Monitoring and responding to HIV and hepatitis C among people who inject drugs (PWID) is the focus of two new reports from the EU drugs agency (EMCDDA) and the European Centre for Disease Prevention and Control (ECDC). The reports are the result of two expert meetings organised by the agencies last autumn which brought together key stakeholders from the areas of drug monitoring and infectious disease surveillance (1).
The meetings had their roots in an ECDC–EMCDDA regional assessment of HIV trends, risks and prevention coverage among PWID conducted in mid-2013. This assessment had identified a low level of prevention coverage in at least one third of European countries, constituting a potential risk of increased HIV transmission among this group (2).
The first expert meeting held in Bucharest (18–19 November 2013) — Detecting and responding to outbreaks of HIV among PWID — provided an important opportunity for sharing knowledge and best practice among experts from six countries in the south and south-east of the European region (Cyprus, Greece, Hungary, Malta, Romania and Slovakia). The participants heard about the Greek response to an HIV outbreak among PWID, which started in 2011, and the subsequent scaling up of prevention interventions. This had been guided by monitoring data and research findings and resulted in significant progress in curbing the epidemic. Participants also discussed the situation in Romania, the second country to report an HIV outbreak since 2011. This outbreak has seen additional challenges associated with: high rates of co-infections; changing patterns of drug use among PWID; and the need to address funding gaps through a coordinated country-level response.
The second meeting, a regional Reitox Academy held in Tallinn (21–22 November 2013) — Monitoring trends in and responses to drug-related infectious diseases among people who inject drugs — contributed to maximising synergies at national level between institutions and experts in the fields of drug monitoring and infectious disease surveillance in four countries (Estonia, Latvia, Lithuania and Poland). The event helped participants from both fields to deepen their knowledge and mutual understanding of the situation; fostered joint initiatives at national level and further strengthened collaboration between neighbouring countries in the Baltic Sea region.
Both meetings acknowledged the critical role and added value of collaboration between the EU agencies in assessing risk and providing technical support to countries as well as in informing policies with evidence-based guidance (3).
Experts examined progress and defined common priorities regarding actions to be taken forward at national level (e.g. improvements in screening and prevention coverage) and recognised the key role of monitoring and surveillance for evaluating whether prevention efforts to are adequate to avert outbreaks.