VΙREAD is Associated With Long-Term, Irreversible Kidney Damage, Η ΧΡΗΣΗ ΤΟΥ VIREAD (ΤΕΝΟFOVIR) ΣΥΝΟΔΕΥΕΤΑΙ ΑΠΟ ΑΝΕΠΑΝΟΡΘΩΤΗ ΝΕΦΡΙΚΗ ΒΛΑΒΗ

By Courtney McQueen
Published: Feb 15, 2012 9:11 am


Αποτελέσματα μεγάλης σύγχρονης μελέτης επιβεβαιώνουν οτι το Viread (βασικό φάρμακο αντιρετροϊκής θεραπείας) συστατικό επίσης των φαρμάκων truvada και Atripla προκαλεί νεφρική βλάβη στους ανθρώπους με HIV.

Τα αποτελέσματα της μελέτης αποτελούν επίσης ένδειξη οτι η νεφρική βλάβη είναι μη αναστρέψιμη.

Οι συγγραφείς συνιστούν οι ασθενείς να γνωρίζουν την κατάσταση λειτουργίας των νεφρών τους πριν την ένταξη του viread στη φαρμακευτική αγωγή τους.

Για τους ασθενείς που δεν έχουν κάποιο πρόβλημα νεφρικής βλάβης το φάρμακο μπορεί να χρησιμοποιηθεί.

Προηγούμενες μελέτες έχουν αναδείξει οτι τα άτομα με HIV έχσουν μεγαλύτερη πιθανότητα εμφάνισης νεφρικής βλάβης αφου τόσο τα αντιρετροϊκά όσο και και η ίδια η HIV λοίμωξη μπορούν να προκαλέσουν νεφρική βλάβη.

Viread Is Associated With Long-Term, Irreversible Kidney Damage

Results from a recent large study confirm that Viread, which is also a component of Truvada and Atripla, causes kidney damage in people with HIV.
The results also indicate that the kidney damage increases with each year of exposure and is irreversible.

Based on the results, the study authors recommended frequent kidney function monitoring for people who take Viread, Truvada, or Atripla.

They also suggested that people who already have kidney problems may need to consider other antiretrovirals.

“Patients need to be aware of their kidney disease risks before they start therapy, and this should influence the medications that they choose in consultation with their doctor,” said Dr. Michael Shlipak, a professor of medicine at University of California, San Francisco and lead author of the study, in a press release.


“For an otherwise healthy patient, the benefits of [Viread] are likely to exceed the risks, but for a patient with a combination of risk factors for kidney disease, [Viread] may not be the right medication,” he added.

“We do not know the long-term prognosis for… patients who stop [Viread] after developing kidney disease.”

Previous research has indicated that people with HIV are more prone to kidney disease than people without HIV, because both antiretrovirals and the HIV virus, which can infect and kill kidney cells, can damage the kidneys (for more information on kidney disease in people with HIV, see related AIDS Beacon news).

Viread (tenofovir), in particular, has been associated with loss of kidney function (see related AIDS Beacon news).
Viread is a nucleoside reverse transcriptase inhibitor that can be prescribed separately or as component of Atripla (efavirenz/emtricitabine/tenofovir) or Truvada (emtricitabine/tenofovir).

According to the study authors, Viread’s role in causing kidney disease is still controversial, as not all studies have found evidence that Viread causes kidney damage.
The authors hypothesized that this discrepancy may be due to varying patient populations (for example, patients with more or less pre-existing kidney damage) or other factors.

In this study, the researchers set out to definitively determine whether Viread use over time is associated with kidney damage. The study included 10,841 HIV-positive United States veterans who started antiretroviral therapy for the first time between 1997 and 2007.

The average participant age was 46 years old. Almost all participants (98 percent) were male and just under half (49 percent) were African-American.

Researchers measured participants’ kidney function and HIV-related outcomes, such as viral loads (amount of HIV in the blood) and CD4 (white blood cell) counts.

They also measured their blood pressure and blood glucose levels, since high blood pressure and diabetes can also lead to kidney damage.

Results showed that each year of Viread use was associated with a 30 percent higher risk of having abnormally high levels of protein in the urine, a sign of kidney damage. In addition, each year of Viread use increased the risk of a rapid decline in kidney function by 11 percent and increased the risk for chronic kidney disease by 33 percent.

Any exposure to Viread was associated with about a 50 percent increased risk of high levels of protein in the urine, rapid kidney function decline, and chronic kidney disease.

There was no evidence that taking Viread with protease inhibitors, non-nucleoside reverse transcriptase inhibitors, or the antiretroviral boosting agent Norvir (ritonavir) increased the risk of kidney damage.

Results also showed that stopping Viread did not decrease the risk of abnormal protein in the urine or rapid loss of kidney function, although it did slightly decrease the risk for chronic kidney disease.
The study authors concluded that damage caused by Viread is likely irreversible.

Various types of kidney damage were more or less likely after certain lengths of time taking Viread.
For example, risk of abnormally high levels of protein in the urine was higher in study participants who had taken Viread for more than three years, while risk of rapid decline in kidney function decreased after three years.

Traditional risk factors for kidney disease, such as high blood pressure and diabetes, did not increase the risk of Viread-induced kidney damage.

For more information, please see the study in the journal AIDS (abstract) or the press release from the University of California, San Francisco.

ΔΙΚΑ ΜΑΣ ΣΧΟΛΙΑ:

Το viread της φαρμακευτικής εταιρείας GILEAD, φαίνεται πως παρά την επιτυχία του και τα πολλά κέρδη που προσέφερε στην εταιρεία παραγωγής του,
έχει μια αμαρτωλή προϊστορία.

Μελέτη με 1.000 εκδιδόμενα άτομα είχε ξεκινήσει στην Καμπότζη από ερευνητές του πανεπιστημίου της Καλιφόρνια Σαν Φραντσίσκο με χρηματοδότηση του Eθνικου Ινστιτούτου Υγείας (ΝΙΗ) των ΗΠΑ και του πανεπιστημίου της Νεας Ν. Ουαλίας.

Οι μισές από τις γυναίκες θα έπαιρναν Viread και
οι άλλες μισές ένα πλασματικό φάρμακο (placebo).

Ενα χρόνο αργότερα οι ερευνητές θα συνέκριναν (ανερυθρίαστα) τις δύο ομάδες.
Μελη των τοπικών ομάδων εκδιδομένων γυναικών αρνήθηκαν να συμμετάσχουν.

Ακτιβιστές στο Παγκόσμιο Συνέδριο AIDS στην Μπαγκόνγκ διαμαρτυρήθηκαν επίσης λέγοντας πως οι εκδιδόμενες ήταν αντικείμενα εκμετάλλευσης.

Οι διαδηλωτές καθοδηγούμενοι από την ACT UP PARIS κατηγόρησαν τους ερευνητές για σκόπιμη ανεπαρκή εκπαίδευση των εθελοντών προκειμένου να εξυπηρετηθεί η μελέτη.


Δέστε το σχετικό δημοσίευμα της εποχής:

Tue, Aug. 03, 2004
Cambodia Prime Minister Opposes Testing Anti-HIV Drug
by KER MUNTHIT, Associated Press

PHNOM PENH, Cambodia - Prime Minister Hun Sen said Tuesday he opposes the testing of drugs on Cambodians, a position that could derail a planned trial for an anti-AIDS medicine here.

His remarks seemed directed at a test, partially funded by the Bill and Melinda Gates Foundation, of the drug Tenofovir DF by the California-based biotech company Gilead Sciences Inc.

"Please, don't use Cambodians for (any drug) trial," Hun Sen said at a groundbreaking ceremony for a hospital, noting that his country had been selected to test AIDS medication. "If a trial is needed, please do it on animals, and don't use Cambodians."

Hun Sen did not single out any project, but his remarks come amid a controversy on the ethics of testing Tenofovir, called Viread DF by Gilead Sciences Inc., in Cambodia.

The study, which seeks to recruit almost 1,000 sex workers, is being conducted by researchers from the University of California San Francisco with funding from the U.S. National Institutes of Health, and the University of New South Wales.

Half those volunteers in the Cambodia experiment will be given Viread, and the others will take a placebo. A year later, researchers will compare the two groups to determine if significantly fewer volunteers taking Viread were infected with HIV than those receiving the dummy pill.

Members of a local sex workers' rights group, Women Network for Unity, said in March they would refuse to participate, citing a lack of insurance against potential side effects.

Activists at last month's International AIDS conference in Bangkok also protested the test, saying the prospective participants were being exploited.

The protesters, led by the AIDS activist group Act Up, accused the researchers of purposely providing insufficient prevention education to the volunteers because it needs infection data to analyze Viread's potential to protect against the virus.

The protesters also demanded that the company take care of the lifetime medical needs of any volunteers who contract AIDS during the experiment - partially funded by the Bill and Melinda Gates Foundation.

The study was approved by the ethics council of Cambodia's Health Ministry last year, but has not yet formally started, said Khol Vohith, a research officer at Cambodia's National Center for HIV/AIDS, Dermatology and Sexually Transmitted Diseases.

Saphonn Vonthanak, a chief of the center's research unit, said he heard about Hun Sen's remarks but was unable to comment on them or say if the Cambodian leader was referring to the Viread study. He said the center would seek clarification.

Cambodia's current HIV infection rate is 2.6 percent among people of 15-49 age group, the highest in Southeast Asia.

Women Network for Unity welcomed Hun Sen's remarks, saying he was "defending the interests of the Cambodian people."

"I'm very glad with what the prime minister has said. I wish for the study to fail, and I will get our girls together to celebrate when it actually fails," said Sou Sotheavy, one of the group's leaders.


from ACT UP/Paris
http://medilinkz.org/central-africa/cameroon/12040.html

Novartis Sues Indian Government over Health Safeguards in Indian Patent Law

ΕΠΕΙΓΟΝ !!!
H novartis ΜΗΝΥΕΙ την Ινδική κυβέρνηση για τον Ινδικό νόμο για τις Φαρμακευτικές Πατέντες

ΕΡΩΤΗΣΗ ΔΙΚΗ ΜΑΣ
ΑΝ ΚΕΡΔΙΣΕΙ Η ΦΑΡΜΑΚΟΒΙΟΜΗΧΑΝΙΑ Η ΕΛΛΗΝΙΚΗ ΚΥΒΕΡΝΗΣΗ ΘΑ ΜΠΟΡΕΣΕΙ ΠΟΤΕ ΝΑ ΥΠΟΣΤΗΡΙΞΕΙ ΤΟ ΕΛΛΗΝΙΚΟ ΓΕΝΟΣΙΜΟ - ΓΕΝΕΡΙΚΟ ΦΑΡΜΑΚΟ... ΓΙΑ ΤΟ ΟΠΟΙΟ ΠΡΟΣΠΑΘΟΥΝ ΝΑ ΜΑΣ ΠΕΙΣΟΥΝ ΟΤΙ ΚΑΝΟΥΝ ΤΑ ΠΑΝΤΑ...?

48 HOURS OF ACTION // 22-23 FEBRUARY 2012
48 ώρες δράσης // 22-23 Φεβρουαρίου 2012

publié en ligne: 18 February 2012

Η Ελβετική φαρμακοβιομηχανία novartis συνεχίζει να μηνύει τις κυβερνήσεις αναπτυσσόμενων χωρών για τη στάση τους στη νομοθεσία για την πατέντα.

Το 1999 η Novartis μαζί με άλλες φαρμακευτικές εταιρείες μήνυσαν την κυβέρνηση της Ν. Αφρικής για τον ίδιο λόγο.

Από το 2006 μηνύουν την Ινδική κυβέρνηση για το νόμο περί πατέντας.
Η Ινδία προσφέρει γενερικά φάρμακα σε όλο τον αναπτυσσόμενο κόσμο και στους ανθρώπους με HIV/AIDS.

H Novartis δεν πέτυχε την έγκριση πατέντας για ένα αντινεοπλασματικό φάρμακο και τώρα επιτίθεται στην Ινδική κυβέρνηση.
Εάν επιτύχει, αυτό ΘΑ ΣΥΜΠΑΡΑΣΥΡΕΙ ΚΑΙ ΤΑ ΑΛΛΑ ΓΕΝΕΡΙΚΑ ΦΑΡΜΑΚΑ, ΑΡΑ ΚΑΙ ΤΑ ΦΑΡΜΑΚΑ ΓΙΑ ΤΟ HIV/AIDS.

H εταιρεία έχει χάσει την πρώτη δίκη ενάντια στην Ινδική κυβέρνηση.
Στις 28 Φεβρουαρίου το ανώτατο δικαστήριο της Ινδίας θα δικάσει την υπόθεση της Νοvartis.

Το 2011 η εταιρεία είχε πωλήσεις άνω των 54 εκ δολλαρίων.
Ενώ τα κέρδη της μεγαλώνουν μηνύει τη Ινδική κυβέρνηση.
Καθώς οι φίλοι μας στην Ινδία αγωνίζονται ομάδες σε όλο τον κόσμο θα διαδηλώνουν 22-23 Φεβρουαρίου για να στείλουν στην Novartis ένα σαφές μήνυμα:

Η επίθεση στον Ινδικό νόμο για τα γενερικά φάρμακα πρέπει να σταματήσει τώρα!

