Lessons learned from the first European project on the integration of infectious diseases in testing services, data collection and country responses.

Despite the progress in effective treatments for HIV, viral hepatitis, tuberculosis and sexually transmitted infections (STIs), these infections remain major public health concerns across Europe. Recurring challenges of late presentation and unprioritized prevention programmes need to be effectively addressed in order to control and prevent transmission and ensure that people are diagnosed early and rapidly enter the care system. The prevalence of co-infections is high due to the social context of key populations and the shared modes of transmission, varying with local epidemiology, which underlines the need to combine efforts throughout the continuum of care

Implications of Carbon Markets for Implementing Circular Economy Models

Carbon markets have become a prominent policy innovation to internalize the external costs of fossil energy use. Cap and trade schemes, such as the European Union Emissions Trading System (EU ETS, launched in 2005), allocate tradable emissions allowances to facilities; and offset programs, such as the Kyoto Protocol’s Clean Development Mechanism, credit emissions reductions at the level of individual projects. In parallel, policymakers in various countries around the world are embarking on efforts to conceptualize and move towards closed loop “circular economy” models. This paper explores the implications of existing carbon markets for efforts to transform economies from a linear to a circular model, based on selected case studies that highlight issues related to achieving material, energy and water efficiency (e.g., end-of-life treatment of tires, incentive schemes for home appliances). Policy relevant insights are also presented. With a “gigaton gap” between emission reduction pledges currently put forward by all countries and the reductions necessary to have a reasonable chance of keeping global warming below 2°C, it is imperative to find effective means of achieving the structural changes that will lead to a low-carbon economy in time. Ironically, the improbability that an effective and comprehensive global climate protection strategy for the period beyond 2012 will be adopted in the near future presents a valuable opportunity to consider how market based mechanisms can be designed to drive, rather than hinder, the transition to a circular, low-carbon economy, as well as for leading countries to experiment with related policy innovations. Keywords: super-efficient home appliances, scrap tire recycling, resource efficiency, low-carbon economy, governance and policy coherenc

National medical specialty guidelines of HIV indicator conditions in Europe lack adequate HIV testing recommendations: a systematic guideline review

Background: Adequate identification and testing of people at risk for HIV is fundamental for the HIV care continuum. A key strategy to improve timely testing is HIV indicator condition (IC) guided testing. Aim: To evaluate the uptake of HIV testing recommendations in HIV IC-specific guidelines in European countries. Methods: Between 2019 and 2021, European HIV experts reviewed guideline databases to identify all national guidelines of 62 HIV ICs. The proportion of HIV IC guidelines recommending HIV testing was reported, stratified by subgroup (HIV IC, country, eastern/western Europe, achievement of 90-90-90 goals and medical specialty). Results: Of 30 invited European countries, 15 participated. A total of 791 HIV IC guidelines were identified: median 47 (IQR: 38-68) per country. Association with HIV was reported in 69% (545/791) of the guidelines, and 46% (366/791) recommended HIV testing, while 42% (101/242) of the AIDS-defining conditions recommended HIV testing. HIV testing recommendations were observed more frequently in guidelines in eastern (53%) than western (42%) European countries and in countries yet to achieve the 90-90-90 goals (52%) compared to those that had (38%). The medical specialties internal medicine, neurology/neurosurgery, ophthalmology, pulmonology and gynaecology/obstetrics had an HIV testing recommendation uptake below the 46% average. None of the 62 HIV ICs, countries or medical specialties had 100% accurate testing recommendation coverage in all their available HIV IC guidelines. Conclusion: Fewer than half the HIV IC guidelines recommended HIV testing. This signals an insufficient adoption of this recommendation in non-HIV specialty guidelines across Europe