The AIDS Healthcare Foundation began in the United States, but it’s now very much a global organization with operations in 45 countries. This week we heard from some of our leaders in Europe about how AHF is bringing the organization’s mission to European patients.
AHF in Europe
Exploring how AHF’s mission is progressing across the Atlantic
Zoya Shabarova is the Europe Bureau Chief based in the Netherlands, covering the UK, Netherlands, Estonia, Lithuania, Ukraine, Georgia, Greece, Portugal, and soon Poland.
CORE TOPICS + DETAILS:
[4:36] - Picking Our Places
Deciding where to expand in Europe and beyond
Expanding AHF in Europe and elsewhere is a balancing act. On one hand, the organization’s leaders look for the areas of greatest need, such as Ukraine in recent months. But they also seek opportunities where governments are open to partnerships and policymakers are actively seeking help from organizations such as this one. Where need and opportunity meet, AHF is able to accomplish amazing things.
[7:35] - Caring During Wartime
How AHF’s mission in Ukraine continues even amidst war
AHF’s program activities in Ukraine have not stopped for a moment, thanks to the tireless efforts of AHF team members at every level of the organization. “We were prepared, we had supplies, we had communication, and we really started to provide very efficient care to our patients— and not only patients who continue to be on the site, but patients who were on the road, fleeing for safe places, and also patients who then became refugees in other countries.”
[13:34] - AIDS in Europe: Where We Stand
The status of the fight against HIV and AIDS in Europe
In 2021 the Europe Bureau of AHF celebrated ten years since its establishment in 2011. Since then, the need continues— Eastern Europe is the only part of the world where HIV infection continues to grow. In Western Europe, countries are actively participating in international aid and funding. So AHF’s two primary tasks in the battle are to develop cost-efficient and community-based models for access to care, and providing migrants coming from developing countries with the care they need.
[17:31] - Overcoming Challenges
Unique roadblocks to establishing AHF in European countries
AHF must face and overcome unique challenges to adoption and care everywhere we go, including in Europe. Much of Estonia actively pursues a monopolist healthcare system in which community organizations are kept from providing care. AHF is seeking to help this and other nations see the power of partnership with civil society.
ABOUT AFTER HOURS:
AIDS Healthcare Foundation is the world’s largest HIV/AIDS service organization, operating in 45 countries globally. The mission? Providing cutting-edge medicine and advocacy for everyone, regardless of ability to pay.
The After Hours podcast is an official podcast of the AIDS Healthcare Foundation, in which host Lauren Hogan is joined by experts in a range of fields to educate, inform, and inspire listeners on topics that go far beyond medical information to cover leadership, creativity, and success.
Learn more at: https://www.aidshealth.org
ABOUT THE HOST:
Lauren Hogan is the Associate Director of Communications for the AIDS Healthcare Foundation, and has been working in a series of roles with the Foundation since 2016. She’s passionate about increasing the public visibility of AIDS, the Foundation's critical work, and how everyday people can help join the fight to make cutting-edge medicine, treatment, and support available for anyone who needs it.
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Get unfiltered lessons from our leaders at AHF as we uncover real, raw stories of where we came from and where we are going. Join us for an unscripted look at the connections our senior leadership have to our mission core values and hot initiatives.
AHF is the world's largest HIV/AIDS service organization operating in 45 countries globally, 16 states domestically, including DC and Puerto Rico. Our mission is to provide cutting edge medicine and advocacy regardless of ability to pay.
Hello and welcome to the After Hours podcast. I'm your host, Lauren Hogan, serving as your liaison to take you through this journey to learn more about AIDS Healthcare Foundation. Before we start the show, please make sure to remember to check out the show notes so you can follow along. Now, let's get started.
Hello everyone and welcome back to another episode of the After Hours podcast. As always, I'm your host, Lauren Hogan and today we have a lovely spotlight. I'm really excited to be speaking with the head of our AHF Europe Bureau. So really quickly, Zoya, do you mind introducing yourself to everyone, what your role is and how long you've been with AHF?
Hello everybody and I'm very excited too about this opportunity to tell a little bit more about AHF work in Europe. And my name is Zoya Shabarova. I'm Europe Bureau chief and based in Netherlands.
So thank you so much for being here with us today, Zoya. We're really excited to be talking to you and getting some more insight into Europe. So the first question I have for you is how many countries are we currently serving in Europe?
Europe Bureau currently covered the United Kingdom, the Netherlands, Estonia, Lithuania, Ukraine, Georgia. We also work in Greece and in Portugal and we are just about to start a new program in Poland.
So you're very busy to say the least.
Yeah. Yeah, yeah.
So do you recall where was the first location that we actually opened in Europe?