Τα φάρμακα που παράγονται στην Ινδία είναι το ίδιο αποδοτικά με εκείνα των Δυτικών χωρών.
Η δυσφήμιση των γενερικών φαρμάκων που έχουν παραχθεί και ελεγχθεί και από την WHO, εξυπηρετεί MONAXA τα κέρδη των φαρμακευτικών πολυεθνικών εταιρειών και των συνοδοιπόρων τους.

Αντιδράστε άμεσα.!
Γυρίστε κάποιο μικρό video με ένα πλακάτ με μήνυμα κατά της Novartis και στείλτε το στο mail της ACT UP BASEL actupbasel@gmail.com, προκειμένου να το ανεβάσει στο site της.


Μπορείτε επίσης να χρησιμοποιήσετε και όλα τα άλλα μέσα δικτύωσης και επικοινωνίας.
ΑΚΟΛΟΥΘΟΥΝ ΤΡΟΠΟΙ ΠΟΥ ΜΠΟΡΕΙΤΕ ΝΑ ΕΠΙΚΟΙΝΩΝΗΣΕΤΕ:
• CLICK IT: If you cannot make a video, send us your photo with your message for Novartis. (please send the photo and message to: actupbasel@gmail.com)
• SIGN IT: Avaaz is aiming to get 100,000 signatures on the Novartis Case. Sign the petition here and get everyone you know to sign too.

• TWEET IT : Join the MSF campaign and tweet your message using #STOPnovartis or take action here

• WALK IT: If there is a Novartis Office in your country, organise your own demonstrations and send them your own message.

• TALK IT: Even though you might not be able to support the demonstrations you can help us by spreading the word about the Novartis case. Write an editorial in your local paper. Hold a press conference. Issue a press release or press statement.

• SHARE IT: PLEASE send us photos, articles, videos of all your actions immediately (actupbasel@gmail.com ) and FOLLOW the actions of other groups here:

• WATCH IT: in English and in German.

• READ IT: Read about the Novartis and its US/EU surrogates triple punch to Indian generics here.
More resources at the end of this alert.


Διαβάστε το άρθρο και ενεργοποιηθείτε τώρα!!!

Swiss MultinationalPharmacuetical company Novartis is continuing its tradition of suing developing country governments for their pro-health patent laws.

In 1999, Novartis along with other pharmaceutical companies sued the South African government over pro-health amendments in their patent law.

Since 2006, they have been suing the Indian government over the health safeguards (Section 3d) in its patentlaw.
India supplies generic medicines across the developing world and health and PLHIV groups in India have been using Section 3(d) of the Indian law to ensure that key medicines stay off-patent.

Novartis did not get a patent in India on a cancer medicine and wants this law (Section 3d) weakened.

BUT THIS WILL IMPACT ALL OTHER GENERIC MEDICINES AS WELL.
Novartis is suing the Indian government and cancer patients.
It lost its first case in a lower court in India.
Now it’s before the Indian Supreme Court.
On the 28th of February 2012, the Indian Supreme Court will hear the Novartis case. Read about the case in the Background below.

48 Hours of Action: 22-23 February, 2012
On 23 February, a few days before the hearing in the Indian Supreme Court, Novartis’ shareholders are meeting in Basel at their Annual General Meeting (AGM).

In 2011, Novartis recorded more than $54 billion in sales and is one of the biggest pharmaceutical companies in profits.

While its profits are still increasing, the firm is suing the government of India.
As our friends in India gear up to fight this legal battle, groups around the world will be demonstrating on 22 and 23 February 2012 to coincide with the day of the Novartis AGM to send Novartis a clear message:
THE ATTACK ON THE INDIAN LAW AND ON GENERIC MEDICINES MUST STOP NOW!

JOIN US! WHAT can YOU DO?

• RECORD IT:
Send us a 30 second to 1 minute video—if possible holding a visual/poster against Novartis.
Record your message to Novartis or explain the consequences of the Novartis case for your life and for access to medicines in your country. Your video will be streamed on the ACTUP Basel website and will be used in demonstrations on the 22nd and 23rd of February.

Please send the video to: actupbasel@gmail.com by 21 February;

Tips: Record your video from your cell-phone or camera, upload it and΅email it to us! OR

If you have skype, write to us and we can help you record your message.

Write to actupbasel@gmail.com with your skype name if you are interested.

• CLICK IT: If you cannot make a video, send us your photo with your message for Novartis. (please send the photo and message to: actupbasel@gmail.com)
• SIGN IT: Avaaz is aiming to get 100,000 signatures on the Novartis Case. Sign the petition here and get everyone you know to sign too.

• TWEET IT : Join the MSF campaign and tweet your message using #STOPnovartis or take action here.

• WALK IT: If there is a Novartis Office in your country, organise your own demonstrations and send them your own message.

• TALK IT: Even though you might not be able to support the demonstrations you can help us by spreading the word about the Novartis case. Write an editorial in your local paper. Hold a press conference. Issue a press release or press statement.

• SHARE IT: PLEASE send us photos, articles, videos of all your actions immediately (actupbasel@gmail.com ) and FOLLOW the actions of other groups here:

• WATCH IT: in English and in German.

• READ IT: Read about the Novartis and its US/EU surrogates triple punch to Indian generics here. More resources at the end of this alert.

BACKGROUND
What is the Novartis case in India about?
Novartis patented the molecule imatinib in 1993. A
fter the signing of the WTO TRIPS agreement by India in 1995, Novartis filed another patent application on the mesylate salt form of imatinib in 1998 at the Indian patent office.

In 2005 India amended its patent law to comply with the WTO TRIPS agreement but also included Section 3(d) an important health safeguard thatdoes not allow companies to get patents on new forms of old medicines.

Novartis’ application was rejected by the Indian patent office on several grounds including that the application claimed a new form of an already existing medicine.

The company then sued the Indian Government, cancer patients and several generic companies in order to get its patent monopoly on imatinib mesylate and wanted Section 3(d) knocked out of the patent law.

When it failed to do this in a lower court, it has now gone to the Indian Supreme Court to try and change the interpretation of Section 3(d).

In essence, Novartis wants section 3(d), which requires stringent evidence of proof of significantly enhanced therapeutic efficacy if a modification of an existing pharmaceutical entity is to receive new patent protection, to be reinterpreted to allow routine “ever-greening” of minor modifications to existing medicines resulting in additional 20-year patent monopolies.

Imatinib Mesylate: Novartis: $2500 per person per month Generics: $200 per person per month

What if Novartis wins this case?
If Novartis wins this case, the ability of India to produce cheap generic medicines will be severely affected as it will set a precedent for all future patent applications.

India is known as the ‘Pharmacy of the developing world’ for producing and supplying affordable generic drugs to more than 150 developing countries in Asia, Africa and Latin America.

In particular, India supplies nearly 80% of the medicines used to treat over seven million people living with HIV/AIDS in developing countries. India’s capacity to provide affordable drugs across all disease categories can be seriously undermined by victory of Novartis in this court case.

Novartis through its press statements, continues to assert that access to medicines is not impacted by the granting of patent for a new medicine.
The company stresses that it is simply about availability of medicines not affordability.
But they are wrong.
In the ordinary course of events, obtaining a patent gives the right holder authority to exclude others from making the patented product or using a patented process hat right toexclude in turns gives rise to monopoly pricing power, especially in the pharmaceutical contexts.

Big Pharma companies price their medicines at exorbitant rates catering only to elite group to make more profits instead of selling larger quantities at lower prices that poor people and poor countries might afford.

In economic jargon, these excluded patients are called a dead-weight cost – in the real world, they are merely called dead.

Resources on the Novartis Case
Lawyers Collective
Cancer Patients Aid Association
Berne Declaration
Act-Up basel
Health Gap
Oxfam
MSF
Treatment Action Campaign
Novartis Boycott

HIV and Pregnancy, HIV και ΕΓΚΥΜΟΣΥΝΗ, Δε χρειαζόμαστε Σύγχρονες ΣΠΙΝΑΛΟΓΚΕΣ για τις Μητέρες με HIV+

Επικαιροποίηση του υλικού «HIV και εγκυμοσύνη» από τις ΗΠΑ.

Είναι πληροφορίες σε απλή γλώσσα για τις HIV (+) γυναίκες που είναι έγκυοι ή σκέφτονται να κάνουν παιδί.

H επικαιροποίηση έλαβε υποψη της την τελευταία εκδοχή των Οδηγιών για τη χρήση των αντιρετροϊκών φαρμάκων σε γυναίκες HIV+ και των αναγκαίων παρεμβάσεων προκειμένου να μειωθείη περιγεννητική μετάδοση του HIV στις ΗΠΑ.

Δικό μας σχόλιο:

Το νέο ίσως στο εν λόγω κείμενο αφορά στην οδηγία αποφυγής της καισαρικής τομής για τον τοκετό οροθετικών γυναικών με την προϋπόθεση επίτευξης αρνητικού ιϊκού φορτίου της μητέρας πριν τον τοκετό.

Νέο δεν είναι είναι,
αλλά είναι καλό να θυμόμαστε οτι οι HIV+ γυναίκες έχουν δικαίωμα στη μητρότητα και δεν έχουν ανάγκη ειδικών μονάδων για να γεννάνε.

ΟΛΟΙ οι γιατροί οφείλουν να τις ξεγεννάνε.

Μέχρι τώρα στην Ελλάδα έτσι γεννάνε σε κρατικά αλλά και σε μη κρατικά νοσοκομεία, έστω με κάποια δυσκολία.

Αυτό οφείλει να είναι το αίτημα των ίδιων των οροθετικών γυναικών και κυρίως των οργανώσεων που ασχολούμαστε με το HIV/AIDS:

Το απλό συνταγματικά κατοχυρωμένο δικαίωμά τους ίσης πρόσβασης στις υπηρεσίες υγείας..
Δε χρειαζόμαστε Σύγχρονες ΣΠΙΝΑΛΟΓΚΕΣ για τις Μητέρες με HIV+
Παρατίθεται το υλικό από το AIDS info:

The AIDSinfo fact sheet series “HIV and Pregnancy” was recently updated.
These easy-to-understand fact sheets are intended for women infected with HIV who are pregnant or thinking about becoming pregnant.
The series was updated based on the latest version of the Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States


FACT SHEETS
HIV and Pregnancy
These fact sheets on HIV and pregnancy are intended for women infected with HIV who are pregnant or thinking about becoming pregnant.

The fact sheets include information to help women infected with HIV stay healthy during pregnancy and reduce the risk of transmitting HIV to their babies.
The information in these fact sheets is based on the Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1- Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States.

THe Guidelines are developed by the U.S. Department of Health and Human Services (HHS) Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission, a working group of the Office of AIDS Research Advisory Council (OARAC).

The Guidelines are updated according to the latest advances in the management of HIV in pregnant women and the prevention of mother-to-child transmission of HIV.
The current Guidelines are available on the AIDSinfo website at http://aidsinfo.nih.gov/guidelines.

These fact sheets are not intended as a substitute for the expert advice and care of medical professionals.
For individualized treatment, pregnant women infected with HIV should consult with a health care provider experienced in managing HIV during
pregnancy.

Table of Contents
1. HIV Testing and Pregnancy
2. Mother-to-Child Transmission of HIV
3. Anti-HIV Medications for Use in Pregnancy
4. Safety of Anti-HIV Medications During Pregnancy
5. Preventing Transmission of HIV During Labor and Delivery
6. Women Infected with HIV and eir Babies After Birth

HIV and Pregnancy – HIV Testing and Pregnancy

I am pregnant. Will I be tested for HIV?
HIV testing is recommended for all pregnant women.
HIV testing is provided to pregnant women in two ways: opt-in
or opt-out testing.
In areas with opt-in testing, women may be offered HIV testing.
Women who accept testing will need to sign an HIV testing consent form.
In areas with opt-out testing, HIV testing is automatically included as part of routine prenatal care. With opt-out testing, women must specifically ask not to be tested and sign a form refusing HIV testing.
The Centers for Disease Control and Prevention (CDC) recommends that opt-out testing be provided to all pregnant women.
Ask your health care provider about HIV testing in your area.
If HIV opt-out testing is not available, ask to be tested for HIV.

What are the benefits of HIV testing for pregnant women?
A mother who knows early in her pregnancy that she is HIV infected has more time to make important decisions.
She and her health care provider will have more time to decide on effective ways to protect her health and prevent mother-tochild transmission of HIV. She can also take steps to prevent passing HIV to her partner. (See the Preventing HIV Transmission fact sheet.)

How will I be tested for HIV?
The most common HIV test is the HIV antibody test.
HIV antibodies are a type of protein the body produces in response to HIV infection. An HIV antibody test looks for HIV antibodies in a person’s blood, urine, or fluids from the mouth.
When a person has a positive result from an HIV antibody test, a second and different type of antibody test is done to confirm that the person is indeed infected with HIV.
The second test is called a confirmatory HIV test. To be diagnosed with HIV, a person’s confirmatory HIV test must also be positive. (For more information, see the Testing for HIV fact sheet.)

Getting results from an HIV antibody blood test generally takes only a few days. (Results from some tests that use fluids from the mouth are ready within an hour.) Getting results from a confirmatory HIV test can take longer—from a few days to a few weeks after the test.
People generally receive their results during a follow-up visit with a health care
provider.
It is important to keep your appointment for your HIV test results.
Pregnant women who test positive for HIV have many options to stay healthy and protect their babies from becoming HIV infected.
Health care providers recommend that women infected with HIV take anti-HIV medications to prevent mother-to-child transmission of HIV and, if needed, for their own health.

