(November 14, 2023 – EPC)
Speakers:
- Carlos Iniesta, Research and Institutional Relations Coordinator, SEISIDA;
- Cyrus Engerer, Member of the European Parliament, Group of the Progressive Alliance of Socialists and Democrats;
- Elizabeth Kuiper, Associate Director and Head of the Social Europe and Well-being Programme, European Policy Centre;
- Felipe Rogatto, Executive Director, Medical Affairs HIV, Gilead;
- Frances Fitzgerald, Member of the European Parliament, European People’s Party;
- Harriet Langanke, Combination Prevention Chair, European Aids Treatment Group;
- Joëlle Verluyten, Executive Director, The European AIDS Clinical Society.
Moderator:
- Danielle Brandy, Policy Analyst, European Policy Centre.
Elizabeth Kuiper provided a comprehensive overview of policy recommendations aimed at addressing and ultimately ending the HIV epidemic in Europe. Collaborating with Gilead, she emphasized the importance of maintaining political commitment and momentum for HIV, especially in the context of upcoming EU elections. Ms. Kuiper highlighted the need for a dedicated EU-wide awareness campaign to ensure the continued focus on HIV preventions and treatment, emphasizing that prevention pays off in terms of citizen participation and quality of life.
Moreover, she stressed the significance of stablishing a best practice platform and EU guideline document for HIV, recognizing the diverse healthcare systems across Europe. This platform would not only set standards but also facilitate knowledge exchange among member states, ultimately enhancing the options available for people living with HIV. Ms. Kuiper underscored the critical role of accurate data to achieve effective planning and monitoring to make reality a more standardized data collection and reporting across EU member states. Additionally, she emphasized the importance of promoting research and innovation, calling for sustained funding at the EU level to support HIV research and the development of new prevention methods and treatments.
At the member state level, Ms. Kuiper recommended an increase of investment in testing and prevention, a diversification of testing methods, and an expansion on testing services to include community-based approaches. She highlighted the need to tackle stigma discrimination through multifaceted approaches and accurate data, emphasizing collaboration between different ministries. Lastly, Ms. Kuiper emphasized the importance of engaging with civil society and people living with HIV, stressing their crucial role in driving sustainable change and advocating for policy changes. Overall, her recommendations encompassed a holistic and collaborative approach to address the complexities of the HIV epidemic in Europe.
Frances Fitzgerald, reflected on the parallels between the COVID-19 pandemic and HIV/AIDS epidemic of the 1980s. She had the experience to be a social worker, in London, during the AIDS crises and she could see in first hand, the problems that aroused at that time, like the uncertainty, lack of understanding, and social stigma that surrounded the illness. She enunciated all progress in treatment and prevention, and significant reduction in mortality rates and the development of new drug therapies. However, despite of all those positive aspects that has been accomplished, she underscored the ongoing challenges, particularly the need for intensified preventions efforts, with pre-exposure prophylaxis (PrEP) being a crucial tool. Ms. Fitzgerald commended Gilead Sciences for their work in this area and called for European countries to make PrEP accessible to all citizens. She urged the EU to facilitate bulk purchases to reduce costs for member states, ensuring inclusivity across diverse populations. Ms. Fitzgerald emphasized the importance of scaling up existing HIV prevention and treatment services and highlighted the essential role of the European Center for Disease Control in monitoring HIV prevalence. Addressing persistent discrimination and stigma, she stressed the need to combat misinformation and promote accurate expert-backed knowledges. Despite the challenges, Ms. Fitzgerald expressed optimism that with renewed political focus and concerted efforts, the EU can achieve its goal of ending the HIV epidemic by 2030.
Cyrus Engerer highlighted the need for sustained political focus and commitment in addressing the HIV epidemic. He expressed concern that discussions about HIV often arise seasonally rather than being a constant focus throughout the political year. Mrs. Engerer, drawing on his experience as a social worker, compared the current global response to HIV with the early years of the epidemic, emphasizing the progress made in treatment and prevention. However, he noted that challenges persist, particularly in his home country, Malta, which has seen a concerning increase in new HIV cases.
