HIV in Eastern Europe: Only human rights and a strong civil society can curb the epidemic
Experts call for empowerment of affected groups and cooperation between governments and non-governmental organisations, lighthouse projects should get support.
The conference, which took place online on Dember 14, 2020, brought together civil society representatives from Eastern Europe and Central Asia (EECA) together. They draw out the need for a fundamental change of course in the HIV policies to bring the still expanding epidemic in the EECA region under control.
How can that be achieved?
That's the question being addressed at the online conference entitled "Is HIV-work human rights work?" organised by AIDS Action Europe, Action against AIDS Germany, Brot für die Welt and Deutsche Aidshilfe. Experts from the region discussed paths to effective prevention measures and care. The number of HIV infections has been rising in Eastern Europe and Central Asia for years – against the global trend. The reason lies in a disastrous mixture of stigmatisation and persecution of the most affected groups, as well as in the growing weakening of civil society organisations, which always play a key role in measures against HIV. The coronavirus pandemic is now exacerbating the situation even more.
Neglected groups at high risk
While in Western countries HIV work is usually also considered human rights work, focusing on the rights of the individual, prevention in the countries of Eastern Europe is all too often limited to collective health care. HIV affects 99 percent of persecuted and marginalised groups in the region: People who use drugs intravenously, men who have sex with men, sex workers, people in prison, migrant workers and their partners. However, all the experience of almost four decades of HIV work shows that sustainable success can only be achieved if the human rights of these groups are taken seriously, if they are countered by discrimination and if they are offered tailor-made prevention, HIV testing and medical care. It is high time to exploit the potential for this in Eastern Europe too!
Address by NGOs is essential
Michel Kazatchkine, UN Envoy on HIV/AIDS in Eastern Europe and Central Asia, in his opening speech: "In times of the COVID-19 pandemic, we realise that while we can all be affected, some of us have a much higher health risk than others. Non-governmental and community organisations are best placed to ensure access to HIV-related services for the most vulnerable populations. Civil society organisations can also identify and address the social, economic, political and moral injustices and inequalities that drive the epidemic in the region."
The influence of civil society disregarded
The positive experiences in Germany in particular show: Cooperation between governments and non-governmental organisations (NGOs) is one of the decisive factors in promoting successful measures against the spread of HIV. In Eastern Europe in particular, they have much better access to the most affected groups. However, they are often hindered in their work and their scope and funding are restricted. Susanne Müller, European consultant at Brot für die Welt, says: "The governments of many Eastern European countries are failing to seize the opportunity for cooperation. Instead of finding allies in government, nongovernmental organisations are stigmatised as 'enemies' and 'agents of foreign countries'. The people most affected by HIV thus lose their voice. The increasing restriction of civil society is becoming another driving force behind the HIV epidemic in the region.”
Loss of funding endangers supply by NGOs
Civil society is currently being weakened by changes to the financing of measures against HIV. Many countries in Eastern Europe are in a process of transition: Internationally financed support, such as that provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), can no longer be provided because conditions for the proper use of the funds are not met or because the countries themselves have sufficient financial power. The countries have to pay for their measures themselves – and do so according to their own criteria. That means NGOs often no longer receive support. The consequences are fatal, as Sylvia Urban, board member of the German Aids Federation and Action against Aids, explains: "The changes in financing are actually causing care systems to collapse. Civil society organisations can no longer maintain prevention services, access to information and community-based programs. People with HIV or tuberculosis and those groups that are particularly hard hit are left alone. As a result, the number of new infections increases and previous successes are cancelled out.”
Strengthening exemplary policies
It has become difficult to counter this combination – a political blockade of prevention and mistrust of civil society on the one hand, and financing changes on the other. An exchange of expertise and political pressure at the international level can help, as can bilaterally implemented lighthouse projects in the region, which show that human rights-based HIV measures are epidemiologically more successful.