If you are diagnosed with HIV, your health care provider will answer your questions about HIV and discuss ways to help you and your baby stay healthy.
Together you can make decisions about HIV care during your pregnancy.

What happens if I ask not to be tested for HIV?
You will not be tested for HIV. However, your health care provider will likely re-emphasize the importance of HIV testing.
You may be offered counseling on how HIV is spread and ways to prevent HIV transmission.
Throughout your pregnancy, your health care provider may encourage you to
reconsider your decision not to be tested.

Where can I find information on HIV testing in my state?
The U.S. Department of Health and Human Services (HHS) offers information on HIV testing for each state. Contact HHS at 1–877–696–6775 or 1–202–619–0257. You can also
find information on your state health department website.

For more information:
Contact an AIDSinfo health information specialist at 1– 800–448–0440 or visit http://aidsinfo.nih.gov.
See your health care provider for medical advice.

HIV Testing and Pregnancy
Terms Used in This Fact Sheet:
Mother-to-child transmission of HIV: the passing of HIV from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding.
HIV antibody test: an HIV test that checks for HIV antibodies in a person’s blood, urine, or fluids from the mouth.
When the body is infected with HIV, the immune system (the system of the body that fights off infections) produces HIV antibodies.


How is HIV transmitted?
HIV is transmitted (passed) from one person to another through specific body fluids—blood, semen, genital fluids, and breast milk.
Having unprotected sex or sharing needles with a person infected with HIV are the most common ways HIV is transmitted.

Mother-to-child transmission of HIV is when a woman infected with HIV transmits HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding.
Because HIV can be transmitted through breast milk, women infected with HIV should not breastfeed their babies.
In the United States, baby formula is a safe and healthy alternative to breast milk.

Although the risk is very low, HIV can also be transmitted toa baby through food that was previously chewed (prechewed) by a mother or caretaker infected with HIV. To be safe, babies should not be fed pre-chewed food.
HIV cannot be transmitted through casual contact, such as hugging and closed-mouth kissing.

HIV also cannot be transmitted by items such as toilet seats, door knobs, or
dishes used by a person infected with HIV.

When are anti-HIV medications used to prevent mother-to-child transmission of HIV?
Anti-HIV medications are used at the following times to reduce the risk of mother-to-child transmission of HIV:
• During pregnancy, pregnant women infected with HIV receive a regimen (combination) of at least three different anti-HIV medications.
• During labor and delivery, pregnant women infected with HIV receive intravenous (IV) AZT and continue to take the medications in their regimens by mouth.
• After birth, babies born to women infected with HIV receive liquid AZT for 6 weeks. (Babies of mothers who did not receive anti-HIV medications during pregnancy may be given other anti-HIV medications in addition to AZT.)

In addition to taking anti-HIV medications to reduce the risk of mother-to-child transmission of HIV, a pregnant woman infected with HIV may also need anti-HIV medications for her own health.
Some women may already be on a regimen before becoming pregnant.
However, because during pregnancy some anti-HIV medications may not be safe to use or may be absorbed differently by the body, the medications in a woman’s regimen may change.

How do anti-HIV medications help prevent mother-to-child transmission of HIV?
Taking anti-HIV medications during pregnancy reduces the amount of HIV in an infected mother’s body.
Having less HIV in the body reduces the risk of mother-to-child transmission
of HIV.

Some anti-HIV medications also pass from the pregnant mother to her unborn baby through the placenta (also called the afterbirth).
Τηe anti-HIV medication in the baby’s body helps protect the baby from HIV infection.
Τηis is especially important during delivery when the baby may be exposed to HIV in the mother’s genital fluids or blood.

After birth, babies born to women infected with HIV receive anti-HIV medication.
Τηe medication reduces the risk of infection from HIV that may have entered the babies’ bodies during delivery.

For information on what anti-HIV medications to take during pregnancy, see the Anti-HIV Medications for Use in Pregnancy fact sheet.

For more information:
Contact an AIDS info health information specialist at 1– 800–448–0440 or visit http://aidsinfo.nih.gov.
See your health care provider for medical advice.

Mother-to-Child Transmission of HIV
Terms Used in This Fact Sheet:
Unprotected sex: sex without using a condom.
Mother-to-child transmission of HIV: the passing of HIV from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding.
Regimen: Anti-HIV medications are grouped into “classes” according to how they fight HIV. A regimen is a combination of three or more anti-HIV medications from
at least two different classes.
Intravenous (IV): to give a medication through a needle directly into a vein.
AZT: an anti-HIV medication in the nucleoside reverse transcriptase inhibitor (NRTI) class. AZT is also called zidovudine, Retrovir, or ZDV.
Placenta (also called the afterbirth): tissue that develops within the mother’s uterus during pregnancy to provide the baby with oxygen and nutrition.


I am HIV infected and pregnant. When should I start taking anti-HIV medications?
When to start taking anti-HIV medications depends on your health, how much HIV has affected your body, and how far along you are in your pregnancy.
In general, people infected with HIV who are not pregnant begin taking anti-HIV medications when their CD4 counts fall below 500 cells/mm3 orif they develop certain other infections.
(See the When to Start Anti-HIV Medications fact sheet.)
Pregnant women infected with HIV must also consider whether they need anti- HIV medications for their own health or only to prevent mother-to-child transmission of HIV.

Women who need anti-HIV medications for their own health:
• may be taking anti-HIV medications before becoming pregnant; or
• may start taking anti-HIV medications when they become pregnant.

Women who need anti-HIV medications only to prevent mother-to-child transmission of HIV can consider waiting until after the first trimester of pregnancy to take anti-HIV medications. However, starting medications earlier may be
more effective at reducing the risk of mother-to-child transmission
of HIV.

All pregnant women infected with HIV should be taking anti-HIV medications by the second trimester of pregnancy.
Women diagnosed with HIV later in pregnancy should start taking anti-HIV medications as soon as possible.

What anti-HIV medications should I use during my pregnancy?
All pregnant women infected with HIV should take a regimen (combination) of at least three anti-HIV medications.
However, the specific medications in your regimen will depend on your individual needs.
To select a regimen, your health care provider will review your medical history and
order blood tests to assess your health and the stage of your HIV infection. Your health care provider will also consider:
• why you need anti-HIV medications—for your own health or only to prevent transmitting HIV to your baby;
• changes in how your body may absorb medications during pregnancy; and
• the potential of anti-HIV medications to harm your baby or cause birth defects.

I am currently taking anti-HIV medications and just learned I’m pregnant.
What should I do?
Continue taking your anti-HIV medications until you talk to your health care provider.
Stopping treatment could harm both you and your baby.

If you are in the first trimester of pregnancy, tell your health
care provider right away if you are taking Sustiva (or Atripla, an anti-HIV medication that contains Sustiva).
Sustiva alone or in Atripla may cause birth defects that develop during the first few months of pregnancy.
Your health care provider may recommend safe alternatives for these medications. After the first trimester, Sustiva or Atripla can be used safely.
Anti-HIV Medications for Use in Pregnancy

Terms Used in This Fact Sheet:
CD4 count:
CD4 cells, also called T cells or CD4+ T cells, are white blood cells that fight infection. HIV destroys CD4 cells, making it harder for the body to fight infections. A CD4 count is the number of CD4 cells in a sample of blood. A CD4 count measures how well your immune system is working.
Mother-to-child transmission of HIV:
the passing of HIV from a woman infected with HIV to her baby during pregnancy,
during labor and delivery, or by breastfeeding.
Regimen:
Anti-HIV medications are grouped into “classes” according to how they fight HIV. A regimen is a combination of three or more anti-HIV medications from at least two different classes.

Sustiva:
an anti-HIV medication in the NNRTI class. Sustiva is also called efavirenz or EFV.
Atripla:
a combination of three anti-HIV medications in one pill—Sustiva (also called efavirenz or EFV), Emtriva (also called emtricitabine or FTC), and Viread (also called tenofovir or TDF).
Viral load:
the amount of HIV in a sample of blood. Viral load measures how much virus you have in your body and how well anti-HIV medications are controlling the infection.
Drug-resistance testing:
a blood test to identify which, if any, antiretroviral (ARV) drugs will not be effective against a person's specific strain of HIV. Resistance testing is done using a sample of blood.

Talk to your health care provider about the anti-HIV medications in your regimen. Because pregnancy can affect how the body absorbs medications, the doses of some medications you take may change later in pregnancy.

If you are taking anti-HIV medications and your viral load is more than 500 copies/mL, your current regimen may not be effective at suppressing HIV.
Your health care provider will recommend a test to see if the medications are still working against HIV (drug-resistance testing) and use the test results to find more effective anti-HIV medications.

I used to take anti-HIV medications, but I don’t anymore. What should I do?
Talk to your health care provider about all anti-HIV medications you have used, the results of past drug-resistance testing, and why you no longer take anti-HIV medications.
Your medical history, past drug-resistance test results, and additional drug-resistance testing will help you and your health care provider select a new regimen that is safe for use during pregnancy.

Whether you were on anti-HIV medications before becoming pregnant or are just starting a regimen, your health care provider will:
• explain the risks and benefits of using anti-HIV medications during pregnancy;
• stress the importance of taking anti-HIV medications exactly as directed; and
• arrange for additional medical or social support you may need to help you have a healthy pregnancy.

For more information:
Contact an AIDSinfo health information specialist at 1–800– 448–0440 or visit http://aidsinfo.nih.gov.
See your health care provider for medical advice.

HIV and Pregnancy – Safety of Anti-HIV Medications During Pregnancy

I am HIV infected and pregnant. Is it safe to use anti-HIV medications during my pregnancy?
Women infected with HIV can safely use many anti-HIV medications during pregnancy to protect their health and to prevent transmitting HIV to their babies.
However, some anti-HIV medications can cause problems when used during pregnancy. Knowing more about the safety of anti-HIV medications and pregnancy will help you and your health care provider decide what medications are right for you.

Is my baby at risk from anti-HIV medications
I take during pregnancy?
It’s not known if babies will have any long-term effects from
the anti-HIV medications their mothers use during pregnancy.
However, the risk of mother-to-child transmission of HIV is known. And the illness that results when HIV infection is passed from a mother to her child is very real. Because anti-HIV medications can greatly reduce the risk of passing HIV infection from a mother to her child during pregnancy, all pregnant women infected with HIV should take anti-HIV medications.

Information on the use of anti-HIV medications during pregnancy is limited.
But enough information is known to make recommendations about the safety of the most commonly used medications from the three most commonly used classes of anti-HIV medications—protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and nucleoside reverse transcriptase inhibitors (NRTIs).
(Not enough information is known to make recommendations about use during pregnancy of entry inhibitors and integrase inhibitors, two additional classes of anti-HIV medications.)

Protease inhibitors (PIs)
There may be a link between the use of some PIs and high blood sugar (hyperglycemia) or diabetes. For some women, the risk of hyperglycemia increases in pregnancy. It is unclear if taking PIs adds to this risk. Talk to your health care provider about the use of PIs during pregnancy and about when to have blood tests to check for hyperglycemia or diabetes.

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
Two NNRTIs, Sustiva and Viramune, should be used in pregnant women only under certain conditions.
• Sustiva may cause birth defects that develop during the first few months of pregnancy. therefore, if possible, use of Sustiva should be avoided in the first trimester of pregnancy. Atripla, a combination pill that contains Sustiva, Safety of Anti-HIV Medications During Pregnancy should also be avoided in the first trimester of pregnancy.
After the first trimester, Sustiva or Atripla can be used safely.
• Viramune increases the risk of very serious liver damage in women with CD4 counts greater than 250 cells/mm3.
Viramune should only be started in pregnant women with CD4 counts higher than 250 cells/mm3 if the benefits very clearly outweigh the risks.
Women who begin using Viramune during pregnancy are carefully monitored for early
signs of liver damage.
Women taking Viramune without problems before they become pregnant can safely continue to take the medication.
Liver damage from Viramune use in pregnancy has not been seen in women already taking the medication without side effects.

Nucleoside reverse transcriptase inhibitors (NRTIs)
Using NRTIs can sometimes lead to lactic acidosis, a condition caused by the buildup of a specific acid in the blood.
Women should not take the combination of Zerit and Videx during pregnancy because the combination has caused deaths from lactic acidosis and liver failure.
Women taking NRTIs during pregnancy are watched carefully for signs of lactic acidosis.

Talk to your health care provider about the safety of anti-HIV medications during pregnancy.
There are many anti-HIV medications to choose from that will keep you and your baby
healthy.
For more information:
Contact an AIDSinfo health information specialist at 1–800– 448–0440 or visit http://aidsinfo.nih.gov.
See your health care provider for medical advice.

