Adolescents falling through gaps in HIV services

25 November 2013 | Geneva - More than 2 million adolescents between the ages of 10 and 19 years are living with HIV, and many do not receive the care and support that they need to stay in good health and prevent transmission. In addition, millions more adolescents are at risk of infection.

The failure to support effective and acceptable HIV services for adolescents has resulted in a 50% increase in reported AIDS-related deaths in this group compared with the 30% decline seen in the general population from 2005 to 2012.

Addressing the specific needs of adolescents

The WHO recommendations "HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV" are the first to address the specific needs of adolescents both for those living with HIV as well as those who are at risk of infection. They are being released in advance of World AIDS Day 2013 (1 December).

“Adolescents face difficult and often confusing emotional and social pressures as they grow from children into adults,” says Dr Gottfried Hirnschall, Director of WHO HIV/AIDS Department. “Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”

“Adolescents need health services and support, tailored to their needs. They are less likely than adults to be tested for HIV and often need more support than adults to help them maintain care and to stick to treatment.”

Dr Gottfried Hirnschall, Director of WHO HIV/AIDS Department

Across sub-Saharan Africa, many who were infected at birth are becoming adolescents. In addition to the many changes associated with adolescence, they also face the challenges of living with a chronic infection: disclosing the news to friends and family and preventing transmission to sexual partners.

“Adolescent girls, young men who have sex with men, those who inject drugs or are subject to sexual coercion and abuse are at highest risk. They face many barriers, including harsh laws, inequalities, stigma and discrimination which prevent them from accessing services that could test, prevent, and treat HIV,” says Craig McClure, Chief of HIV programmes for UNICEF. “About one-seventh of all new HIV infections occur during adolescence. Unless the barriers are removed, the dream of an AIDS-free generation will never be realized.”

Making it easier to know HIV status

Furthermore, many young people do not know their HIV status. For example, in sub-Saharan Africa, it is estimated that only 10% of young men and 15% of young women (15-24 years) know their HIV status and, in other regions, although data is scarce, access to HIV testing and counseling by vulnerable adolescents is consistently reported as being very low.

WHO recommends governments review their laws to make it easier for adolescents to obtain HIV testing without needing consent from their parents. The guidelines also suggest ways that health services can improve the quality of care and social support for adolescents. And they highlight the value of involving this age group to create an adolescent-centered approach to the services that work for people of their age.

Better equipping adolescents

“Young people need to be better equipped to manage their HIV infection and take ownership of their health care,” says Dr Elizabeth Mason, Director of WHO Maternal, Newborn, Child and Adolescent Health Department. “We have seen for example in Zimbabwe that, by developing adolescent friendly services, it is possible to achieve good treatment outcomes among adolescents. We urge others to be inspired by these examples.”

To help health workers put these recommendations into practice WHO has developed a new online tool which will be launched in January 2014. It uses practical examples from country programmes that are working closely with adolescents on HIV issues.

Note to editors

The guidelines provide recommendations and expert suggestions – mainly for policy-makers and national programme managers – on prioritizing, planning and providing HIV testing, counselling and care services for adolescents. Designed to be used with the recent WHO consolidated Antiretroviral guidelines, these new guidelines provide complimentary recommendations and guidance to support better provision of services to help adolescents remain in care and adhere to treatment.

The guidelines were developed based on scientific evidence, community consultations with adolescents and health workers, field experience of health workers and expert opinion. WHO led the development of these guidelines in collaboration with the United Nations Children’s Fund (UNICEF), the Global Network of People Living with HIV (GNP+), the United Nations Educational, Scientific and Cultural Organization (UNESCO), and the United Nations Population Fund (UNFPA).

For more information please contact:

Mr Glenn Thomas
Communications Officer, WHO
Telephone: +41 22 791 3983
Mobile: +41 79 509 0677
E-mail: thomasg@who.int

Rita Ann Wallace
UNICEF Media
Telephone: +1 212 326 7586
E-mail: rwallace@unicef.org

Iman Morooka
UNICEF Strategic Communications
Telephone: +1 212 326 7211
E-mail: imorooka@unicef.org

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Humanitarian emergencies, an opportunity for fresh start in providing sustainable, long-term mental health services

16 August 2013 | Geneva - Humanitarian agencies work hard to help people with their mental health and psychosocial needs in the aftermath of emergencies, but too often opportunities are missed to strengthen mental health systems for the long-term, according to a new World Health Organization (WHO) report, "Building back better: Sustainable mental health care after emergencies" released for World Humanitarian Day (August 19).

“In spite of their tragic nature, emergency situations are opportunities to improve the lives of large numbers of people through improving mental health services,” says Dr Bruce Aylward, WHO’s Assistant Director-General overseeing the Organization’s work in humanitarian emergencies. "We can do better for emergency-affected populations by working with the government on sustainable mental health care from the outset.”

