In Ukraine it is still difficult to present that in our MFA the position of the Ambassador on sexual, reproductive health and human rights in the near future can appear. In small safe Holland it is realities, and here in the largest country of Europe in which over the years HIV/AIDS epidemic storms, to human rights, authorities are indifferent to reproductive and sexual health. And as the world practice shows, until a problem of HIV/AIDS didn't become personal history of political leaders, it will not find the solution. A bright example of that – the leader of the Republic of South Africa Nelson Mandela who was pushed on fight against HIV/AIDS epidemic by the death of his younger son. Lambert Griyns is the Ambassador of the Netherlands on sexual, reproductive health and human rights especially responsibly perceives HIV response. At the recently ended 21st international AIDS 2016 conference in the South African Durban, the head of Small Heart with Art public organization Evgenia Smirnova has discussed with the Dutch diplomat importance of the personal involvement in overcoming of HIV/AIDS and also value for Ukraine of the next conference which will take place in Amsterdam in 2018. Already now it is called "critical" as it will be focused on HIV/AIDS epidemic in Eastern Europe, Central Asia and the Middle East.
- Why, being a diplomat, have you decided to deal with a problem of HIV? On top of all of this, the personal involvement is also very important in this question.
I am a diplomat, and each four-five years I have other position. Now I am an Ambassador concerning AIDS of the Ministry of Foreign Affairs of the Netherlands. When you work with this problem, you just had to be participating. Just look around here – there's a lot of people at this conference, and everyone has own personal history connected with HIV. It seems to me that HIV is a consequence of inequality. HIV-positive people often are the victims of sexual or other violence, or suffer from poverty – they have no choice, or not access to education, or to goods and services. And it makes me mad, but also gives me force to work for full. This that, as for the personal party of my work.
- The next AIDS 2018 conference will take place in your country. Tell me why did organizers choose exactly Amsterdam?
It is very important the fact that the next conference will take place in Europe. First, if to look at the latest data on recently infected HIV, then the highest rates of spread of the disease are just in Europe, namely in Eastern Europe and also in Central Asia and on the Middle East. These territories are either directly in Europe, or just a short distance away from it. So we cannot ignore it. I don't think that people understand that even in our region there are such high rates of HIV spread. Secondly, I consider that we have to show to our authorities that it is very current problem. Financing from the donor countries is reduced, but our governments don't offer any alternative – I mean the Western European authorities and also the authorities in Eastern Europe and Central Asia, including Russia. So we want that everyone will took part at the conference in Amsterdam, including the countries of Africa, Latin America and Asia, and, of course, Europe. I would like that associations of the people living with HIV and also authorities – those who make decisions, who can inform of these problems to influential and rich people, have participated in a conference. It is necessary to change the current situation. We hope that Amsterdam will become the place where people will exchange opinions and inspire each other, especially representatives of Eastern Europe and Central Asia.
- And how public associations can take part in this process?
For now, the most important issue: how can we make sure that members of associations of the people living with HIV are really included in fight against AIDS – at all its stages, but not only formal? Exactly they have to head fight against this disease. And how I, as the authority, can help these communities to arrive to a conference to Amsterdam to have an opportunity to join in this fight. Yes, we have provided the corresponding financing. We provide grants, including for countries of Eastern Europe – Ukraine, for example, and Central Asia – Tajikistan, Kyrgyzstan, and Georgia too. It is fund for 45 million US dollars. Also there is one more fund – on 40-45 million. These programs are aimed at strengthening of the local organizations working with the population, on expansion of their opportunities for rendering of services to the people living with HIV, and also on support in upholding of their interests before own government which has to bear responsibility for them.