Terms Used in This Fact Sheet:
Mother-to-child transmission of HIV:
the passing of HIV from a woman infected with HIV to her baby during pregnancy,
during labor and delivery, or by breastfeeding.
Protease inhibitor (PI):
a class of anti-HIV medications. PIs block HIV protease, an enzyme HIV needs to make copies of itself.
Non-nucleoside reverse transcriptase inhibitor (NNRTI):
a class of anti-HIV medications. NNRTIs bind to and alter reverse transcriptase, an enzyme HIV needs to make copies of itself.
Nucleoside reverse transcriptase inhibitor (NRTI):
a class of anti-HIV medications. NRTIs block reverse transcriptase, an enzyme HIV needs to make copies of itself.
Entry inhibitor:
a class of anti-HIV medications. Entry inhibitors block CCR5, a protein on the CD4 cells that HIV needs to enter the cells.
Integrase inhibitor:
a class of anti-HIV medications. Integrase inhibitors work by blocking HIV integrase, a protein HIV needs to make copies of itself.
Hyperglycemia:
too much glucose (sugar) in the blood. Diabetes (also known as diabetes mellitus): high levels of glucose (sugar) in the blood.
Sustiva:
an anti-HIV medication in the NNRTI class. Sustiva is also called efavirenz or EFV.
Viramune:
an anti-HIV medication in the NNRTI class. Viramune is also called nevirapine or NVP.
Atripla:
a combination of three anti-HIV medications in one pill—Sustiva (also called efavirenz or EFV), Emtriva (also called emtricitabine or FTC), and Viread (also called tenofovir or TDF).

CD4 count: CD4 cells, also called T cells or CD4+ T cells, are white blood cells that fight infection. HIV destroys CD4 cells, making it harder for the body to fight infections. A CD4 count is the number of CD4 cells in a sample of blood. A CD4
count measures how well your immune system is working.
Lactic acidosis:
a condition caused by too much lactic acid in the blood.
Zerit:
an anti-HIV medication in the NRTI class. Zerit is also called stavudine or d4T.
Videx:
an anti-HIV medication in the NRTI class. Videx is also called didanosine or ddI.


Preventing Transmission of HIV During Labor and Delivery

I am HIV infected and pregnant. Will I need anti-HIV medications during labor and delivery?
Women infected with HIV take anti-HIV medications during labor and delivery to reduce the risk of mother-to-child transmission of HIV. (See the Mother-to-Child Transmission of HIV fact sheet). During labor and delivery, women continue to take the anti-HIV medications they took throughout their pregnancies.
They also receive an anti-HIV medication called AZT intravenously to protect their babies from HIV in the mother’s genital fluids or blood during labor and delivery.
Talk to your health care provider about the use of anti-HIV medications during labor and delivery well before your due date.

Will I have a vaginal or a cesarean delivery?
The risk of mother-to-child transmission of HIV is low for women who take anti-HIV medications during pregnancy and have a viral load less than 1,000 copies/mL near the
time of delivery.

For some HIV-infected mothers, a scheduled cesarean delivery (also called a C-section) at 38 weeks of pregnancy (2 weeks before the due date) can reduce the risk of motherto- child transmission of HIV. A scheduled cesarean delivery
is recommended for HIV-infected women who:
• have not received anti-HIV medications during pregnancy;
• have a viral load greater than 1,000 copies/mL or an unknown
viral load near the time of delivery.

If, before her scheduled cesarean delivery, a woman’s water breaks (also called rupture of membranes) or she goes into labor, a cesarean delivery may not reduce the risk of motherto- child transmission of HIV.
If there is not another pregnancy- related reason to have a cesarean delivery, the risks of going ahead with the scheduled cesarean delivery may be greater than the benefits.
Depending on an individual woman’s situation, a vaginal delivery may be the best alternative to a planned cesarean delivery.

What are the risks of delivery?
All deliveries have risks—even for mothers without HIV infection. In general, a cesarean delivery has greater risks than a vaginal delivery.

For the mother, the risk of infection or a blood clot in the legs or lungs is greater with a cesarean delivery than with a vaginal delivery.
All women who have a cesarean delivery, including women infected with HIV, should receive antibiotics to prevent infection.
For the infant, the risk of temporary breathing difficulties may be greater with a cesarean delivery.

Talk to your health care provider about the risks and benefits of each type of delivery early in your pregnancy.

For more information:
Contact an AIDSinfo health information specialist at 1–800–448–0440 or visit http://aidsinfo.nih.gov.
See your health care provider for medical advice.


Preventing Transmission of HIV During Labor and Delivery
Terms Used in This Fact Sheet:
Mother-to-child transmission of HIV: the passing of HIV from a woman infected with HIV to her baby during pregnancy, during labor and delivery, or by breastfeeding.
AZT:
an anti-HIV medication in the nucleoside reverse transcriptase inhibitor (NRTI) class. AZT is also called zidovudine, Retrovir, or ZDV.
Intravenously:
giving a medication directly into a vein through a needle.
Viral load: the amount of HIV in a sample of blood.

Cesarean delivery (C-section):
delivery of a baby by a surgical incision through the mother's abdominal wall and
uterus.
Rupture of membranes:
when the amniotic sac (“bag of waters”) holding the unborn baby bursts. Also called
“water breaking.”

Women Infected with HIV and Their Babies After Birth

I am HIV infected and pregnant. What are the chances my baby will be born with HIV?
In the United States and Europe, fewer than 2 babies in 100 born to mothers infected with HIV are infected with the virus.
This is because most women infected with HIV and their babies receive anti-HIV medications to prevent motherto- child transmission of HIV and do not breastfeed. If you take anti-HIV medications during pregnancy and labor and delivery, if your baby receives anti-HIV medications after birth, and if you do not breastfeed your baby, the risk of passing HIV to your baby is very low.

Will my newborn baby receive anti-HIV medications?
Yes. Within 6 to 12 hours after delivery, babies born to women infected with HIV receive an anti-HIV medication called AZT.
AZT helps prevent mother-to-child transmission of HIV.
The babies receive AZT for 6 weeks. (In certain situations, some babies may receive other anti-HIV medications in addition to AZT.)

When will my baby be tested for HIV?
HIV testing for babies born to women with known HIV infection is recommended at 14 to 21 days, at 1 to 2 months, and again at 4 to 6 months.
Testing for babies is done using a virologic HIV test.
Virologic HIV tests look directly for the presence of HIV in the blood.
• To be diagnosed with HIV, a baby must have positive results from two virologic HIV tests.
• To know for certain that a baby is not infected with HIV, the baby must have two negative virologic HIV tests, the first at 1 month of age or older, and the second at least 1 month later.

Babies who are HIV-infected receive a combination of anti- HIV medications to treat HIV.
At 4 to 6 weeks of age, babies infected with HIV also start a medication called Bactrim. (Bactrim is also given as a precaution when it’s not known if a baby is HIV infected or not.) Bactrim helps prevent Pneumocystis jiroveci pneumonia (PCP), a type of pneumonia
that can develop in people with advanced HIV.

What is the best way to feed my baby?
Because HIV can be transmitted through breast milk, women infected with HIV who live in the United States should not breastfeed. In the United States, infant formula is a safe and healthy alternative to breast milk.
Although the risk is very low, HIV can be transmitted to a baby through food that was
previously chewed (pre-chewed) by a mother or caretaker infected with HIV. To be safe, babies should not be fed prechewed food.

Will my anti-HIV medications change after I give birth?
After your baby is born, you and your health care provider may decide to stop or change your anti-HIV regimen. The decision to continue, change, or stop your anti-HIV medications will depend on several factors:
• current expert recommendations on the use of anti-HIV medications
• your CD4 count and viral load
• issues that make it hard to take medications exactly as directed
• whether or not your partner is infected with HIV
• the preferences of you and your health care provider
Don’t stop taking any of your anti-HIV medications without first talking to your health care provider. Stopping your medications may limit the number of anti-HIV medications that will work for you and may cause your HIV infection to
worsen.

Having a new baby is exciting!
However, caring for a new baby while dealing with the physical and emotional changes that follow childbirth can be stressful.
It may be difficult to take your anti-HIV medications exactly as directed.
If you feel sad or overwhelmed or have concerns about taking your medications,
talk to your health care provider.
Together you can make a plan to keep you and your baby healthy.

For more information:
Contact an AIDSinfo health information specialist at 1–800–
448–0440 or visit http://aidsinfo.nih.gov. See your health care
provider for medical advice.

Terms Used in This Fact Sheet:

Mother-to-child transmission of HIV:
the passing of HIV from a woman infected with HIV to her baby during pregnancy,
during labor and delivery, or by breastfeeding.
AZT:
an anti-HIV medication in the nucleoside reverse transcriptase inhibitor (NRTI) class. AZT is also called zidovudine, Retrovir, or ZDV.
Virologic HIV test:
a laboratory test that measures the amount of HIV in a sample of blood.
Bactrim:
an antibiotic used to prevent and treat infection with Pneumocystis jirovecii pneumonia (PCP). Bactrim is also called Septra, Sulfatrim, Sulfamethoxazole/
Trimethoprim, or TMP-SMX.
Pneumocystis jiroveci pneumonia (PCP):
a lung infection caused by a fungus that occurs in people with weakened immune systems.
Regimen:
Anti-HIV medications are grouped into “classes” according to how they fight HIV.
A regimen is a combination of three or more anti-HIV medications from at least two different classes
CD4 count:
CD4 cells, also called T cells or CD4+ T cells, are white blood cells that fight infection. HIV destroys CD4 cells, making it harder for the body to fight infections.
A CD4 count is the number of CD4 cells in a sample of blood. A CD4 count measures how well the immune system is working.
Viral load:
the amount of HIV in the blood.


This information is based on the U.S. Department of Health and Human Services’ Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce erinatal HIV Transmission in the United States (available at http://aidsinfo.nih.gov/guidelines).

Reviewed February 2012

Το μανιφέστο της Act Up-Paris ενάντια στην ACTA Act Up-Paris manifesto against ACTA

Published online: February 11, 2012

• ACTA, Free Trade Agreements Their profits against our lives
• ACTA: τα κέρδη τους ενάντια στις ζωές μας

Φαντάσου.
Είσαι άτομο με HIV/AIDS και ζεις στην Ταϋλάνδη, στο Μπενίν, στο Εκουαδόρ.
Τα φάρμακα που μπορούν να σου σώσουν τη ζωή είναι φτηνά και τίποτα δεν μπορεί να δικαιολογήσει το εξωφρενικό τους κόστος.

Δεν μπορείς να τα πληρώσεις ενώ τα ιδρύματα που παρέχουν θεραπεία δεν έχουν πως να τα αγοράσουν..
Ετσι σου προσφέρουν αντίγραφα φαρμάκων που είναι πολύ φθηνότερα και που σώζουν τη ζωή σου.

Λίγα χρόνια μετά, διεθνείς συμφωνίες που όμως διαπραγματέυθηκαν και συμφώνησαν ελίτ από πλούσιες χώρες που δεν ξέρουν τίποτα για τη ζωή σου, απειλούν την παραγωγή ή τη διαχείριση των φθηνών φαρμάκων που σου σώζουν τη ζωή.

Η ACTA είναι μια απο αυτές τις συμφωνίες.

Μέρος της συμφωνίας αυτής που αφορά στα πνευματικά δικαιώματα, θα μπλοκάρει τα γενώσιμα φάρμακα και θα κάνει τις θεραπείες πολύ ακριβές.

Εν τω μεταξύ, η Ευρώπη, διαπραγματεύεται με πολλές χώρες - και με τη μεγαλύτερη παραγωγό –χώρα των γενερικών, την Ινδία, συμφωνίες ελεύθερου εμπορίου που θα επιτρέψουν την κυκλοφορία μερικών νόμιμων αντιγράφων φαρμάκων.

Σήμερα η ζωή του 80% των ανθρώπων στην Αφρική που παίρνουν φάρμακα για το HIV/AIDS εξαρτάται από την παραγωγή γενερικών φαρμάκων από την Ινδία.
Ο ανταγωνισμός μεταξύ των γενερικών φαρμάκων, μπορεί να προσφέρει θεραπεία σε χιλιάδες ανθρώπους.
Παρά την πρόοδο, 15.000 άνθρωποι πεθαίνουν από AIDS, φυματίωση, ελονοσία.
Εαν εφαρμοστεί η ACTA, η τιμή των φαρμάκων θα εκτιναχθεί και μαζί της, ο αριθμός των νεκρών.

Μπορεί το θέμα να μοιάζει μακρινό.

Αλλά ανάμεσα στα δικαιώματά μας
στην ελεύθερη διαχείριση του internet,
στο ελεύθερο λογισμικό, ή
τα γενερικά φάρμακα,
οφείλει να επικρατήσει η λογική.

Η λογική που βάζει τα δικαιώματά μας στην ελεύθερη έκφραση, στην τεχνολογία, στην ανταλλαγή γνώσης και στη ζωή,
ΠΑΝΩ ΑΠΟ ΤΑ ΚΕΡΔΗ ΤΩΝ ΦΑΡΜΑΚΕΥΤΙΚΩΝ ΕΤΑΙΡΕΙΏΝ..

Η ACT UP PARIS δίνει το δικό της αγώνα κατά της ACTA,
αντιμετωπίζοντας και τη δικαστική διαδικασία.

Eμείς, να σημειεώσουμε οτι η Ελλάδα συγκαταλέγεται στις χώρες που υπέγραψαν την ACTA .. ως πλούσια χώρα;;;;

το ίδιο χρονικό διάστημα που οι πολιτικοί μας μας οδηγούν στο ΜΝΗΜΟΝΙΟ Β΄ και που όλος ο κόσμος μιλάει για την ΧΡΕΟΚΩΠΕΙΑ της Ελλαδας, ο Υπουργός Κος Βορίδης Υπογράφει την ACTA
Δεν ξέρουμε αν η οικονομική κατάσταση θα επιτρέψει επι πολύ την έστω και μετα δυσκολιών –όπως σήμερα- παροχή πατενταρισμένων ακριβών φαρμάκων.

