HIV programme review in Georgia: March 2015

This WHO country mission conducted in March 2015 aimed to review three key components of the HIV/AIDS programme in Georgia: HIV treatment and care along the cascade of services; HIV services for key populations; and service delivery models for populations affected by the HIV epidemic from the perspective of the health system as well as review the draft new National Strategic Plan. This technical assistance was provided ahead of the submission of the Global Fund concept note, due on 20 April 2015. It follows a June 2014 WHO country mission carried out to assess the achievements, strengths and shortcomings in the implementation of the Georgian National HIV/AIDS Strategic Plan.Georgia has a concentrated HIV epidemic but is facing serious challenges in controlling it. In 2013, of the newly diagnosed HIV infections with information about transmission mode, 37% were transmitted through heterosexual contact, 29% through injecting drug use and 14% through sex between men. At the end of 2014, the number of people living with HIV in Georgia was estimated to be 6,800, and some 45% of these people were not aware of their status. The recommendations from the mission are presented as four priority areas: HIV testing, treatment, leadership and governance, services for key populations as well as suggestions for the revision of the National Strategic Plan.

HIV programme review in Armenia: March 2015

This WHO country mission conducted in January 2015 aimed to review five key components of the HIV/AIDS programme in Armenia: epidemiology; the HIV surveillance system; HIV treatment and care along the cascade of services; HIV services for key populations; and service delivery models for populations affected by the HIV epidemic from the perspective of the health system. Armenia has a low HIV prevalence overall with a concentrated epidemic specifically affecting people who inject drugs, migrant workers, men who have sex with men, and sex workers. According to 2014 data, an estimated 4,000 people are living with HIV in the country of whom fewer than two out of five are aware of their status and only one-third are linked to care. HIV and AIDS services are centralized at the National Centre for AIDS Prevention in the capital of the country and a key overarching recommendation for the country is to carefully fully or partially decentralize aspects of HIV prevention, treatment and care to reach those most in need including targeted testing to reach those unaware of their status. As a part of this process, additional training for health care providers as well as non-governmental organizations is needed and both stigma and discrimination will need to be addressed among health care providers and the general populations. Additional recommendations are made in this report for the rationalization of antiretroviral therapy regimens; expanded testing; the increased provision of opioid substitution therapy, and government supported needle and syringe programmes for people who inject drugs.

Bioethics in Ibero-America and the Caribbean

Bioethics has become a field of new challenges for Ibero-America and the Caribbean. A seeming uniformity in the region hides a rich heterogenous society. A brief survey of bioethical developments in different Ibero-American countries is provided as well as the bioethical problems and approaches peculiar to the region. Some of the unique features of bioethics in this region, it is suggested, could infuse new life into the U.S., and European bioethics discussion. Finally, a bibliography of Ibero-American bioethics literature is provided for North American and European readers (AU)

Medical ethics in Latin America: a new interest and commitment.

Recent visits to five Latin American nations indicate that some medical professionals are eager to increase the role of bioethics in their countries. Conversations with key figures there point up similarities and differences among Latin nations, and between Latin countries and the United States, in their approaches to ethics. Opportunities exist for U.S. bioethicists to help get bioethics teaching and research off the ground in Latin America.