During the visit Lord Fowler advocated for HIV prevention and called on the Government of Ukraine to increase funding of harm reduction work.
The visit was facilitated by the International HIV/AIDS Alliance in Ukraine, the UK’s All Party Parliamentary Group on AIDS and the secretariat of the International HIV/AIDS Alliance.
The Global Fund to Fight AIDS, TB and Malaria is decreasing its aid to middle-income countries and current gains may be lost unless the Ukrainian government makes HIV prevention a bigger priority and starts funding harm reduction programmes.
As the former UK Minster of Health under Margret Thatcher’s government Lord Fowler is a champion of evidence-informed HIV responses in the UK and internationally, which includes providing clean needles to injecting drug users and harm reduction. He was instrumental to the UK’s ‘Don’t Die of Ignorance’ campaign, which raised awareness of HIV dramatically during the 1980s.
Speaking on a Ukrainian evening news programme Lord Fowler gave the example of how harm reduction has worked in the UK, saying “We introduced in UK harm reduction in 80s and the HIV prevalence among people who use drugs is low. Introduction of harm reduction did not lead to the increase in criminality”.
Meeting people affected by HIV
Above: Lord Fowler with activists for communities most affected by HIV
While in Ukraine Lord Fowler visited harm reduction and HIV treatment services and met many people who have been affected by HIV. This included clients of centres for people who use drugs in Kiev, street children and activists for LGBT communities, sex workers and people who use drugs.
Lord Fowler’s willingness to meet with and speak to communities most affected by HIV was strongly welcomed. He was praised by Elena Tsukerman, a sex workers’ rights activist (legalife.com.ua), who commented that “Ukrainian politicians say that they are not ready to have the dialogue with sex workers, thinking that this harms their reputation”. She went on to say, “We hope that Lord Fowler’s and our continued work will contribute to reforming Ukrainian legislation related to the sex work and will increase the inclusion of sex workers in decision making processes”.
Meeting with policy makers
Lord Fowler also met with government officials and international and national development partners. This included a meeting with Tatiana Bakhteeva, Chair of the Healthcare Commission of the Ukrainian parliament, and Oleksandr Tolstanov, Deputy Minister of Health. Lord Fowler told them about the results of harm reduction programmes in UK and their cost-effectiveness.
While MP Bakhteeva agreed that ART, syringe exchanges and substitution treatment must be prioritised to effectively tackle HIV in Ukraine, she said that the Ukrainian government would not be able to take over the responsibility for harm reduction programs or finance them.
Recognising Alliance Ukraine’s achievements
Lord Fowler highlighted the significant progress in Ukraine’s HIV response that has been made by Alliance Ukraine, its civil society partners, community networks and the government.
He was particularly impressed by the HIV prevention and community mobilisation projects implemented by Alliance Ukraine with the support of the Global Fund, USAID and the European Union. Key achievements have been the decrease in new HV infections among people who use drugs, increased availability of prevention and harm reduction services for communities who are most affected by HIV, and significant scale up of treatment services.
After learning about the Alliance’s Community Action on Harm Reduction project, Lord Fowler enthusiastically supported the idea of sharing best practices learnt in Ukraine with other countries.
Stigma and discrimination
Lord Fowler emphasised how stigma and discrimination could remain major obstacles to the HIV response in Ukraine. A key aspect of this is the ongoing police persecution of people most affected by HIV, particularly people who use drugs, sex workers and men who have sex with men.
Treatment and prevention
During the meetings Lord Fowler stressed that HIV treatment and prevention are closely linked and should be equally prioritised by the government if ongoing progress is to be achieved.
Much work still to be done
Lord Fowler’s visit to Ukraine has been crucial in raising important questions about what is needed to bring an end to AIDS in Ukraine, and the increased focus and determination needed by the Ukrainian Government, and the ongoing political and financial support an effective response to HIV requires.
Much progress has been made in Ukraine’s response to HIV but much more remains to be done. Lord Fowler’s visit helped to highlight some of these gains, and the impressive work being undertaken by many partners and will hopefully inspire continued leadership in the effort to bring an end to AIDS in Ukraine. This will hopefully drive a community-centred HIV response to improve on the gains which have already been made, prevent new HIV infections and save more lives.