‘EU has no real HIV/AIDS strategy for neighbouring countries’

Europe’s strategy to combat HIV/AIDS in its neighbouring countries is mere words on paper and EU investment being put behind the response to HIV/AIDS and tuberculosis in these countries is far from being enough, argues the executive director of the International HIV/AIDS Alliance.

Alvaro Bermejo is the executive director of the 
International HIV/AIDS Alliance
 – the largest European NGO working specifically for HIV/AIDS in developing countries. It is a network working with civil society organisations in thirty countries to support community responses to HIV/AIDS thus helping small groups of sexual workers, intravenous drug users, men who have sex with men and women caring for HIV orphans by giving them small grants and providing technical support.


To read a shortened version of this interview, please click here. 

What are the EU’s commitments to combating HIV/AIDS in developing countries? 

The EU has made specific commitments to HIV/AIDS and used to have a specific budget line, which is now being merged into the EU’s ‘Investing in people’ thematic programme and has been a significant donor to the global fund against AIDS, tuberculosis and malaria. 

The problem is now that all this HIV money has gone to the common global fund – leaving very little for any other complementary mechanisms that are needed for the response to the problem. I also think that the EU has not really had policy dialogue with the governments to make sure that they implement the response – in particular in countries in which it should play a key role and which have yet to acknowledge the role the groups that are difficult to work with have in the response to HIV/AIDS. Without these groups, we will not be able to respond. The EU should use this experience in influencing government responses in Russia in Ukraine and other nearby countries. 

So there is both a financing and a policy-dialogue issue that the EU should address. 

What is the HIV/AIDS situation in the EU’s neighbouring countries? 

Our biggest programme is actually in Ukraine – eastern Europe has the fastest-growing epidemic. In terms of absolute numbers, Africa is the worst off but the HIV/AIDS epidemic is growing very rapidly in the EU border countries. We are also finding a very dangerous combination of HIV/AIDS and drug-resistant tuberculosis is developing at the same time in these countries – in the former Soviet Union countries in particular as well as in central Asia and eastern Europe. 

This is clearly a situation about which the EU should be worried, but the current level of EU funding for HIV/AIDS in these countries is very low. In addition, the drug-resistant tuberculosis has no boundaries, it will come into the EU, no doubt as it develops in neighbouring countries. So the EU should be getting more worried and look at what it does there much more. 

How would you judge the EU’s strategy to combat HIV/AIDS in the neighbouring countries? 

There is a strategy, but still there is very little investment taking place. There’s a lot of debate within the EU, there are strategy papers, but there isn’t any real strategy from the EU in terms of response to HIV/AIDS in these countries. 

There’s a difference between writing something on a piece of paper and really having a strategy that member states and the Commission implement to combat HIV/AIDS in these countries. It does not exist. Investment being put behind the response to HIV/AIDS and tuberculosis in these countries is insufficient. In none of these countries is the EU the major donor. 

For example in Ukraine, the EU took an incredible policy stance, arguing that, as all its HIV money is going to the global fund against HIV, tuberculosis and malaria, it had no additional money to give for these countries, whereas the principles of the global fund states that it should be the additional funding going into it. So, the Commission’s statement shows a principle problem – it is using the investment made into the global fund to justify no additional investment in HIV/AIDS. 

If there was more funding to combat HIV/AIDS in the EU’s neighbouring countries, what should be the strategy? 

Most of these countries have their own strategies and well-planned and budgeted programmes that are not being funded. So we know what to fund – those existing national plans. The EU needs to put more money behind those. 

I also think that there should be a real interest from the EU to fund civil-society organisations in these countries to respond to health issues because by achieving better health outcomes they also contribute to a much more dynamic civil society in countries that are coming through a transition process, in which civil-society organisations are very young and where health has always been a good mechanism through which to, as a secondary role, fill that civil- society response as well as to contribute to shifting health systems that are very vertical (responses to HIV/AIDS and tuberculosis dealt with separately) towards more horizontal and integrated ones. 

So, what matters is support for the funding of national plans and involving civil society in those plans.