Toespraak van minister Ploumen bij de conferentie over Dutch leadership in ending AIDS

Toespraak | 09-04-2015

Ladies and gentlemen,

I'm delighted to see you all here today. But, of course, not everyone is here. We're missing Joep Lange, Jacqueline van Tongeren, Pim de Kuijer, Martine de Schutter, Lucie van Mens and others. They never made it to the International AIDS Conference in Melbourne last July. But you are all here, I'm happy to say, and we must continue their work.

The story of HIV and AIDS is one of great paradoxes. There have never been so many people infected with HIV as there are today. About 35 million worldwide. That's an appalling statistic. And yet, hiding within it is some good news.

The number of people with HIV is so high because, thanks to anti-retrovirals and better access to treatment, people are living much longer on average. Every year fewer people are dying. The AIDS epidemic is in retreat. The number of infections is falling worldwide. Thanks to information, testing facilities and condoms. And thanks to people like you.

But that brings us to another paradox. Some people simply aren't so afraid of HIV and AIDS anymore. In a way, that's understandable. In the 1980s, the disease was almost always a death sentence, while now you can take a pill to fight this invisible virus. I'm certainly glad that people now have the comfort of knowing they don't have to die of this disease.

But this loss of fear poses a grave threat to the fight against AIDS. Because, too often, it results in a lack of concern. And the combination of a lack of concern and 35 million people living with HIV and AIDS is a deadly cocktail. All those people with HIV could potentially infect others. That simply must not happen. That's why we must keep pouring our efforts into prevention. We still have a long way to go.

And here we encounter the next paradox: the AIDS mortality rate is falling in all age groups except young people. 40% of all new HIV infections are among people under 25. Every hour, 30 more young people are infected with HIV. And most of them are girls. Yet health care in this area isn't properly geared to young people. They are tested less often than adults, and they're often too embarrassed or ashamed to seek help. What's more, girls are often unable to insist on having safe sex, and are frequently the victims of sexual violence.

And there are other disturbing developments. We often associate AIDS with Sub-Saharan Africa. That's understandable. Certainly, the region is still the hardest hit. But more and more, the disease is spreading in middle-income countries. In Russia, for example. 10 years ago, there were 170,000 people with HIV there. Now there are 1.2 million. And you can see the same trend throughout Eastern Europe and Central Asia. The reason is the failure to work effectively with at-risk groups.

Because there are still groups that run a much higher risk of HIV infection: above all, drug addicts, sex workers and men who have sex with men. And here's yet another paradox: men who have sex with men are 19 times more likely to contract HIV than heterosexuals, and transgender people 49 times more likely. And once they've contracted the virus, these people have far less access to treatment. That's a big problem, and a big danger. But unfortunately, these are precisely the people that many societies want nothing to do with.

The Netherlands wants to draw more attention to these groups. Because other countries won't, or aren't doing nearly enough. We have a good track record. In the Netherlands now, hardly any drug users get infected with HIV. That is thanks to our harm-reduction approach: working not only to stop drug abuse, but also - and especially - to limit the spread of drug-related infectious diseases. Needle exchange, easy-access care facilities and dedicated areas for users. Few interventions are as provenly effective as these. So the Dutch approach is an example for other countries. Take Germany, for instance. At first it wasn't keen on this policy of harm reduction, and opted for a stricter approach. But when that didn't work, Germany changed its policy and copied the Dutch model. And it worked.

But it's not only European countries that are applying this strategy. Countries like Kenya, Indonesia, China and Iran are also adopting our recommendations - even if they're sometimes a bit hesitant. But in many countries - like Russia - this is still a hard message to get across. That can change. It must change. I think we need to take the lead in this fight. And I see a key role for civil society. Local NGOs are best placed to reach these people. Working with strategic partners like the Aids Fund, the HIV/AIDS Alliance and the COC, I want to focus our efforts squarely on lobbying and advocacy.

But, of course, funding is needed as well. And here, too, we see a paradox. Currently, the most money is going to the poorest countries. That's only logical: that's where the money is needed most. But at the same time, more and more people with HIV live in middle-income countries. So I say: let's shift our focus from countries in need to people in need. We have to look beyond country lists and GDP lists. What matters is ensuring that people who need access to information and treatment get it. Whether they're in Rwanda, Russia or Romania.

I also want to call on public authorities in middle-income countries to invest more in health care for all. In July, the Financing for Development Conference will take place in Addis Ababa in Ethiopia. There, the international community will sketch the first outlines of a new, workable framework for global development cooperation. Above all, we will be looking at how to fund such a new, innovative system. In Addis I intend to underline the importance of combating HIV and AIDS. The UN's slogan for the new Sustainable Development Goals is 'Leave no one behind'. That must certainly include the 35 million people living with HIV. Let's not leave them behind.

Ladies and gentlemen,

In 2018, the International Aids Conference will be held in Amsterdam. That is a recognition of the crucial role the Netherlands plays in the global fight against AIDS. It is also a recognition of the work of those people I mentioned at the start of my speech - people who are not here with us today. Our goal for 2018 must be to find a narrative that would make them proud. We certainly aren't there yet. I wish you every success in the work that lies ahead.

Thank you.