Αλλά φαίνεται δύσκολο να τα βάλει κανείς με τις φαρμακευτικές πολυεθνικές..
που βραβεύονται για την «εταιρική τους ευθύνη» και από τις ΜΚΟ που γι αυτό τις στηρίζουν..

Ζώντας στην Ελλάδα με τον HIV..

(παρουσίαση βιβλίου που εκδόθηκε από ΜΚΟ του χώρου του HIV/AIDS, με την επιμέλεια Ιατρικής Εταιρείας, στην Ελλάδα χρηματοδοτήθηκε από πολυεθνική φαρμακευτική, έγινε σε γνωστό κεντρικό βιβλιοπωλείο την εβδομάδα που μας πέρασε..)

Act Up-Paris manifesto against ACTA

Imagine.
You live with the AIDS virus in Thailand, Benin, Ecuador. Drugs that may save your life are priceless, and nothing justifies the exorbitant cost. You can not pay them, and associations or institutions that provide access to treatment programs have not enough means to buy them. They then offered copies equally effective but much cheaper, which save your life. And a few years later, a series of international agreements negotiated by a few elites in rich countries, who know nothing about your life, threatening the production or movement of such generic save your life.
ACTA is one of those agreements. Some of its provisions will block generics, so make treatment more expensive.
Meanwhile, Europe is negotiating with several countries, including India's largest producer of generics, free trade agreements that they too will interfere a little more access to legal copies.
Today, the lives of 80% of people in Africa take treatment against AIDS, depend on generic drugs produced in India; Generic competition can put hundreds of thousands of people living with HIV on treatment.

Despite this progress, 15,000 people die every day from AIDS, malaria, tuberculosis.

If ACTA was applied, if the free trade agreements were signed, the prices of treatments in the world increase, and with them the death toll.

You may not be coming to demonstrate against ACTA on this topic.
It may seem far away.

Yet, between threats on the Internet, free software or generic, there is a common logic that we must face together, a logic that puts our fundamental rights, health, expression, technology, to exchange, knowledge, entertainment and culture after the profits of some pharmaceutical companies.

After the lesbian, gay, bi and trans, Act Up-Paris is an association of people living with HIV and activists who fight against AIDS.
Education, health, research, income, discrimination, justice, social rights, housing, etc..:
The fight against AIDS touches on all these topics and many others.
Poz, we struggle with patients in developing countries who lack access to treatment for the right to health is not an expression.

We fight against ACTA agreements and free trade for over two years, we have shown the doors of the home of Commissioner de Gucht in July.
Yesterday we prevented workers from working Gucht calling them constantly.
These people ignore us?
Are we imposing on them and they have no legitimacy to threaten our rights and our lives.

Act Up-Paris demands that ACTA is buried, and that free trade agreements negotiated by Europe with India, and many countries continue to threaten the flow of generic drugs.

Perspectives Assessment of public health issues of migrants at the Greek-Turkish border, April 2011

Συμπεράσματα από την επίσκεψη κλιμακίου της ΠΟΥ (Παγκόσμιας Οργάνωσης Υγείας) στον Εβρο, κατά τη διάρκεια εφαρμογής εξάμηνου προγράμματος παρέμβασης του ΥΥΚΑ με χρηματοδότηση από το ERF (Ευρωπαϊκό Ταμείο Προσφύγων) για τους διακινούμενους μετανάστες.

Το κύριο πρόβλημα των κέντρων κράτησης είναι οι υγειονομικές συνθήκες ειδικά ο υπερπληθυσμός και το έλλειμμα χώρων προσωπικής υγιεινής (βλέπε τουαλέτες) καθώς και το έλλειμμα φρέσκου αέρα και άσκησης δηλ.,
θέλει να πει ο ποιητής, έλλειμμα προαυλισμού..!!

Οι συνθήκες οφείλουν να βελτιωθούν άμεσα επισημαίνει ο συγγραφέας.

Για να αποφευχθούν επιδημίες οφείλει να συνεχιστεί ο εμβολιασμός τόσο των κρατουμένων όσο και του προσωπικού.

ΔΕΝ ΥΠΑΡΧΕΙ ΚΑΜΙΑ ΕΝΔΕΙΞΗ ΑΠΕΙΛΩΝ ΥΓΕΙΑΣ ΓΙΑ ΤΟΥΣ ΕΛΛΗΝΕΣ ΠΟΥ ΝΑ ΠΡΟΕΡΧΕΤΑΙ ΑΠΟ ΤΟΥΣ ΜΕΤΑΝΆΣΤΕΣ!!
(Στο ΛΟΒΕΡΔΟ το δείξανε το άρθρο;)

Επίσης οφείλει να συνεχίσει και να αυξηθεί περαιτέρω η παροχή ψυχοκοινωνικών υπηρεσιών αν λάβει κανείς υπόψη το τραύμα των μεταναστών.

Για το smuggling και το trafficking που περνά μπροστά στα μάτια του, κουβέντα το Προστασίας του Πολίτη!!

Εννοείται ότι από άποψη υποδομών δεν έγινε τίποτα.

Ο κος Παπουτσής αρκείται στο να ντρέπεται..

Μια απορία έχουμε: όταν θα λήξει και η χρηματοδότηση επειγόντων μέτρων από την Ε.Ε. τι θα γίνει;

ΑΠΟΛΑΥΣΤΕ ΤΟ

E Mertens (contact@elke-mertens.eu)1,2, G Rockenschaub3, A Economopoulou4,5, P Kreidl5
1. Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany
2. European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
3. World Health Organization (WHO) Regional Office for Europe, Copenhagen, Denmark
4. Hellenic Centre for Disease Prevention and Control, Athens, Greece
5. European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
Citation style for this article: Mertens E, Rockenschaub G, Economopoulou A, Kreidl P. Assessment of public health issues of migrants at the Greek-Turkish border, April 2011.
Euro Surveill. 2012;17(2):pii=20056.
Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20056
Article published on 12 January 2012

A joint mission to assess the public health situation of migrants in Greek detention centres was undertaken in April 2011 by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe.
The assessment visit follows the increased migration to the Evros prefecture, Eastern Macedonia and Thrace region, at the Greek-Turkish border where large numbers
of migrants are entering Greece via the Evros River, a natural border.
Migrants are housed in local detention centres.
The main problem in detention centres are the substandard hygiene conditions, especially overcrowding and lack of personal hygiene facilities, lack of basic supplies and lack of access to fresh air and physical exercise.
As the migration route via the Evros region is increasingly used since 2009, and due to the unstable political situation in North Africa and the Middle East, an increased influx of migrants was to be expected with the falling water
levels of the Evros River in summer, resulting in further deterioration of the already critical situation in the Thrace region’s detention centres.

Background

Since the beginning of 2010, the number of migrants [1] that enter the Evros prefecture by crossing the Greek- Turkish border has increased considerably.
Until the end of 2009, approximately 3,500 migrants per year are reported to have entered the Evros prefecture in Greece by crossing the 206 km long Greek-Turkish
border.
The border follows the Evros River, hence the name of this prefecture [2].
During 2010, the number of migrants increased more than tenfold to 47,000 in the
same region [3].
In October 2010, the European Agency for the Management of Operational Cooperation at the External Borders of the Member States of the European Union (FRONTEX), reported that Greece accounts for 90% of all detections of illegal border crossings in the European Union (EU)[4].

For the purpose of this report, ‘migrants’ are defined as including refugees, asylum
seekers, displaced populations, irregular migrants and in some cases labour migrants, as defined by the International Organization for Migration (IOM) in the
Glossary on Migration [1].

In the first months of 2011, the average number of migrants detected per day was about 58 in the Evros prefecture [5].
Migrants enter the region mainly by crossing the Evros.
When water levels are high, migrants either swim or ferry over in small boats. In
2011, several persons have been reported to have died when crossing the border [6].
The increasing influx of migrants without documents in early 2011 led to massive overcrowding of the detention centres in the Evros prefecture and worsened
the already poor humanitarian conditions that have been repeatedly criticised since 2005 by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment and Amnesty International [7–11].
In addition to worsening humanitarian conditions, the overcrowding also increases the
risk for the spread of communicable diseases such as tuberculosis, diarrhoea and respiratory infections [12].
The Greek Ministry of Health and Social Solidarity (MoHSS)had sought to address the health-related implications of overcrowding by setting up a project for the provision of healthcare inside the detention centres.

Additionally in March 2011, the Greek Health Minister invited representatives from the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) Regional Office for Europe to conduct a joint mission to the Thrace region.
The objective of the mission was to support Greek health authorities in assessing the public health situation in the detention centres for irregular migrants, with emphasis on communicable diseases, overwww. eurosurveillance.org 15 all health condition of the migrants and potential additional needs.

Demographic features of migrants

The geographical and cultural origin of migrants seems to vary.
In March 2011, FRONTEX reported the largest groups of migrants in Evros as coming from Afghanistan (24%), Pakistan (14%) and Bangladesh (12%) [5].
For the earlier period of August to December 2010, the Hellenic Centre for Disease Control and Prevention (HCDCP) had reported a total of 31 countries of origin, with Afghanistan (33%) and the Occupied Palestinian Territory (28%) being the most common, followed by Somalia (7%), Morocco (6%), Iraq and Algeria (4%
each).

Data on age and sex were available for 1,229 migrants apprehended at the Evros river outposts between 8 August 2010 and 12 December 2010. Most of them (1,017; 83%) were male.
Adolescents and young adults aged 12 to 40 years accounted for 91% (Data not
shown).

Detention

Police authorities report that most migrants arrive without valid identification papers, such as passports or ID cards, and intend to claim asylum, mostly in other European countries such as Denmark, France, Germany, Norway, Sweden, Switzerland and the United Kingdom.
According to Greek law, persons without identity papers shall be detained in closed centres for a maximum period of up to six months, until identification and nationality are validated. Lack of identity documents complicates the already bureaucratic and time-consuming process of seeking legal status [13], especially when the competent authorities are overburdened, and therefore prolongs the period of detention.
There are seven centres for migrants in the Eastern Macedonia and Thrace region, of which six are in the Evros prefecture [14].
One serves as a screening centre for entry assessment only and one for imprisoned
traffickers only.
Local police authorities are responsible for security and supplies in these centres which are often located within the local police stations.
Most detention centres are regular police prisons having one to six cells, of variable size and with a maximum of two toilets and showers per cell. Only two centres have separate cells for women and families.
The five-month migrant healthcare project, ’Implementation of healthcare and psychosocial support activities for third country nationals that may require international protection in the area of Evros- Greece‘, was implemented in March 2011 [15].
It aimed at providing medical and psychosocial support to detained persons. It was funded by the EU (80%) and by the Greek national authorities (20%). Its implementation was under the responsibility and coordination of the HCDCP.
Funding was limited to five months and ended in July 2011. Prior to March 2011, healthcare was mainly provided by medical doctors of the local authorities,
non-governmental organisations such Médecins Sans Frontières (MSF) Greece and the HCDCP.

Assessment visit

In order to assess the public health situation of migrants in Greek detention centres, a joint mission was undertaken in April 2011 by the ECDC and the WHO
Regional Office for Europe.
The assessment was carried out through visits to detention centers and the University Hospital of Alexandroupolis, where interviews were carried out. The course of the visits and interviews in displayed in the Figure.
The mission team consisted of two senior experts from ECDC and WHO Regional Office for Europe and a fellow of the European Programme for Intervention Epidemiology Training (EPIET).
The international team and Greek experts from the HCDCP and the MoHSS visited all detention and entry assessment centres, as well as the University Hospital of Alexandroupolis, where migrants are admitted if they need specialised
Figure Course of visits and interviews, assessment visit to Greece, April 2011

Mission team
- Two WHO senior experts
- Two ECDC senior experts
- One EPIET fellow
Greek experts
- HCDCP
- MoHSS
jointly visited All detention and entry assessment centres University Hospital of Alexandroupolis Interviews were conducted with
- Detainees
- Physicians, nurses, psychologists, social workers, translators
- Police o cers
- Representatives from HCDCP, MoHSS, MSF
Representatives from
- University Hospital of Alexandroupolis
- two district hospitals

ECDC:European Centre for Disease Prevention and Control;
PIET:European Programme for Intervention Epidemiology Training;
HCDCP: Hellenic Centre for Disease Prevention and Control;
MoHSS: The Greek Ministry of Health and Social Solidarity;
MSF: Médecins Sans Frontières; WHO: World Health Organization
16 www.eurosurveillance.org
healthcare. The centre for traffickers was not visited.

Unaccompanied minors (if stated age is less than 18 years) are sent to special centres for minors outside the Evros prefecture which minors can leave on demand.
These centres were not visited during this mission.
In the detention centres, we conducted interviews with convenience samples of detained persons on their health, access to food, water, sleeping conditions,
hygiene and what they regarded as the main problems of their situation.
We also met representatives from MSF and gathered information on their assessment of the situation.
Semi-structured interviews were conducted with representatives of the HCDCP, the MoHSS, the University Hospital of Alexandroupolis, two district hospitals, as well as with physicians, nurses, psychologists, social workers, translators and police officers at the detention and screening centres.
The ’health system crisis preparedness assessment method‘ [16], a tool available from the WHO, was used as framework during the three-day field visit.
Minimum standards for occupancy (3.5m² per person) and hygiene conditions (one toilet per 20 persons) were assessed according to WHO emergency standards [17].
Visit findings
The visit findings are based on the mission teams’ observations and semi-structured interviews.
We interviewed two administrative employees of the migrant healthcare project and the programme manager, all from the HCDCP. In every centre, we interviewed (i) one to three police officers, (ii) one physician and one nurse working on site and (iii) ten to forty detainees.
Of the staff that rotates between the centres, we interviewed one social worker, three translators and three psychologists.

