We need to act now on HIV, says Netherlands ambassador

Photo by bobbyramakantKey Correspondent, Ishdeep Kohli interviewed Paul Bekkers, the HIV and AIDS Ambassador of the Netherlands, during the first Asian Consultation on the Prevention of HIV Related to Drug Use on 29 January 2008.

Bekkers is also the Director of the Netherlands Social and Institutional Development Department under the Ministry of Foreign Affairs and has served the ministry for more than 15 years. He was named Ambassador for HIV and AIDS in 2005.

The Netherlands has sponsored 27 people attending the Asian Consultation on the Prevention of HIV Related to Drug Use in Goa, India. Why do you think the meeting is important? How will you take the outcome of this meeting to the international arena and future policy work?

“I think this meeting is important because harm reduction itself, especially in relation to drug abuse and HIV and AIDS, is not sufficiently on the agenda internationally. It is an agenda for ourselves in the Netherlands and other foreign countries like the UK, but it should be much more part of the international community’s dialogue.

“This consultation will assist, first of all, in raising awareness but it could also be a platform for sharing experiences and learning from each other. So everybody here at the consultation, I hope, will benefit from this meeting and take important information back to his work and constituency to really become more active.

“I am really happy that the parliamentarians are here. The presence of the politicians is essential because legislation is crucial in creating an enabling environment.”

International harm reduction policies emphasize the need for treatment, care and prevention services for vulnerable communities, especially those in prison settings, sex workers and men who have sex with men (MSM). How does this impact on the actual implementation of policies? Are these policies supported by UN agencies and governments?

“It is very country specific. If you ask me how it is done in this region, of course this region is huge consisting of different countries all with their own cultural and religious backgrounds. Societies are different.

“So even when we are talking about vulnerable groups, about IDUs [injection drug users], MSM [men wwho have sex with men] and sex workers, they have to be understood in a different context in every country. I really want to stress that we need country specific approaches. You should know who you should target, and in which way.

“… We are a relatively important player as the main donor for UNFPA [United Nations Population Fund] and UNAIDS [Joint United Nations Programme on HIV/AIDS]. Actually per capita we are the biggest sponsor of the fight against HIV and AIDS. In our policies we really stress the importance of addressing vulnerable groups, especially IDUs, but we need to understand this is region specific.

“In sub-Saharan Africa, the focus is on sex workers. We should stress in the various UN forums that we should target vulnerable groups, be it prisoners or prison inmates. We are already looking at it in Russia with the prison population, with sex workers in Cambodia and IDUs in different countries. But within the UN we convey the message that the regulations go in the same direction within UNAIDS and UNODC [United Nations Office on Drugs and Crime].”

How is it possible to achieve clear harm reduction policies? Is it possible for different agencies such as the UN, donors and implementing partners and governments, to speak the same language? Does the Dutch government have a road map for cooperation with different countries?

“A couple of years ago we had the global task team based on the division of labour. Countries, agencies and donors should focus on specific areas that they are good at. Like the focus of UNICEF [United Nations Children’s Fund] on children – that is their area of expertise.

“But with harm reduction, it is more complicated. Contrary to HIV and AIDS, as the Indian minister, Mr Oscar Fernandes remarked at the opening ceremony, there is the political issue in harm reduction. It is a political issue, as it involves drugs and drug abuse. There is a lot of difference of opinion. It is difficult, sensitive and political.”

The clean needle programmes were started in the Netherlands. How can the experiences learnt there be adapted to use in this region?

“It is true our policy has developed over years, over decades and indeed it has resulted in a policy that is successful. You can see within the European Union, of all the 25 countries we have the lowest amount of people creating trouble with hard drugs or actually using hard drugs. This is very interesting.

“If you see the amount of HIV transmitted via IDUs it has gone down considerably in past five years. I am impressed with these figures. It is not my work but the work of my colleagues, my fellow citizens.

“We can only convey our experience and make available our expertise. But every country is different. Our experience should be adapted to local circumstances and that is up to the countries themselves.”

The Netherlands is supporting the ‘Margins to Mainstream’ programme through different community-based organizations in Asia. How do we scale up treatment and care, considering that we need to increase the capacity of existing programmes instead of launching new ones?

“We need to consider two things. First we need to find more support for this idea within the community themselves not just the NGOs. The authorities should become involved and even the local and national communities should be part of the programmes. That is important.

“The second is that we need to make more finances available. We need to scale up. The donor community could also assist with this. A lot of things are clear on paper – we all know what to do and we need to act. Implementation is important, not just with harm reduction but in all areas in the fight against HIV and AIDS.”

Ishdeep Kohli-CNS

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