Yeah, absolutely. We started to work in Europe in Odessa. This is a seaport city in Ukraine and it was really a great need. We need to tell that initially HIV epidemic in the former Soviet Union started in this city Odessa, and we started our work in 2008 exploring it, so it was quite a while ago. And actually we receive a request from local [inaudible 00:03:08] administration to help with the satellite clinic because this is a remote area of the city. Odessa is a city resort and the big port, and on one part of the city was situated in the hospital which provided care and treatment to HIV women. And specifically, they were doing deliveries, but they did not have a possibility to establish care and treatment for women and newborn babies, and they asked us to help.
And with this really great mission, we entered into the partnership and very soon we expanded our services not only for the provision of pregnant women and newborn babies who were living with HIV, but also to the partners, to the friends, relatives because of our patient-centered care approach. And yes, we are still working there. We are still taking care of our patient in Odessa. Yes.
That is phenomenal. Thank you for that background.
Yeah. So how did you guys decide where to expand to in Europe? You gave that background of the first site, but how did you guys determine how to continue to expand?
This is a very good question, and we always look for the needs. And we have very close connections with the communities on the ground, very good connections with decision makers, policymakers, and sometimes it is community who came to us, who ask us for the help. For example, this was a case with starting our partnership programs in Greece and in Portugal in 2012, 2013 because we receive a request from two big local NGOs, in Greece it's Positive Voice and in Portugal it's [inaudible 00:05:35], advocates for treatment. We know that during that time it was a big financial crisis and government stop the provision of the funds to support NGOs and provide so much needed support for the communities. And in this case it was HIV testing. And basically AHF with a decision to give a hand to the NGOs on one hand, but on other hand to provide the technical support in terms of AHF rapid testing model. They establish this partnership and still we are working together.
On other hand, we also respond to the needs from the governments, and this is then in many cases our case in Ukraine, where after the successful Odessa model, the head of the National AIDS Center in Ukraine, Dr. [inaudible 00:06:45], she came to us and asked to provide technical assistance and established partnerships also in other regions in Ukraine. And now AHS has taken care for approx approximately 35% of all people who are on ART in Ukraine. Of course, we do it in partnership with Ukrainian government institutions and of course local NGOs. So basically AHF is really nimble to respond to the needs, both by the getting invitation from the government institution, but then also by the non-government civil society sector.
Wow, that's a huge number of folks who to be taken care of. And since you mentioned Ukraine, I did want to ask too, with the war going on in Ukraine right now and AHF of taking care of so many people, how have we been able to navigate still providing the need, and how are we continuing to care for our patients and employees in the midst of what's happening?
Yes, actually at this point I would like to say I am really very proud to be part of AHS because AHS is committed to be with the patients through the best and through the worst, through the most difficult and challenging time. And this is the best example, one of the best example of really AHF mission in action. Our program activities in Ukraine did not stop for the second and it was possible and it is possible only through the support of AHF president, of AHF senior management, of all the leadership, and of course a heroic leadership of our country program director, who unfortunately could not join us now for the podcast, but I hope one situation will be more stable on the ground, she will be able really to tell stories and what actually was driven the team and how they can really withstand right now it's nine months.
But also I would like to tell that HR director of safety and security together with director of financial management were very good this preparing the team before they was started. And as soon as it started, our team recognized what was happening, they were really ready and they exactly know what to do. There was no time for the panic. We were prepared, we had supplies, we had communication and we really started to provide very efficient care to our patients, and not only patients who continue to be on the site, but patients who were on the road, fleeing for the safe places, and also patients who then became a refugees in other countries. We keep a very close contact and communication. So I'm really proud to be part of AHF and this is an excellent example that the whole AHF family is standing together.
And I really also would like to thank a human resource team now who is helping to give this example to others. And I think it's important for everybody to realize what does it mean to be part of AHF.
Well, I want to say I hear you thanking everybody, but thank you for all that you were doing to your leadership as well. Contributed to doing all of the things that you're describing, so thank you as well for being able to take all of that on and really manage such a very honestly traumatic situation.
I do want to do one follow-up question though too, is I know you said that we're able to keep in contact with our patients that go to other countries, but overall what has been the impact on our operations in Ukraine since the war happened? Does it look very different now?
We really become much stronger. And I don't think there is something existing which can stop us to do what we are doing. We are not only know it theoretically, but we convinced. And of course, day-to-day activities change. It started with check-ins in use, seeing where are rocket and missiles attacks, contacting our sites there, our offices there, making sure that everybody are safe.
Of course, we need to foresee much more things. For example, in July we started with [inaudible 00:12:33] and with our Ukrainian team, with Dr. [inaudible 00:12:37], to think what the winter will look like. We did not know that infrastructure will be attacked but we know that winter is coming, and really AHF established, AHF Ukraine, established in our sites heating stations. We bought blankets, we bought heating devices. Of course, because of all we didn't think about it, there was no need about it, but now we are prepared. We know everything about emergency communications and how to live actually from based on very limited resources but what is really essential. So we become much more resilient. But I think this resilience was inside, only it was implemented when the time ask for it.