Mrs. Engerer emphasized the importance of comprehensive strategies, addressing issues ranging from research funding to education and testing accessibility. He criticized the lack of comprehensive sexuality education in some European countries, citing the correlation between inadequate education and high rates of prolonged waiting times for HIV testing in public clinics, pointing out the urgent need to address the issue across Europe. Additionally, he stressed the importance of inclusive policies regarding to the marginalized communities often left outside of the health system, for example: refugees, asylum seekers, migrants, sex workers, and the LGBTQ+ community.
In the context of the pharmaceutical strategy, Mrs. Engerer called for increased investment in research and innovation in Europe. He echoed Fraces Fitzgerald’s endorsement of joint procurement of medicines at the EU level, advocating for a unified pharmaceutical market to ensure fair access to affordable medicines for all member states.
Carlos Iniesta focused on HIV prevention, particularly the role of Pre-Exposure Prophylaxis (PrEP). Acknowledging the progress made in Spain and Europe in meeting 1999 targets, he emphasized the importance of reducing new infections further. In particular, he highlighted the potential impact of PrEP, citing successful examples in cities like London and Amsterdam. However, he stressed the need to address stigma and discrimination associated with HIV and PrEP, emphasizing the importance of political support and collaborative networks among communities, healthcare professionals, and policymakers.
Joëlle Verluyten highlighted various initiatives aimed at advancing HIV prevention and care. European AIDS clinical society (EACS) has prioritized education and training programs for young clinicians, including medical exchange programs, career development fellowships, and an HIV summer school with a research and clinical module. The organization is also developing an overarching HIV diploma to unify its courses and has published annual guidelines for HIV management. Mrs. Verluyten emphasized the importance of funding and training younger clinicians to address research gaps and foster interest in research. EACS is actively involved in developing standards of care, with ongoing projects focusing on HIV prevention, testing, and combating stigma in healthcare settings. The organization is conducting a survey on healthcare-related stigma across Europe. Mrs. Verluyten stressed the significance of dedicated HIV best practice platforms and the need to address data gaps, particularly in areas such as PrEP for women. She concluded by underscoring the pivotal role of clinicians in collaboration with civil society, policymakers, and pharmaceutical companies to collectively work towards ending the HIV epidemic.
Joelle’s initiatives through EACS showcase a comprehensive approach that combines education, research, and standards of care to address current challenges in HIV prevention and management. The organization’s emphasis on engaging the next generation of clinicians and fostering collaboration across various stakeholders demonstrates a commitment to achieving sustainable goals in ending the HIV epidemic in Europe.
Felipe Rogatto provided a positive reflection on the progress made in addressing HIV over the past 40 years, emphasizing the transition from HIV being a sentence to a chronic condition with near-normal lifespans. However, he acknowledged that significant challenges remain, particularly in areas such as stigma, mental health, and achieving the 95-95-95 targets in the Cascade of Care. Mrs. Rogatto highlighted the importance of both best practices sharing and learning from worst practices. He noted disparities across Eastern and Western Europe and stresses the need for increased prevention access, especially in economically challenged regions and areas where HIV is not prioritized in the political agenda. Mrs. Rogatto emphasized the critical role of innovation detached from the healthcare system. Despite the challenges, he expressed optimism about the region’s potential to lead in lead in ending the epidemic, provided concerted efforts are made to address existing disparities and work towards the 95% target for access to combination prevention.
Harriet Langanke highlighted the crucial need for data, especially concerning women’s health in HIV prevention and treatment. She emphasized the limited inclusion of women in clinical trials and underscored the importance of addressing this gap to inform more specific approaches. Mrs. Langanke advocated for leveraging the European health data space to overcome the scattered nature of data at the member state level, promoting interoperability, and fostering advancements in healthcare innovation and research. She pointed out the potential of the European health data space to enhance surveillance and research, ultimately leading to improved approaches in HIV prevention and care. Mrs. Langanke stressed the significance of political will, urging the Spanish presidency to not only advocate for a high-level recommendation on HIV but also to actively support the negotiations and successful conclusion of the European Health data space, mitigating potential delays in the upcoming date.
Link to the event: https://www.epc.eu/en/past-events/Ending-the-HIV-epidemic-in-Europe-Towards~54afb0