Basic conditions

According to police authorities, a total of approximately 950 persons were detained in all five detention centres for migrants two days before our visit.
Migrant fluctuation was high, as more than 200 persons had been released on the day prior to our visit, and more than 200 persons arrived in one of the centres during
the two days of our visit.
Occupancy varied between 75 in the smallest and 360 in the largest centre. According
to the estimate of MSF representatives, the current number of detained persons therefore exceeded capacity two- to three-fold in four of the five detention centres
(personal communication, MSF representatives, 6 April 2011).
As far as the mission team could judge, none of the centres met the WHO minimum standard for occupancy of 3.5 m² per person.
We were able to obtain data on length of stay from 27 detainees.
Among them, the median period of detention was 30 days (range five to 210 days). Police authorities were not able to give reliable estimations of proportions of minors because their number was fluctuating strongly.
That opinion was shared by the longest serving on-site physician.
In the interviews with police authorities, the most pressing concern was the further deterioration of the problems due to overcrowding, as the numbers of
migrants were expected to increase as soon as the river’s water level dropped in summer.
It was confirmed by several sources that unlimited drinking water was available in sufficient quality and quantity apart from in one centre were detainees
reported the tap water to have a brownish colour and bad taste.
Police officers and the healthcare team confirmed that the tap water in the whole village has a brownish colour due to high iron rust levels.
Food was provided by catering services on a daily basis and was assessed by healthcare workers and most detainees to
be sufficient in both quantity and quality.
Two or three meals a day were made available to the migrants, consisting of bread alone for breakfast, and bread with mixed salad for lunch and dinner. In one centre, detainees reported that rations were insufficient on days when many new migrants arrived in the centre.
The visiting team noted that no centre had cooling facilities for the salad boxes.
The visiting team further noted that hygienic conditions of toilets, cleanliness of premises and availability of personal hygiene resources were sub-standard.
Detainees reported a lack of soap and detergents as well as too few toilets and showers.
In four of five detention centres, police and detainees confirmed that less than one toilet was available per 20 persons.
In one centre, 79 persons had to share one toilet and one shower.
All of the centres were undersupplied with beds, mattresses and blankets. Beds/mattresses and blankets had to be shared by two to four persons in two centres,
according to detainees.
In the remaining three centres, a substantial number of detainees had to sleep
on the concrete floor; it was observed by the visiting team and confirmed by detainees that thin industrial felts instead of mattresses were available for only the half of the detainees.
Detainees had very limited (once every three to four days) or no access to an outside
yard/physical exercise.
This was confirmed by police present at the centres.
The physician of the largest centre reported an average of two fights per month during which detainees are injured and have to be isolated for their own protection.
Ethnicity and religion were not considered for assigning detainees to cells.
However, women or families were detained separately from men.
Health According to the HCDCP, an entry assessment of all migrants, psychosocial and medical support upon request, as well as a telephone-based early warning
www.eurosurveillance.org 17 system were introduced under the newly established
migrant healthcare project.
Services were delivered by seven physicians, eight nurses, five psychologists and three social workers.
The team was complemented by fourteen translators who covered Greek, English,
French, Arabic, Farsi, Urdu, Pashto and Russian.
Sustained healthcare provision to detained persons beyond the completion of the project is still under discussion.
The services of the migrant healthcare project are described below. Entry medical examination and assessment of all migrants In all six visited screening and detention centres, healthcare for inmates was provided by one to two nurses and one physician as established by interviews with several parties.
After apprehension, all migrants undergo a health check that consists of questions about their medical history and a clinical examination. Detained migrants are additionally tested for tuberculosis (Mantoux test) and their blood samples screened for hepatitis B, Crimean Congo haemorrhagic fever and syphilis.
According to detention centre healthcare staff and the HCDCP, migrants apprehended but released due to decisions by police authorities, undergo the entry examination but not blood or tuberculosis screening, as follow-up treatment is not possible.
Psychosocial support Psychological and social support is offered to detainees by psychologists and social workers, assisted by cultural mediators who rotate between the centres.
A particular focus is on supporting children and adolescents, especially unaccompanied ones.
All new migrants are screened by psychologists with the assistance of translators. During the first session, a standardised questionnaire for each migrant is filled
in.
Once an environment of trust is created, more details are collected in further sessions.
For migrants suffering traumatisation, psychologists provide counselling in single and group sessions and are responsible for psychiatric referrals.
The type of session as well as the number and intervals of sessions are determined
by psychologists case by case.
Psychologists are supported by translators during the sessions when possible.
Social workers support detainees in handling administrative matters such as identity confirmation.

Disease surveillance

Health conditions as diagnosed during entry assessment and follow-up examinations are systematically documented after release from detention with a delay of approximately one week for data entry.
Diseases that need immediate and/or specialised care are reported by the medical staff in the detention centres via telephone to the healthcare project manager.
In addition to entry assessments, physicians and nurses conduct daily assessments of the health of detainees by visiting the cells and treating patients on
request.
They assume an outbreak if they find more than three persons in one cell with similar respiratory or gastroenteric symptoms or fever.
Additionally, the project manager receives written summaries of the migrants’ health from all detention centres on a daily basis.
The HCDCP and healthcare staff reported three cases of tuberculosis between March and mid-July 2011, but no outbreaks of communicable diseases were noted.
Vaccination
As part of the migrant healthcare project, children (<18 years) are vaccinated against diphtheria, tetanus, pertussis, polio, measles, mumps and rubella.
Adultsare vaccinated against diphtheria, tetanus and polio.
These vaccinations are administered to all detainees because the migrants without identity documents do not have vaccination cards and their vaccination status
cannot be validated.
The staff at detention centres is encouraged to get vaccinated against the same diseases as adult detainees. Vaccines against diphtheria, tetanus and polio are available for staff at the centres where they work.

Specialised healthcare

Migrants who need specialised healthcare are referred to the University Hospital of Alexandroupolis (670 beds) or one of two district hospitals (217 and 150 beds) in
the Evros prefecture.

Conclusion

The main problem in all visited detention centres were the substandard hygiene conditions, especially overcrowding and lack of personal hygiene facilities, lack of basic supplies and lack of access to fresh air and physical exercise.
The very poor humanitarian conditions in the centres needed to be improved urgently. In order to limit the risk for outbreaks of vaccine-preventable diseases, vaccination of detainees, healthcare workers and other staff in the centres should be continued.
There was no evidence for immediate threats to the health of the Greek population originating from the migrants.
Considering the traumatisation many migrants have gone through, the psychosocial support services also need to be sustained and increased.
The severe overcrowding should be addressed as it increases the risk for communicable diseases such as diphtheria, tetanus and polio spreading, psychosocial distress and the aggravation of traumatisation, as well as causing potentially violent conflicts.
As the migration route via the Evros region is increasingly used since 2009, and due to the unstable political situation in North Africa and the Middle East, an increased influx of migrants is to be expected with the falling water levels of the Evros River in summer, resulting in further deterioration of the already critical
18 www.eurosurveillance.org situation in the Thrace region’s detention centres.
EU Member States should share public health best practices for managing detention centres.
According to the police authorities, the translators and detainees, the implementation of the migrant healthcare project has greatly improved access to healthcare including psychosocial support for migrants.
The early warning system that was introduced by the migrant healthcare project, was based on personal communication, vulnerable to human and technical errors and
depended on the presence of the project manager.
During the time between the assessment visit and the submission of this article, a syndromic surveillance system was developed and successfully implemented within the framework of the EPIET programme [18].

Acknowledgments

The ECDC and WHO Regional Office for Europe would like to thank the Hellenic Centre for Disease Prevention and Control and the Ministry for Health and Social Solidarity for their hospitality, the effective mission preparations and the openness
and transparency during the visit.
The authors thank Florian Burckhardt, Katharina Alpers, Ioannis Karagiannis and Evelyn Depoortere, for their comments and encouragement.

Full report

The ECDC Mission report [19] is available from http://www.
ecdc.europa.eu/en/publications/Publications/1105_MIR_
Joint_WHO_Greece.pdf

References
1. International Organization for Migration (IOM).
Glossary onMigration [Internet]. Geneva: IOM; 2004 [accessed 2011 May 11].
Available from: http://www.iom.int/jahia/webdav/site/ myjahiasite/shared/shared/mainsite/published_docs/serial_ publications/Glossary_eng.pdf
2. Central Intelligence Agency (CIA) The world factbook, Greece.
[accessed 2011 April 12]; Available from: https://www.cia.gov/ library/publications/the-world-factbook/geos/gr.html
3. FRONTEX. Press Pack may 2011: FRONTEX; 2011 [accessed 2011 October 09].
Available from: http://www.frontex.europa.eu/ newsroom/news_releases/art98.html
4. Frontex Frontex deploys Rapid Border Intervention Teams to Greece.
Frontex European Union Agency; 2010 [accessed 2011 July 27];
Available from: http://www.frontex.europa.eu/ newsroom/news_releases/art79.html.
5. FRONTEX RABIT Operation 2010 Ends, Replaced By JO Poseidon 2011.
FRONTEX; 2011 [accessed 2011 May 11];
Available from: http://www.frontex.europa.eu/newsroom/ news_releases/art98.html
6. Médecins Sans Frontières (MSF) [Internet]. Greece:
Immediate action needed to improve unbearable living conditions.2011 [updated 2011 Jan 26; accessed 2011 May 11];
Available from: http://www.msf.org.uk/Evros_living_conditions_20110126. news
7. CPT. Report to the Government of Greece on the visit to Greece carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 27 August to 9 September 2005 [Internet].
Strasbourg: CPT; 2006 [accessed 2011 May 11].
Available from:
http://www.cpt.coe.int/documents/grc/2006-41-inf-eng.htm.
8. CPT. Report to the Government of Greece on the visit to Greece carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 20 to 27 February 2007 [Internet].
Strasbourg: CPT; 2008 [accessed 2011 May 11].
Available from: http://www.cpt. coe.int/documents/grc/2008-03-inf-eng.htm.
9. CPT. Report to the Government of Greece on the visit to Greece carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 17 to 29 September 2009 [Internet].
Strasbourg: CPT; 2010 [accessed 2011 May 11].
Available from: http://www. cpt.coe.int/documents/grc/2010-33-inf-eng.htm
10. CPT [Internet]. Strasbourg. Public statement concerning Greece.
European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) 2011 [updated 2011 March 15; accessed 2011 May 11];
Available from: http://www.cpt.coe.int/documents/grc/2011-10-inf-eng.htm
11. Amnesty International [Internet]. Greece must urgently remedy deplorable detention conditions.2011 [updated 2011 March 16; accessed 2011 May 11];
Available from: http://www.amnesty. org/en/library/asset/EUR25/006/2011/en/14f92528-a129- 42d4-9053-a25a99a2edba/eur250062011en.html
12. European Centre for Disease Prevention and Control (ECDC). Risk assessment: Situation in northern Africa/Libyan Arab Jamahiriya and the influx of migrants to Europe. 2011. 2011.
Available from: http://ecdc.europa.eu/en/publications/ Publications/Forms/ECDC_DispForm.aspx?ID=667
13. European Commission. Clandestino Project. Final Report.
Athens: European Commission 2009.
14. GlobalDetentionProject Greece Detention Profile. GlobalDetentionProject; 2009 [updated November 2009; accessed 2011 May 11];
Available from: http://www.
globaldetentionproject.org/countries/europe/greece/ introduction.html
15. Hellenic Centre for Disease Prevention and Control (HCDCP) Evros Project. HCDCP; [accessed 2011 26 October];Available from: http://www2.keelpno.gr/ blog/?cat=10&lang=en&paged=2 16. World Health Organization (WHO). Health Needs Assessment, Malta [Internet]: WHO; 2011 [accessed 2011 July 01].

Available from: http://www.euro.who.int/__data/assets/pdf_ file/0011/144011/Health_Needs_Assess_Malta_2011.pdf
17. World Health Organization (WHO). Communicable disease control in emergencies: a field manual [Internet]: WHO; 2005 [accessed 2011 May 11].
Available from: http://www. who.int/infectious-disease-news/IDdocs/whocds200527/
ISBN_9241546166.pdf
18. Bosman A, Schimmer B, Coulombier D. Contribution of EPIET to public health workforce in the EU, 1995-2008. Euro Surveill. 2009;14(43).
19. European Centre for Disease Prevention and Control (ECDC).
MISSION REPORT: Increased influx of migrants at the Greek–Turkish border: European Centre for Disease Prevention and Control (ECDC); 2011 [accessed 2011 May 28].
Available from: http://www.ecdc.europa.eu/en/publications/

Διορισμός μελών του Εθνικού Συμβουλίου Δημόσιας Υγείας (Ε.ΣΥ.Δ.Υ.)