The report provides guidance for strengthening mental health systems after emergencies and examples from Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, Somalia, Sri Lanka, Timor-Leste, and West Bank and Gaza Strip.

Contributors from each area report not only their major achievements, but also their most difficult challenges and how they were overcome. Key overlapping practices emerging from these experiences are summarized.

Findings from the report include:

• Indonesia (Aceh): Like many provinces in Indonesia, Aceh had only institution-based care before the tsunami of 2004. Today, most districts have primary mental health services supported by secondary care at district general hospitals.
• Iraq: Since 2004, significant progress has been made toward the creation of a comprehensive mental health system. More than 50% of general practitioners have received mental health training.
• Kosovo: Starting from a hospital-based model of care in 1999 after the conflict, a system of community-based mental health care is now available.
• Sri Lanka: Since the 2004 tsunami, a new national mental health policy has guided reform, which now extends to most parts of the country. Several new cadres of community-based mental health workers have been developed.
• Timor-Leste: Building from a complete absence of mental health services in 1999, the country today has a comprehensive community-based mental health system.

The possibilities presented by emergency situations are significant because major gaps remain worldwide in the realization of comprehensive, community-based mental health care.

“The current situation is alarming,” says Dr Shekhar Saxena, WHO Director for Mental Health. “Health systems have not yet adequately responded to the burden of mental disorders. We know that the vast majority of people with severe mental disorders receive no treatment whatsoever in low-income and middle-income countries.”

Transforming the mental health care systems in turn would improve the well-being, functioning, and resilience of individuals, societies, and countries recovering from emergencies, the report notes.

By releasing this report, WHO aims to help guide policymakers to reform their mental health systems, especially those which may be susceptible to future emergencies. Already in 2013, the world has witnessed numerous emergency situations, from the crisis in Syria and neighbouring countries to heavy fighting in Mali and the Central African Republic, major flooding in parts of the Americas, Africa, and Asia, and others.

For more information please contact:

Tarik Jasarevic
WHO Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 793 676 214
E-mail: jasarevict@who.int

View the original article here

Humanitarian emergencies, an opportunity for fresh start in providing sustainable, long-term mental health services

16 August 2013 | Geneva - Humanitarian agencies work hard to help people with their mental health and psychosocial needs in the aftermath of emergencies, but too often opportunities are missed to strengthen mental health systems for the long-term, according to a new World Health Organization (WHO) report, "Building back better: Sustainable mental health care after emergencies" released for World Humanitarian Day (August 19).

“In spite of their tragic nature, emergency situations are opportunities to improve the lives of large numbers of people through improving mental health services,” says Dr Bruce Aylward, WHO’s Assistant Director-General overseeing the Organization’s work in humanitarian emergencies. "We can do better for emergency-affected populations by working with the government on sustainable mental health care from the outset.”

The report provides guidance for strengthening mental health systems after emergencies and examples from Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, Somalia, Sri Lanka, Timor-Leste, and West Bank and Gaza Strip.

Contributors from each area report not only their major achievements, but also their most difficult challenges and how they were overcome. Key overlapping practices emerging from these experiences are summarized.

Indonesia (Aceh): Like many provinces in Indonesia, Aceh had only institution-based care before the tsunami of 2004. Today, most districts have primary mental health services supported by secondary care at district general hospitals.Iraq: Since 2004, significant progress has been made toward the creation of a comprehensive mental health system. More than 50% of general practitioners have received mental health training.Kosovo: Starting from a hospital-based model of care in 1999 after the conflict, a system of community-based mental health care is now available. Sri Lanka: Since the 2004 tsunami, a new national mental health policy has guided reform, which now extends to most parts of the country. Several new cadres of community-based mental health workers have been developed. Timor-Leste: Building from a complete absence of mental health services in 1999, the country today has a comprehensive community-based mental health system.

The possibilities presented by emergency situations are significant because major gaps remain worldwide in the realization of comprehensive, community-based mental health care.

“The current situation is alarming,” says Dr Shekhar Saxena, WHO Director for Mental Health. “Health systems have not yet adequately responded to the burden of mental disorders. We know that the vast majority of people with severe mental disorders receive no treatment whatsoever in low-income and middle-income countries.”

Transforming the mental health care systems in turn would improve the well-being, functioning, and resilience of individuals, societies, and countries recovering from emergencies, the report notes.

By releasing this report, WHO aims to help guide policymakers to reform their mental health systems, especially those which may be susceptible to future emergencies. Already in 2013, the world has witnessed numerous emergency situations, from the crisis in Syria and neighbouring countries to heavy fighting in Mali and the Central African Republic, major flooding in parts of the Americas, Africa, and Asia, and others.

Tarik Jasarevic
WHO Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 793 676 214
E-mail: jasarevict@who.int

View the original article here