Global AIDS Response Progress Reporting 2012 Civil Societys Complimentary Report about NCPI

Edited by: National Coordinating Committee of Associations against AIDS Associa (http://www.salute.gov.it/hiv/paginaDettaglioHiv.jsp?id=200&menu=consulta http://www.salute.gov.it/hiv/paginaDettaglioHiv.jsp?id=200&menu=consulta) Italian Civil Society Forum on HIV/AIDS (http://www.forumhivaids.it/) (

Dear Sirs, Through this complimentary report, we would like to add an overall evaluation about the themes examined by the Composit Policy Index. In the last two years, at a national level, there have been no implementation of the multisectorial strategy in response to 1 HIV/AIDS, as stated by the Three Ones principles about Coordination of National Responses to HIV/ AIDS. Themes regarding the implementation of the HIV infection surveillance, test access and prevention have been included in n 2 3 general programmatic acts, such as the National Sanitary Plan , and National Prevention Plan . Furthermore, there have been no cooperation plans between Ministries, nor common response strategies for HIV: in Italy, no agreement has been reached between institutions to start prevention programmes based on scientific evidences, and no actions aimed to protect the rights of vulnerable populations and PLHIV have been enforced. This probably happened because of the absence of a national strategic response plan for HIV/AIDS with clear, programmatic objectives and a dedicated budget: in absence of a strategic plan, no monitoring or evaluating initiatives strategic have been implemented. The AIDS Associations Committee of the Ministry of Health and the Italian Forum of Civil Society indicated their priorities about prevention, PLHIV rights and infections monitoring (epidemiological and behavioral surveillance) that were not implemented, too. The synergy between Ministry of Health and Regional Administrations (mostly Health Departments) was scarcely productive: some urgent recommendations, edited by National AIDS Commission and the National Coordinating Commission
Three Ones key principles Coordination of National Responses to HIV/AIDS Guiding principles for national authorities and their partners Three Ones" principles, to achieve the most effective and efficient use of resources, and to ensure rapid action and results-based management: One agreed HIV/AIDS Action Framework that provides the basis for coordinating the work of all partners. One National AIDS Coordinating Authority, with a broad broad-based multisectoral mandate One agreed country-level Monitoring and Evaluation System. level 2 "Piano Sanitario Nazionale PSN 3 "Piano Nazionale di Prevenzione PNP
1

Committee of Associations against AIDS and signed by the Italian Ministry of Health have been implemented by the Regional Administrations after long delays of several months, if ever, and their effects will be visible in the next years, like:

1. Solid Organs Transplant in HIV+ Patients Project, edited with the contribution of the National Transplant Center
(CNT), signed on 20 april 2011.
th

2. HIV Test Access, presented at the State/Regions Conference and signed on 27th July 2011. 3. Carcerary assistance for HIV+ People, presented at the State/Regions Conference and signed on 15th March
2012.

Even data collected by the Regional Administrations are forwarded to the central Institutions with strong delays, and often incomplete, so that the HIV epidemiological surveillance of the last two years only partially covered our Country. A regional collection of strategic core indicators, nationally coordinated by the Ministry of Health, has not been programmed so far. Behavioral surveillance is completely missing throughout the Country and, at the moment, is not even part of the future scheduling, so that the AIDS Associations Committee is implementing small, locally based projects, funded by the Italian Government to partially cover this gap. In the last two years, the Ministry of Health has enforced only one campaign, targeted to the general population, to promote the HIV testing: this initiative has been really expensive, but not proportionally effective, and - so far no evaluation has been made about its impact, even if this would evidently be necessary to schedule future initiatives. Furthermore, no data has been collected about the HIV tests, rendering substantially impossible to verify the actual state of accessibility to HIV Test in Italy (as well as the effectiveness of the national and local campaigns) and raising serious interrogatives about the published incidence curves. All of these elements have made the pragmatic discussion about the national effort against HIV/AIDS between Ministry of Health and Civil Society often conflictual, also because of the lack of information about the national budget expenditure and its repartition for the different categories (prevention, research, treatment). The Ministry of Health, however, expressed its commitment to fill on its side this gap. At an International level, Italy is part of the Esther Project, but has not yet implemented a financial recovery plan for the contribution for GFTAM not corresponded in 2009/2010, nor approved any commitment for 2011/2013. For all the reasons mentioned in this brief relation, our conclusion is that in the last biennium the Italian response to HIV/AIDS has not been adequately implemented at a national and international level.