Louise van Deth: towards an AIDS-free world in 2030

Louise van Deth.jpgOn 1 June 2016, Louise van Deth became responsible for the entire Aids Fonds-STOP AIDS NOW!-Soa Aids Nederland organisation. Louise van Deth had been director of STOP AIDS NOW! since 2008 and had shared the role of director of the tripartite organisation since 2013. Following the departure of co-director Ton Coenen, Louise van Deth has now been chosen as the sole director. We spoke to her about her new role, her vision for tackling the epidemic in Amsterdam and the Netherlands, and for achieving the worldwide goal of an AIDS-free world by 2030.

Congratulations on your new appointment as director of the Aids Fonds-STOP AIDS NOW!-Soa Aids Nederland organisation. What does this mean for the organisation and your own work?

When I began as director of STOP AIDS NOW! it was still a separate organisation. The three organisations, Aids Fonds, STOP AIDS NOW! and Soa Aids Nederland, fused in January 2013, after which Ton Coenen and I shared the directorship. Despite the fact that there are three different ‘brands’, there’s plenty of overlap and collaboration. Projects are therefore no longer brand-based but expertise-based. When Ton left, we decided it would make more sense and be more efficient if we carried on with just one director.

The nature my work changed when STOP AIDS NOW! fused with the other two organisations. Previously my work had a primarily international focus. Now I enjoy working both in the national and international field. It’s great to have this overlap and to be able to use the Netherlands as a feeding ground for international work and, vice versa, to be able to bring our international experience to the Netherlands. This ‘cross-pollination’ is very important.

Where is the HIV field heading to at the moment?

The collective, worldwide goal is to end AIDS by 2030. When I say end AIDS, I mean that people will no longer die of AIDS, there will be no new HIV infections and everyone living with HIV will have proper access to care and receive the right treatment. Our organisation is working hard to achieve this goal within the Netherlands and the rest of the world. In fact, it is very encouraging to see all the efforts being undertaken to achieve the 2030 goal. For example, in 2014 the fast-track cities initiative was set up to provide cities with information and support to fight AIDS and thereby achieve certain goals by 2020. Amsterdam is one of the fast-track cities, with its H-TEAM initiative. In this project, all the stakeholders involved in the fight against HIV, including our organisation, have combined their expertise to cut back the number of new HIV infections. An important cause given that we still have around 1,000 new HIV infections each year in the Netherlands. Looking at other countries, I think the H-TEAM approach is quite unique and exemplifies the way in which we tackle HIV/AIDS in the Netherlands.

What other plans are there for dealing with the HIV epidemic in the Netherlands?

One of the things we are campaigning for is the availability of PrEP in the Netherlands. I firmly believe the HIV prevention pill, PrEP, should be made available in our country. It is already available in France, the US and Kenya; the Netherlands is lagging behind. PrEP should not be used instead of, but as a supplement to the current package of prevention measures and this is why I  want to see it being made available as soon as possible, preferably this year. We are currently putting pressure on both the Minister of Health, Welfare and Sport and the pharmaceutical industry to make it happen.

In addition, I believe there is great potential for tackling the epidemic through the use of data. By data I mean open data and big data. Using these data would not only be valuable for better deciding how to spend our funds, but it could also tell us more about precisely which people are at risk, what causes high-risk behaviour, and, in pursuit of Joep Lange’s dream, how you can trace new infections as early as possible, get these people on treatment immediately and see whether they can then be taken off treatment after, say, two years as a kind of functional cure. Despite the field of big data being incredibly complex due to issues such as privacy, I think it’s an area that would allow us to make great strides forwards.

What do you consider to be the major international challenges to achieving an AIDS-free world?

To achieve the goal of an AIDS-free world, the next five years will be crucial: we need to see a change during this period. We know from various calculations that, if the graphs don’t start sloping downwards in the next 5 years, the epidemic will start to get out of control again. I was therefore very concerned to see that the figures released by UNAIDS on 31 May this year showed that, for the first time in 20  years, the number of new infections has stopped declining. This is due to inequality, stigma, discrimination and political choices. A very good example of these issues is eastern Europe, where the situation is very bad at the moment. The epidemic in this region is concentrated among drug users, sex workers, and their partners, who barely have access to services because they feel unsafe and discriminated. We really need to address these issues during the next 5 years if we want to achieve the goal of an AIDS-free world.  

You recently attended the UN high-level meeting on HIV/AIDS in New York. Could you tell us briefly what was discussed and what the outcome was?

During the UN high-level meeting on HIV/AIDS, 193 countries signed a declaration, making new agreements for the next 5 years on how to achieve the goal together. However, formulating the declaration required substantial negotiations due to major differences between the conservative and more progressive countries involved. While some countries felt the declaration didn’t go far enough, others felt it went too far, and so the outcome will always be a compromise. During a press meeting at the conference, Minister Ploumen of Foreign Trade and Development Cooperation in the Netherlands made it clear that, since we have both the drugs and the knowledge available to tackle HIV/AIDS, she would have liked to have seen the declaration go further. Nonetheless, certain countries continue to oppose the declaration. For example, Russia does not support certain paragraphs in the declaration on key populations and harm reduction in drug users.  On the other hand, some countries in eastern Europe are striving to change the situation. For example, the capital of Romania, Bucharest, is part of the fast-track cities initiative. We will continue to build on these opportunities and find out what works in this region and what we can do to move forwards. In addition, we are lobbying in countries such as Ukraine to stimulate them to increase their efforts. We really need everyone on board to ensure we achieve the 2030 goal.