3η ΟΡΘΗ ΕΠΑΝΑΛΗΨΗ
ΑΝΑΡΤΗΤΕΑ ΣΤΟ ΔΙΑΔΙΚΤΥΟ

ΕΛΛΗΝΙΚΗ ΔΗΜΟΚΡΑΤΙΑ Αθήνα 16 / 12/ 2011
YΠΟΥΡΓΕΙΟ ΥΓΕΙΑΣ KAI Αριθμ. πρωτ.:ΔΥ1δ/Γ.Π/οικ.138287
ΚΟΙΝΩΝΙΚΗΣ ΑΛΛΗΛΕΓΓΥΗΣ
ΓΕΝ. Δ/ΝΣΗ ΔΙΟΙΚ. ΥΠΟΣΤΗΡΙΞΗΣ
ΚΑΙ ΤΕΧΝΙΚΩΝ ΥΠΟΔΟΜΩΝ
ΔΙΕΥΘΥΝΣΗ ΠΡΟΣΩΠΙΚΟΥ
ΤΜΗΜΑ ΣΥΛΛΟΓΙΚΩΝ ΟΡΓΑΝΩΝ

Ταχ. Δ/νση : Αριστοτέλους 19
Ταχ.Κώδικας: 101 87
Τηλέφωνο :2105232821/359
Fax :2108221149

ΘΕΜΑ: Διορισμός μελών του Εθνικού Συμβουλίου Δημόσιας Υγείας (Ε.ΣΥ.Δ.Υ.)

ΑΠΟΦΑΣΗ
Ο ΥΠΟΥΡΓΟΣ ΥΓΕΙΑΣ ΚΑΙ ΚΟΙΝΩΝΙΚΗΣ ΑΛΛΗΛΕΓΓΥΗΣ

Έχοντας υπόψη,
1. Τις διατάξεις:
α. του ν. 2190/1994 «Σύσταση ανεξάρτητης αρχής για την επιλογή προσωπικού και
ρύθμιση θεμάτων διοίκησης», (Φ.Ε.Κ. 28/Α’/3-3-1994), άρθρο 32, παρ.18
β. του ν. 2194/1994 «Αποκατάσταση του Εθνικού Συστήματος Υγείας και άλλες
διατάξεις», (Φ.Ε.Κ.34/Α’/16-3-1994) , άρθρο 8, παρ.6
γ. του ν.2198/1994 «Αύξηση αποδοχών δημοσίων υπαλλήλων εν γένει, σύναψη
δανείων, υπό του Ελληνικού Δημοσίου και δημιουργία στην Τράπεζα της Ελλάδος
Συστήματος Παρακολούθησης Συναλλαγών επί Τίτλων με λογιστική μορφή (Άϋλοι
Τίτλοι) και άλλες διατάξεις», όπως κάθε φορά ισχύουν. (Φ.Ε.Κ 43/ Α’/22-3-1994)
δ. του ν.2530/1997 «Υπηρεσιακή κατάσταση και αναμόρφωση μισθολογίου του
διδακτικού και ερευνητικού προσωπικού και του εκπαιδευτικού προσωπικού των
Ιδρυμάτων της Τριτοβάθμιας Εκπαίδευσης (Α.Ε.Ι –Τ.Ε.Ι)- Μισθολογικές ρυθμίσεις
ερευνητών των ερευνητικών ιδρυμάτων και άλλων συναφών κατηγοριών και άλλες
διατάξεις». (Φ.Ε.Κ 43/Α’/23-10-1997).
ε. του ν. 2519/1997 «Ανάπτυξη και εκσυγχρονισμός του Εθνικού Συστήματος Υγείας,
οργάνωση των υγειονομικών υπηρεσιών, ρυθμίσεις για το φάρμακο και άλλες
διατάξεις», άρθρο 6 παρ. 4,άρθρο 39 παρ. 7 (Φ.Ε.Κ. 165/Α’/21-8-1997).
στ. του ν. 2703/1999 «Αναπροσαρμογή συντάξεων συνταξιούχων μελών Δ.Ε.Π των
Α.Ε.Ι., Ε.Π των Τ.Ε.Ι, γιατρών Ε.Σ.Υ. και διπλωματικών υπαλλήλων, ρύθμιση
συνταξιοδοτικών θεμάτων και άλλες διατάξεις», άρθρο 5 , παρ.11β και 14, (Φ.Ε.Κ
72/ Α’/8-4-1999).
ζ. του ν. 2690/1999 «Κύρωση του Κώδικα Διοικητικής Διαδικασίας και άλλες
διατάξεις», (Φ.Ε.Κ. 45/Α΄/09-03-1999), άρθρο 13.
η. του ν. 3172/2003 «Οργάνωση και εκσυγχρονισμός των Υπηρεσιών Δημόσιας
Υγείας και άλλες διατάξεις», άρθρο 5 (Φ.Ε.Κ. 197/ Α’/6-8 2003)
θ. του ν. 3370/2005 «Οργάνωση και λειτουργία των Υπηρεσιών Δημόσιας Υγείας και
λοιπές διατάξεις». (ΦΕΚ 176/ Α’/11-7-2005)

ι. του ν. 3868/2010 «Αναβάθμιση του Εθνικού Συστήματος Υγείας και λοιπές
διατάξεις αρμοδιότητας του Υπουργείου Υγείας και Κοινωνικής Αλληλεγγύης».
(ΦΕΚ 129/ Α’/ 3-8- 2010)
2. Τις αποφάσεις:
α. την αριθμ. ΔΥ1α/Γ.Π.οικ.140942/10-11-2010 με περιεχόμενο την τοποθέτηση
Προϊσταμένων στις Δ/νσεις του Υπουργείου Υγείας και Κοινωνικής Αλληλεγγύης
β. την αριθμ. 76/2008 του ΕΥΣ με περιεχόμενο την τοποθέτηση Προϊσταμένων στις
Γενικές Δ/νσεις του Υπουργείου Υγείας και Κοινωνικής Αλληλεγγύης.
γ.την αριθμ.ΔΥ1α/Γ.Π.οικ.137308/13-12-2011 με περιεχόμενο ανάθεση καθηκόντων
Αναπληρωτών Προϊσταμένων Δ/νσεων του Υπουργείου Υγείας και Κοινωνικής
Αλληλεγγύης
δ. την αριθμ. ΔΥ1α/Γ.Π.οικ.139031/16-12-2011 με περιεχόμενο τις τοποθετήσεις
υπαλλήλων σε θέσεις Προϊσταμένων Διευθύνσεων της Κεντρικής Υπηρεσίας του
Υπουργείου Υγείας και Κοινωνικής Αλληλεγγύης.
3. Το από 30-9-2011 Υπηρεσιακό Σημείωμα του Γραφείου Υπουργού.

Α Π Ο Φ Α Σ Ι Ζ Ο Υ Μ Ε

1. Συγκροτούμε το Εθνικό Συμβούλιο Δημόσιας Υγείας (Ε.ΣΥ.Δ.Υ) και διορίζουμε
μέλη, τα κατωτέρω πρόσωπα:

α. Τσουρό ΄Αγι του Δημητρίου, Ειδικό σε θέματα Δημόσιας Υγείας, Ανώτερο
στέλεχος του Παγκόσμιου Οργανισμού Υγείας (Π.Ο.Υ.) με ΑΔΤ ΑΙ 037018, ως
Πρόεδρο.
β. Λιονή Χρήστο του Δημητρίου με ΑΔΤ ΑΒ 970534, Καθηγητή Γενικής Ιατρικής και
Πρωτοβάθμιας Φροντίδας Υγείας του Πανεπιστημίου Κρήτης, ως Αντιπρόεδρο.

γ. Τούντα Ιωάννη του Κωνσταντίνου με ΑΔΤ Σ 052825, Αναπληρωτή Καθηγητή
Κοινωνικής Ιατρικής του Εθνικού Καποδιστριακού Πανεπιστημίου Αθηνών,
Πρόεδρο του ΕΟΦ, με αναπληρωτή του τον Φιλαλήθη Αναστάσιο του Ευγενίου, με
ΑΔΤ Π 157021, Καθηγητή Κοινωνικής Ιατρικής – Προγραμματισμού Υγείας
Πανεπιστημίου Κρήτης.

δ. Τσακρή Αθανάσιο του Ζαχαρία με ΑΔΤ Κ 682812, Καθηγητή Μικροβιολογίας καιΔιευθυντή Εργαστηρίου Μικροβιολογίας της Ιατρικής Σχολής Αθηνών του Εθνικού Καποδιστριακού Πανεπιστημίου Αθηνών, με αναπληρωτή του, τον Βατόπουλο Αλκιβιάδη, του Κωνσταντίνου με ΑΔΤ Μ 327439, Ιατρό Βιοπαθολόγο, Καθηγητή Μικροβιολογίας της Δημόσιας Υγείας στην Εθνική Σχολή Δημόσιας Υγείας και Επιστημονικό υπεύθυνο του Κεντρικού Εργαστηρίου Δημόσιας Υγείας.

ε. Γαργαλιάνο-Κακολύρη Παναγιώτη του Βασιλείου με ΑΔΤ Φ 355382, Παθολόγο- Λοιμωξιολόγο, Διευθυντή του Α΄ Παθολογικού Τμήματος και Μονάδας Λοιμώξεων στο Γενικό Νοσοκομείο Αθηνών «Γεώργιος Γεννηματάς» με αναπληρωτή του, το Σκουτέλη Αθανάσιο του Θεμιστοκλή, με ΑΔΤ ΑΕ 046198, Καθηγητή Παθολογίας- Λοιμώξεων, Διευθυντή της Ε΄ Παθολογικής Κλινικής και Μονάδας Λοιμώξεων στο Γενικό Νοσοκομείο Αθηνών «Ο Ευαγγελισμός».

στ. Μαυρέα Βενετσάνο του Γεωργίου με ΑΔΤ ΑΒ 661649, Καθηγητή Ψυχιατρικής
του Πανεπιστημίου Ιωαννίνων, Αντιπρύτανη, με αναπληρωτή του, τον
Παπαγεωργίου Σωκράτη του Γεωργίου με ΑΔΤ Σ 205371, Επίκουρο Καθηγητή
Νευρολογίας της Ιατρικής Σχολής του Εθνικού Καποδιστριακού Πανεπιστημίου
Αθηνών, Α΄Νευρολογική Κλινική Πανεπιστήμιου Αθηνών, Αιγινήτειο Νοσοκομείο.

ζ. Θηραίο Ελευθέριο του Αθανασίου με ΑΔΤ Χ 169636, Γενικό Ιατρό, Επιμελητή Α΄
του ΕΣΥ, Σύμβουλο Π.Ο.Υ. για τη διαχείριση Χρονίων Νοσημάτων Πρωτοβάθμιας
Φροντίδας, με αναπληρωτή του, το Στεργίου Γεώργιο του Σάββα με ΑΔΤ ΑΒ
589929, Αναπληρωτή Καθηγητή Παθολογίας–Υπέρτασης, Κέντρο Υπέρτασης, Γ΄
ΑΔΑ: ΒΟΖΦΘ-5Ρ9
Παθολογική Κλινική του Εθνικού Καποδιστριακού Πανεπιστημίου Αθηνών, Γενικό
Νοσοκομείο Θώρακος «Η Σωτηρία».

η. Πετρίδου Ελένη του Θεμιστοκλή με ΑΔΤ Ξ 403001, Παιδίατρο, Καθηγήτρια
Επιδημιολογίας και Προληπτικής Ιατρικής του Εθνικού Καποδιστριακού
Πανεπιστημίου Αθηνών με αναπληρωτή της, το Παναγιωτάκο Δημοσθένη του
Βασιλείου, με ΑΔΤ ΑΒ 564566, Αναπληρωτή Καθηγητή Βιοστατιστικής –
Επιδημιολογίας του Τμήματος Επιστήμης Διαιτολογίας-Διατροφής του
Χαροκοπείου Πανεπιστημίου Αθηνών.

θ. Τζουμάκα-Μπακούλα Χρυσάνθη του Βασιλείου, με ΑΔΤ ΑΒ 649447, Καθηγήτρια
Παιδιατρικής του Εθνικού Καποδιστριακού Πανεπιστημίου Αθηνών, Διευθύντρια
της Β’ Παιδιατρικής Κλινικής του Νοσοκομείου Παίδων «Παναγιώτη και Αγλαΐας
Κυριακού», με αναπληρωτή της, το Καραγιάννη Δημήτριο του Θεοφάνη, με ΑΔΤ
ΑΕ 562114, Παιδοψυχίατρο, Διευθυντή ΙΚΑ.

ι. Ουλή Κωνσταντίνο του Ιωάννη, με ΑΔΤ ΑΖ 549496, Οδοντίατρο, Αναπληρωτή
Καθηγητή Οδοντιατρικής του Εθνικού Καποδιστριακού Πανεπιστημίου Αθηνών, με
αναπληρωτή του, το Καλαβρυτινό Μιχαήλ του Κωνσταντίνου με ΑΔΤ ΑΙ 149732,
Ορθοδοντικό, Διδάκτορα Πανεπιστημίου Αθηνών.

ια. Υφαντόπουλο Ιωάννη του Νικολάου, με ΑΔΤ Χ 081463, Καθηγητή Οικονομικών
της Υγείας του Εθνικού Καποδιστριακού Πανεπιστημίου Αθηνών, με αναπληρωτή
του, το Βοζίκη Αθανάσιο του Παναγιώτη, με ΑΔΤ ΑΕ 101555, Λέκτορα Οικονομικών
της Υγείας και Πληροφοριακών Συστημάτων του Πανεπιστημίου Πειραιώς.