In Ukraine a situation with HIV is very serious, and we are extremely concerned by it. Because HIV is such problem which has to concern all society, the whole country. But also the government is also obliged to take the responsibility. It is a problem of system of public health care. As the individual or non-governmental organization you can't assume overall responsibility for problems of public health care. Exactly the power has to be engaged in it, change important laws, for example, to resolve an issue of drug abuse. In my opinion, decriminalization of the drug abuse is an effective government measure. It is necessary to make at least so that the persons doing drugs didn't get to prison or the rehabilitation centers at once. Programs of harm reduction for consumers of drugs are very effective – it was shown by experience of many countries. The policy of harm reduction is important and effective. Programs of replacement therapy, and that the most important – treatments of drug addicts, and not as criminals, and as the people needing the help and support. It has to proceed from the power, and not only from the Minister of Health, and from law enforcement agencies, police, prosecutor's office – all system has to understand and accept that consumers of drugs are people, and they can need the help, but not punishment. If people are interested in such approach, I invite them to our country. We were just one of the first, perhaps, even the first who has successfully embodied programs of reduction of harm for consumers of drugs. And it is successful not only from the point of view of human rights – besides, it is positively influences economy and health care because such programs finally save many funds. Therefore it is sometimes unclear why the authorities so are afraid of public associations and non-governmental organizations. They are necessary to us because they help us as to the government to embody the policy. So we need to work together with these organizations. And the power has to make its policy open for participation of civil society.
- What changes should be expected also what will be in a priority at the Amsterdam conference?
- At a conference in Amsterdam we will definitely talk about money because global financing will perhaps be reduced, and financing at the national level will become more important. To what extent our governments are ready and capable to undertake such responsibility? Probably, this is not about the money, and in political will. The termination of AIDS epidemic has to depend not on money, and on societies, on understanding them the fact that we have to take care of prevention, about education – about sexual education and also have to provide medical care. Treatment, of course, is important, but it is not our only care. The main thing – to make so that people will not be infected at all, then it won't be necessary to treat them. Therefore, at future conference we will talk about money, political will, prevention. Also in Amsterdam we will focus on problems of the main groups of the population as we observe concentration of HIV epidemic in the main groups of the population in the countries with the average level of income as Ukraine. It will be an important question on our agenda.
- More than 90% of HIV-positive people in our region are Russian-speaking even if we speak about Estonia or Latvia. Here I communicate with many people and I know that some participants from Russia and Ukraine have problems with the translation. The don't understand English and therefore can't fully join in conference. Perhaps should we pay special attention to Russian-speaking audience which in two years won't learn English for certain?
I understand what you're talking about. Yes, there is such problem, and we are ready to it. During the conference we will provide the translation into Russian, and not only in the main sections, but we will try to offer such opportunity to participants and in smaller, additional sections. We will also try to make official invitations for representatives of the government, we will make everything that scientists and members of non-governmental organizations, etc. will arrive to us. And we will help them to arrive to Amsterdam – for example, we will promote at receipt of a visa or, perhaps, we will pay a trip. But our main goal – to increase the level of knowledge. Together with the Dutch public organization AFEW (AIDS Foundation East-West) we start the program directed to residents of Eastern Europe and Central Asia.
It is very important to enable people to arrive to Amsterdam. We know about a language problem. In March of this year I went for the Moscow conference on HIV/AIDS. There I communicated with many authorities and the different organizations from Eastern Europe, and all had two questions. The first: “Can you send me the official invitation?”, and the second: "And in what language will it be there?". So I know about this problem.
- And will you provide grants?
- Yes. The matter is that we will exactly host a conference, but not to organize it – the IAS association (International AIDS Society) is engaged in it. And they will surely allocate grants for people worldwide. You see, it not a conference for countries of Eastern Europe and Central Asia – that's a global conference. So we want to see in Amsterdam people from all countries. Of course, one of the main problems is HIV among young girls, especially in the countries of Africa. In absolute figures it is just huge problem. But we also see spread of HIV and among girls in the cities of Ukraine. So Ukraine has to participate in a conference, we want to see representatives of your country. And we are ready to listen to all impartial people, there is no uniform correct decision of this problem.
