna, http://www.efus.eu/en/topics/people/migrants-minorities/efus/258/ • 2009 HPYP- Health Promotion for Young Prisoners, Wissenschaftliches Institut der Ärzte Deutschlands gem. e.V.(WIAD), http://hpyp.eu/about.php • 2009 Imp.Ac.T - Improving Access to HIV/TB testing for marginalised groups, Fondazione Villa Mariani onlus (IT), http://www.projectimpact.eu • 2009 REDNET – Recreational Drugs European network:an ICT prevention services addressing the us of novel compounds in vulnerable individuals, University of Hertforddshire (UK), https://www.rednetproject.eu/ • Health Programme 2008 -2013

13. 2010 TUBIDU - Empower civil society and public health system to fight TB epidemic among vulnerable groups, Tervise Arengu Instituut - NIHD (EE), www.tai.ee/tubidu • 2010 New implementation - Nightlife Empowerment & Well-being Implementation Project (NEWIP), Asociación Bienestar y desarrollo ABD (ES), http://www.safernightlife.org/index.php • 2011 HIV and co-infections prevention strategies - concepts for the future, KIT (NL) • 2011 Current state of play of the 2003 Council Recommendation on the prevention and reduction of health-related harm, associated with drug dependence, in the EU and candidate countries, SOGETI (LU) • 2012 Joint Action on HIV prevention: to improve the effectiveness of HIV prevention programmes, under negotiation • Health Programme 2008 -2013

14. Thank you for your attention

15. EAHC Website and project database http://ec.europa.eu/eahc/projects/database.html http://ec.europa.eu/eahc/ Health Portal EU http://health.europa.eu SANCO Web Site http://ec.europa.eu/health/ EMCDDA website http://www.emcdda.europa.eu/ ECDCwebsite http://www.ecdc.europa.eu/ Further Information