ιβ. Νικολοπούλου-Σταμάτη Πολυξένη του Βασιλείου, με Α.Δ.Τ. Φ 018027,
Αναπληρώτρια Καθηγήτρια Ιατρικής Πανεπιστημίου Αθηνών, με αναπληρωτή της
τον Παπαγιάννη Αλέξανδρο του Δημητρίου, με Α.Δ.Τ. ΑΒ 569272, Αναπληρωτή
Καθηγητή Φυσικής Περιβάλλοντος ΕΜΠ.

ιγ. Μανιό Ιωάννη του Βασιλείου, με ΑΔΤ Μ 979341, Επίκουρο Καθηγητή
Διατροφικής Αγωγής και Διατροφικής Αξιολόγησης του Τμήματος Επιστήμης
Διαιτολογίας-Διατροφής του Χαροκοπείου Πανεπιστημίου, με αναπληρωτή του, το
Σκόλια Γεώργιο του Παρίση, με ΑΔΤ Σ 702890, Εργοφυσιολόγο.

ιδ. Κωνσταντινίδη Θεόδωρο του Κωνσταντίνου με ΑΔΤ Ρ 197900, Ειδικό Ιατρό
Εργασίας, Αναπληρωτή Καθηγητή Ιατρικής Σχολής Θράκης, με αναπληρωτή του,
το Βασίλειο Δρακόπουλο του Αντωνίου με ΑΔΤ ΑΒ 102583, Ειδικό Ιατρό Εργασίας.

ιε. Γραβάνη Αχιλλέα του Γεωργίου με ΑΔΤ ΑΙ 450269, Καθηγητή Φαρμακολογίας
Ιατρικής Σχολής Πανεπιστημίου Κρήτης, με αναπληρώτριά του την Σκουρολιάκου
Μαρία του Γεωργίου, με ΑΔΤ ΑΒ 255714, Κλινική Φαρμακοποιό και Επίκουρη
Καθηγήτρια Χαροκόπειου Πανεπιστημίου Αθηνών.


ιστ. Ασημούλα Παπαθανασίου του Κωνσταντίνου με ΑΔΤ Ξ 081153, Προϊσταμένη
Γενικής Διεύθυνσης του Γενικού Χημείου του Κράτους, η οποία αναπληρώνεται
από τη νόμιμη αναπληρώτριά της, Κασσάνδρα Δημητρίου του Δαμιανού, με ΑΔΤ Σ
546778, Προϊσταμένη Δ/νσης Προσωπικού και Τ.Υ. του Γενικού Χημείου του
Κράτους.

ιζ. Από τη Γενική Διεύθυνση Δημόσιας Υγείας του Υπουργείου Υγείας και
Κοινωνικής Αλληλεγγύης τα κατωτέρω πρόσωπα:

- Φωτεινέα-Πανταζοπούλου Αναστασία του Χαραλάμπους με ΑΔΤ ΑΕ 097178,
Γενική Διευθύντρια Δημόσιας Υγείας και Ποιότητας Ζωής, του κλάδου ΠΕ Ιατρών
Δημόσιας Υγείας ΕΣΥ, με αναπληρώτριά της την Κύρλεση Αθηνά του Νικολάου, με
ΑΔΤ Χ 654751, Γενική Διευθύντρια Υγείας, Οφθαλμίατρο, του κλάδου ΠΕ Ιατρών
Δημόσιας Υγείας ΕΣΥ.

- Σύρρο Κωνσταντίνο του Φοίβου-Παύλου με ΑΔΤ Ν 085474, του κλάδου ΠΕ
Ιατρών Δημόσιας Υγείας ΕΣΥ με βαθμό Διευθυντή, Προϊστάμενο της Διεύθυνσης
Δημόσιας Υγιεινής, με αναπληρώτριά του την Παπαγιαννοπούλου Αγγελική του
Δημητρίου, με Α.Δ.Τ ΑΗ 502757, του κλάδου ΠΕ Ιατρών Δημόσιας Υγείας ΕΣΥ, με
βαθμό Διευθυντή, Προϊσταμένη του Τμήματος Επιδημιολογίας Νοσημάτων, της
Διεύθυνσης Δημόσιας Υγιεινής.

- Καραούλη Βασιλική του Ευθυμίου με ΑΔΤ ΑΚ 038785, Διευθύντρια Υγειονομικής
Μηχανικής και Υγιεινής Περιβάλλοντος του κλάδου ΠΕ Υγιεινολόγων Μηχανικών,
με αναπληρωτή της τον Καντζίκη Αντώνιο του Αναστασίου, με ΑΔΤ Ξ 318642,
υπάλληλο του κλάδου ΠΕ Υγιεινολόγων Μηχανικών που υπηρετεί στη Δ/νση
Υγειονομικής Μηχανικής και Υγιεινής Περιβάλλοντος.

- Σταύρου Θεοδώρα του Γεωργίου, με ΑΔΤ Φ 109759, του κλάδου ΠΕ Ιατρών
Δημόσιας Υγείας ΕΣΥ, Προϊσταμένη με ανάθεση της Δ/νσης Συντονισμού και
Συνεργασίας με τους ΟΤΑ Α’ και Β’ βαθμού, με αναπληρωτή της, το Γκογκόση
Κωνσταντίνο του Αποστόλου, με ΑΔΤ ΑΕ 115222, του κλάδου ΠΕ Διοικητικού,
που υπηρετεί στο ΕΚΕΠΥ, Αναπληρωτή Προϊστάμενο στο Τμήμα Χάρτη Υγείας και
Κοινωνικής Αλληλεγγύης.

- Ρίκκο-Κακαλιούρα Τζιουζεπίνα του Ραφαήλ, με ΑΔΤ ΑΑ 197203, του κλάδου ΠΕ
Ιατρών Δημόσιας Υγείας ΕΣΥ, Προϊσταμένη με ανάθεση της Δ/νσης Διατροφής, με
αναπληρώτρια της τη Κωστούλα Βασιλική του Γεωργίου, με ΑΔΤ ΑΙ 101564, του
κλάδου ΤΕ Υγιεινολόγων, Προϊσταμένη του τμήματος Υγειονομικών Κανονισμών
Δημόσιας Υγείας που υπηρετεί στη Διεύθυνση Δημόσιας Υγιεινής.

- Βάλτος Ιωάννης του Ευαγγέλου, με ΑΔΤ Χ 515145, Οδοντίατρος, του κλάδου ΠΕ
Ιατρών Δημόσιας Υγείας ΕΣΥ, Προϊστάμενος με ανάθεση της Δ/νσης Στοματικής
Υγιεινής, με αναπληρώτρια του την Πανταζοπούλου Μαρία του Δημητρίου με ΑΔΤ
Ν 446242, του κλάδου ΠΕ Ιατρών Δημόσιας Υγείας, με βαθμό Α΄, που υπηρετεί
στη Διεύθυνση Δημόσιας Υγιεινής.

- Λιονάκη Χρυσούλα του Ευαγγέλου, με ΑΔΤ Θ 202660, του κλάδου ΠΕ
Ψυχολόγων, Προϊσταμένη με ανάθεση της Δ/νσης Εξαρτήσεων, με αναπληρώτρια
της την Κατσικάρου Σταυρούλα του Λυκούργου με ΑΔΤ ΑΚ 089124 του κλάδου ΠΕ
Διοικητικού με βαθμό Α΄, Προϊσταμένη της Διεύθυνσης Ψυχικής Υγείας.

- Κουλούρη Φωτεινή του Τιμοθέου, με ΑΔΤ Χ 036366, του κλάδου ΠΕ Διοικητικού,
Προϊσταμένη της Δ/νσης Υποστήριξης Άθλησης και Διατροφής με αναπληρωτή της
τον Καρακάση Διονύσιο του Ιορδάνη, με ΑΔΤ ΑΗ 138833, του κλάδου ΠΕ
Διοικητικού, Αναπληρωτή Προϊστάμενο Τμήματος Δημοσίων και Διεθνών Σχέσεων
Άθλησης και Διατροφής.

2. Ο Αντιπρόεδρος αναπληρώνει τον Πρόεδρο ως προς το σύνολο των
καθηκόντων του, όταν αυτός κωλύεται, απουσιάζει ή ελλείπει. Ο Πρόεδρος και τα
μέλη μπορούν να συνεδριάζουν και να λαμβάνουν αποφάσεις με τη φυσική τους
παρουσία ή με τηλεδιάσκεψη.
3. Τα αναπληρωματικά μέλη θα παρίστανται στις συνεδριάσεις του Συμβουλίου και
θα έχουν δικαίωμα διατύπωσης γνώμης και προτάσεων.
4. Το Ε.ΣΥ.Δ.Υ έχει επιστημονικό χαρακτήρα και διατυπώνει απόψεις και
προτάσεις για τα θέματα Δημόσιας Υγείας της χώρας.
5. Για την εύρυθμη λειτουργία και τον καλύτερο συντονισμό του Ε.ΣΥ.Δ.Υ.
συγκροτείται Εκτελεστική Γραμματεία από τον Αντιπρόεδρο Λιονή Χρήστο και το
μέλος Θηραίο Ελευθέριο.
6. Γραμματέα του Συμβουλίου ορίζουμε τη Γαργαλιάνου-Τσεκούρα Αικατερίνη του
Δημητρίου με ΑΔΤ Σ 670698, Διοικητική υπάλληλο του Υπουργείου Υγείας και
Κοινωνικής Αλληλεγγύης που υπηρετεί στο γραφείο του Γενικού Γραμματέα
Δημόσιας Υγείας, με αναπληρώτρια της, τη Τσαντίδου Μαρία- Λεμονιά του
Θεοχάρη με ΑΔΤ ΑΗ 003561, Οδοντίατρο, ομοίως.


7. Η θητεία των ανωτέρω διοριζομένων ορίζεται πενταετής.
8. Η παρούσα απόφαση να δημοσιευθεί στην Εφημερίδα της Κυβερνήσεως.

Ο ΥΠΟΥΡΓΟΣ
ΑΝΔΡΕΑΣ ΛΟΒΕΡΔΟΣ

Κοινοποίηση:
1.Γραφείο κ.Υπουργού
2. Γραφείο κ.κ. Υφυπουργών
3.Γραφείο κ.κ. Γενικών Γραμματέων
4.Γραφείο κ. Προϊστάμενης Γενικής Διεύθυνσης
Διοικητικής Υποστήριξης και Τεχνικών Υποδομών
5.Γραφείο κ. Προϊσταμένου Διεύθυνσης Προσωπικού
6.Δ/νση Προσωπικού-Τμήμα Δ’ (5)
7. Γραμματέα του Συμβουλίου κ. Γαργαλιάνου-Τσεκούρα
Αικατερίνη, προκειμένου να επιδώσει αντίγραφα
της απόφασης στους ενδιαφερόμενους.
8. Εθνικό Τυπογραφείο για τη Δημοσίευση


ΑΥΤΟ ΤΟ ΕΚΤΡΩΜΑ ΔΕ ΧΡΕΙΑΖΕΤΑΙ ΣΧΟΛΙΑΣΜΟ...

ΚΑΙ ΜΟΝΟ Η ΑΝΑΓΝΩΣΗ ΤΩΝ ΟΝΟΜΑΤΩΝ ΤΟΥΣ ΠΡΟΚΑΛΕΙ...

ΕΙΔΙΚΑ ΣΕ ΟΣΟΥΣ ΞΕΡΟΥΝ ΤΗΝ ΙΣΤΟΡΙΑ ΤΩΝ ΤΕΛΕΥΤΑΙΩΝ 30ΕΤΩΝ ΚΑΙ ΤΙΣ ΣΧΕΣΕΙΣ ΚΑΠΟΙΩΝ ΜΕΛΩΝ ΤΗΣ ΕΠΙΤΡΟΠΗΣ ΚΑΙ ΦΑΡΜΑΚΕΥΤΙΚΩΝ ΕΤΑΙΡΕΙΩΝ!

ΑΛΗΘΕΙΑ ΠΙΣΤΕΥΕΙ ΚΑΝΕΙΣ ΟΤΙ ΘΑ ΔΟΘΟΥΝ ΑΠΟΤΕΛΕΣΜΑΤΙΚΕΣ, ΑΞΙΟΠΙΣΤΕΣ, ΑΝΙΔΙΟΤΕΛΕΙΣ ΚΑΙ ΟΙΚΟΝΟΜΙΚΕΣ ΛΥΣΕΙΣ ΣΕ ΠΡΟΒΛΗΜΑΤΑ ΔΗΜΟΣΙΑΣ ΥΓΕΙΑΣ ΜΕ ΟΛΟΥΣ ΑΥΤΟΥΣ?

ΚΑΙ ΚΑΤΙ ΑΚΟΜΑ
ΤΟ ΟΝΟΜΑ ΤΗΣ ΓΡΑΜΜΑΤΕΩΣ ΜΑΣ ΕΚΑΝΕ ΕΝΤΥΠΩΣΗ
ΕΛΠΙΖΟΥΜΕ ΝΑ ΜΗΝ ΕΧΕΙ ΣΧΕΣΗ ΜΕ ΤΟΝ ΣΥΝΕΠΩΝΥΜΟ ΤΗΣ ΣΤΗΝ ΕΠΙΤΡΟΠΗ...!!