How Flanders is playing its part in the fight against Aids

Policy officer Sander Spanoghe, who specialises in development cooperation, is representing Flanders at the event. Here he explains why the region is involved and what it hopes to achieve as part of the global effort to eradicate Aids.

What challenges are faced by those working in this field?

The fact that HIV and Aids mainly affect people from vulnerable groups and countries indicates that HIV is a social rather than a purely health problem. So to reach these groups and to use the right tools, organisations from sectors other than health have to be involved and work together. Of these, education is the most obvious. In addition, nutrition, justice, employment, equal opportunities policy and others have an important role to play.

How are efforts to tackle the issue progressing?

By far the most important thing here is the failure of our collective prevention efforts. For example, the number of new infections per year has decreased by just 18% since 2010. To achieve our dream of wiping out Aids, we should be at 75% reduction by 2020 – within less than two years. In Eastern Europe and Central Asia, we have even witnessed a reversed trend in recent years, where instead of a reduction, we have seen the number of new infections double. As long as we fail to completely liberate people with HIV from the virus, we will have to continue to put all those new people on Aids inhibitors for life. This not only costs a lot of money in medicine, it also requires major efforts by health personnel to carefully monitor these people. The threat of increased resistance can also trigger a new treatment crisis.

What is Flanders doing to support efforts by the international community?

Since 2000, Flanders has been supporting UNAids, the UN Special Program for the fight against HIV and Aids. A third of the annual funding we provide, €250,000, goes to support the secretariat based in Geneva. That’s important because this is where the most effective and progressive policies and guidelines are plotted with the participation of the member states of the UN and civil society. The remaining two thirds of the annual subsidy is used by UNAids to support the country offices in eight African countries with the highest contamination rate, including South Africa, Malawi and Mozambique. The aim is to strengthen the country offices.

Flanders also provides support to the UN Special Program for Human Propagation Research, HRP. This is part of the World Health Organization and carries out research into various themes that are closely linked to the fight against HIV and Aids. For example, they examine how developing countries can best integrate their services for care and prevention of HIV and Aids with the many other services needed to promote citizens’ sexual and reproductive health. In doing so, they also draw up the global guidelines for a complete sexual and reproductive health service for people with HIV.

What is Flanders’ involvement in the event in Amsterdam?

Our role at the conference is diverse. Our presence can help to ensure that best practice for Aids control and treatment that have been developed by partners we support, or within Flemish expertise centres, are adequately addressed. This is the case, for example, for the approach developed by Artsen Zonder Grenzen (Doctors Without Borders) to actively involve patient groups in their treatment. Patients in Mozambique organise themselves to collect their medication from the often-remote health post for all those who need it.

As a result, the periodic but lifelong retrieval of these drugs is a much less stressful task, leading to higher patient compliance. It’s extremely important, in view of the finding that people with HIV who take their medicines faithfully manage to suppress the presence of the virus in their body to the point that they can no longer pass on the infection. In that way, treatment is a hugely important part of prevention.

Flemish microbiologist Peter Piot, who discovered the Ebola virus, is speaking at the conference. Does your department work with him in the field of global health?

Since Dr Piot took up his current position as director of the London School of Hygiene and Tropical Medicine, we have had contact with him at the highest political level. For example, he had several meetings with minister-president Geert Bourgeois during the Davos World Economic Forum and he was awarded the Flemish Community’s highest honour in 2017.

The fact that in addition to his busy management activities at the institute, Dr Piot continues to find time to add his support to the fight against HIV and Aids is extremely important, particularly at a time like this when this fight is under great pressure. His speech at the conference will undoubtedly stress the need for global solidarity.

Photo: ©International AIDS Society/Steve Forrest/Workers’ Photos