- That is, should be a discussion expected?
- We are open for any opinions and are ready to perceive others experience.
Therefore, I would like all to ask everyone to think now about what things you could do till 2018. This is not just about future conference – is important with what you will arrive there. So, begin to arrange workshops, write articles and research, join NGO, tell media about what they can help with case of dissemination of knowledge about HIV. The role of social media is also very big. People are often afraid to admit about their HIV-positive status. And social media allow them to gain a lot of knowledge. So the authorities can provide through them information to people who are too afraid of condemnation therefore don't speak about the problems interesting them. For example, if you are a gay, but in your family it is impossible to be the gay, what can you do? But you also want to obtain information or, at least, to have access to it.
- In our country the problem of HIV-positive children is simply awful. In Europe children are not infected with HIV from mothers any more, but in Eastern Europe and Central Asia it is still real trouble.
- Yes, but there are also exceptions – for example, Belarus …
- Belarus - it's just one country!
- But how did they manage it? How did Belarus manage to reduce infection level among children? In Kazakhstan, by the way, there is a similar situation. And these are good examples for the whole region.
- We got to make sure that the official statistics is true. At the current conference all say that in Africa HIV isn't also transmitted from mother to the child any more, but if there are so much infected young women, won’t their children be infected with the virus?
- I think if the young woman or the girl knows about the HIV-positive status and becomes pregnant, she can complete a therapy course. During this therapy and childbirth if mother is treated, HIV isn't transferred to the child. And it is very important. In the majority of the countries pregnant women go to antenatal clinics where they are checked for HIV. It is an excellent way to reveal HIV-positive women and to begin treatment in time. So it is very important to begin with such bases – it isn't so difficult.
- It's not difficult, but when the level of discrimination and the negative attitude towards HIV-positive people is extremely high, it is already more difficult. In our country pregnant women are tested for HIV three times, but women are afraid of this analysis – they are afraid even to hear the word "AIDS". They think that if they pass a test, then will find in themselves HIV or AIDS. Because of it they prefer not to learn the status at all. And the situation is the same even in the capital – in Kyiv.
- I understand what you're talking about. Existence of a good health care system doesn't mean yet that it is correctly used. But, of course, the problem of the negative relation and discrimination is even more considerable. To admit that you are HIV-positive, it is very difficult even in the Netherlands. How can we change it? I think, it is necessary to begin with leaders who will dare to tell, for example, that his wife has HIV. Or that's how you have told me about your family. It's perfectly normal. Many people lack the knowledge, they don't even know that if treated, then you won't be able to infect anybody at all. In my country not everyone knows about it. I was also very surprised when I have learned about it four years ago, beginning to work at a position of the Ambassador concerning AIDS. It is necessary to inform of this knowledge people. HIV – a normal disease and though it is impossible to recover from it completely, but it it is possible to suspend and live absolutely normally. The expected life expectancy of HIV-positive people is almost same, as at other population. It is necessary to speak about it all the time. But the most important, leaders of opinions and a celebrity have to tell about it. For example, at this conference there are Elton John, prince Harry, princesses of the Netherlands and Luxembourg.
- In the former Soviet Union it is still impossible not to touch policy when it comes about HIV. Up to now activists have to work hard in Russia.
In general, it is more difficult to get there. But it is sometimes simpler to diplomats to find a way out. It helps us to discuss HIV from different positions: and from the point of view of human rights, but also and as a question of health care or economy. The HIV problem, of course, concerns mainly health care. But in the same time is connected also with policy.
Sometimes, the main thing – to find the necessary people. Right now while we talk, on the monitor an interview with the mayor of Amsterdam is showed. Why the mayor of Amsterdam is such zealous participant of fight against HIV? On video he says that he is so involved in a problem of this disease including because his brother has died of AIDS in 1992. So sometimes personal stories motivate people to fight.