HIV/AIDS treatment and care in Estonia: evaluation report June 2014

Abstract

This WHO country mission was performed in May 2014 to assess the achievements, strengths and shortcomings in the implementation of the Estonian national programme on HIV/AIDS treatment and care, and to generate strategic recommendations for improving key outcomes and impacts. The mission focused specifically on providing recommendations on the response of the health system to the many new HIV infections, on organization of procurement and provision of ART, and on improvement of prevention interventions. The mission found that HIV will remain a public health problem in the coming years in Estonia. This was echoed by all involved national stakeholders in the field. The epidemic is concentrated among people who inject drugs (‎PWID)‎, but there are signs that it is increasingly affecting the general population. A worrying observation is the tendency that people with HIV are diagnosed late, that a large share starts treatment late; and there are many examples of non‐adherence to treatment or long‐term treatment interruptions. The problem of linkage and retention in care, particularly for the PWID population, needs urgent attention. The current health care system is not functioning to an extent that provides the PWID community with adequate treatment options and support. This needs to be addressed as high a priority in order to halt the HIV epidemic.