So kind of going back to a more broader perspective now, overall in Europe, what would you say the progress has been in our fight against HIV and AIDS?
In 2021, 2 years ago, it was during the Covid time, but Europe Bureau celebrated 10 years since it was established. It was established in January 2011. It was last bureau which was established within AHF because on one hand, yeah, Europe is developed, why do we need European bureau? But on other hand there are two really big issues. The first eastern part of Europe, this is the only part of the world which HIV infection continue to grow. It's not African, not Asia, but it is Eastern Europe. So need is here. And on the second part, the western part of the Europe is a countries who actively participate in international aid, who actually big funders, along with United States, Canada, Japan, to global fund to as a also bilateral.
So this is our two main tasks. The first one to develop a cost efficient and community-based models in the Eastern Europe to help people to get access to care. So we see then if people with HIV are diagnosed and started treatment, this is a way for the AIDS-free society to eliminate HIV, and we are actively working on it. And our models on patient-centered care, which we established in Odessa clinic now, which we model also in Estonia, which is basically in Narva, the God-forgotten place where only endure like we are working, providing care to the most difficult groups of the population. This model are becoming more and more recognized by the government, and they already gave you an example with Ukraine.
On other hand, on the western part, our focus is on migrants, and migrants who are coming from developing countries, specifically from Africa, to Europe, to Netherlands, to the UK, to Portugal, to Greece. And they don't know how to enter the excellent, let's say excellent healthcare. So they are dying in the countries where there is a state-of-the-art care because they don't know how to enter this high threshold healthcare services.
So we are with our community-based HIV testing model, we are low threshold, free facilities where you don't need to have appointment, where you don't need to have any fee or payment. We are helping people to be diagnosed. And then what is very important, according to AHF model, we are linking these people to this excellent healthcare because excellent healthcare system mean nothing if you don't know how to enter it. So we are helping the most vulnerable, the most challenging groups of population here. And this model, we are actively advocating for this model in Brussels and EU level.
Another thing I wanted to ask you too is that you talk about having to work with the government a lot in order to bring care to a country. What would you say has been the biggest challenge or obstacle you've faced or experienced throughout this process?
It take me some time to reflect why we have, for example, challenge in Estonia, where we have a clinic, and one of the reason for this challenge is a desire of healthcare system to be a monopolist, not to allow civil society, not to allow community organization to participate in shaping care of people who needs the care. They simply in this bubble, in the biomedical approach, which purely it's a disease. They're looking on you as a combination of symptoms and not a person who is coming with the needs, with specifics, and whose life need to accommodate care, because when we are talking about the chronic disease, it's very difficult that patient will adhere to treatment and retained in care if his lifestyle is not in a good combination, if it is not open to him.
And in quite many cases, we are witnessing this desire to keep the monopole and not allow civil society to participate. Of course, civil society [inaudible 00:19:29] will not formulate the diagnosis and prescribe treatment, but we need to be equal partners because our goal is the same. So this is basically what I am witnessing in many countries across Europe and it's our main challenge.
And I wanted to ask too about stigma. I know in the US there's still a lot of stigma around HIV and AIDS and having conversations around them, about the topic I should say. So what is stigma like in Europe? Is it higher? Are people still treated differently if they acquire HIV, or what's the level of stigma like?
Yes, of course there is stigma in one countries are bigger than in another, and it depends on also many cases how religious are communities. For example, in Poland it's very difficult to talk about LGBT or condoms or living with HIV because it's stigmatized, and it's very religious society, very Catholic society. In Netherlands, you can freely talk. My son was learning about a gay relationship at school and it was normal. It was absolutely normal. You cannot imagine this in thousand kilometers from this country. So it's rise, but there is still of course stigma. And we need to fight it and we need to continue to educate and to help people who affected by this. Of course, AHF sites are stigma free and we promote our people-centered approach. We promote friendly and absolutely non-discriminatory and not stigmatized way. And our hope is that people will learn from the best examples.
So we are pretty much at time. So I do have one last question for you, and that is for those that are listening to this episode, what is the main thing that you want them to know about the AHF Europe Bureau?
That in spite of all the challenges, current challenges in Europe, AHF Europe team is striving to implement AHF mission on the ground, that we are providing cutting edge medicine and advocacy regardless of ability to pay to everybody who need it in Europe. And we are proud to do this and we will continue to do this. Thank you.
Zoya, thank you so much. This has truly been an inspiring episode. Thank you for all you and your team are doing, and as always we are praying for our staff, employees and patients and everybody that's currently in Ukraine. So thank you so very much.
Thank you very much for giving me this opportunity in talking to you. Thank you.
Thank you so much for joining us. If you enjoyed this episode and you'd like to help support the show, please subscribe, share with your friends, like, post about it on social media or leave a rating and review. Follow us on Instagram @afterhours and see you next time.