AIDS in Germany

Luis Carlos Escobar Pinzon was named executive director of Deutsche Aidshilfe, a 120-member umbrella organization for community-based health organizations, last January. Born in Columbia, Escobar has lived in Germany for the past 14 years, working in public health research.

DW-WORLD.DE: Dr. Escobar, the situation surrounding AIDS education and treatment has changed a great deal in the past decade. What is the state of affairs in Germany today?

Luis Carlos Escobar de Pinzon: Since anti-retrovirus combination therapies were introduced, people with HIV have better treatment opportunities. They can live for years symptom-free. That may have led to the fact that many people no longer think of HIV and AIDS as deadly diseases.

AIDS is now often seen as a chronic illness, so people aren't protecting themselves as well as they used to. That's been our experience, and we are really sorry to see it. It is a huge new challenge in primary prevention.

Currently in Germany, according to estimates by the Robert Koch institute, there are 56,000 people in Germany living with HIV/AIDS. The biggest group is what we call MSM -- men who have sex with men. Then a big second group is intravenous drug users. A third group, that is catching up with the second group, is immigrants, especially from high-prevalence countries.

You stepped into this job a year ago. What were your goals when you took over -- and how is it going?

My main goal was to once again make HIV and AIDS an important topic in society. It is no longer as present in the media as it was in the beginning of the 1990s. Especially in local politics, the relevance of HIV and AIDS has faded. ... We see this in budget cuts for prevention and sex education. There are budget cuts of up to 30 percent in some regions.

But we're really glad that on the federal level, we found someone like German Health Minister Ulla Schmidt, who is dedicated to putting the topics HIV/AIDS strongly on the political agenda. She has seen to it that we get more federal funding to fight HIV and AIDS.

There is still a lot of work left to be done, especially because in the context of this disease, we just can't deal with it regionally -- it is a global challenge. We will need to take stronger action ... especially with our neighbors in Eastern Europe.

What are the biggest issues facing AIDS-related community health organizations today?

Prevention, prevention, and more prevention. Since 2001, we have noticed that the number of new diagnosis is growing again. We have to find the reasons for this increase, and take appropriate action.

In 2007, DAH is starting an interesting research project that should shed more light on the context and influences of new infections better.

In addition, we are also fighting the discrimination and stigmatization of people with HIV/AIDS. Where HIV/AIDS are taboo topics, prevention can't take hold. We're not talking just about solidarity with people who have HIV and AIDS. This is about anti-discrimination work that is urgently needed to create a protected space for all people with chronic illnesses.

How is the increasing prevalence of HIV/AIDS among immigrants and asylum seekers affecting Germany, and AIDS policy here?

As a person who came here as an immigrant myself, I see it as a very important topic. Asylum seekers are especially threatened and endangered from HIV infection here.

It is important to point up the difficult situation for immigrants in Germany, especially those who are also are infected with HIV. They don't only have to fight the usual problems like racism, legal status, and financial difficulties. They have an infection that is strongly taboo within their own community. And naturally, because of cultural and language differences, they have difficulty accessing sex-education and prevention material.

Has the German regime under Angela Merkel been supportive of HIV/AIDS health organizations? What is your relationship with her administration?

We work tightly together with the government. ... We're really happy that the German health minister Schmidt recently promised 3 million additional euros ($4 million) for funding for primary prevention in 2007.

Beyond that, she announced that when Germany holds the EU presidency (starting in 2007) it wants to put the topic HIV/AIDS very high up on its political agenda.

In Germany we have a very privileged situation. The numbers of new infections hasn't risen as much as in other countries, even within Europe. But we need to help our neighbors, especially those from Eastern Europe, to do better and more intensive work on prevention. We are all equally responsible for containing this disease.

You've had an exciting tenure so far at the head of the DAH -- what are your targets for this year?

Above all, we want to lead a very important discussion on the role of civil society in primary prevention. The catchword will be "responsibility." DAH believes responsibility is not divisible. Everybody has equal responsibility for containing the spread of new infection in our country. HIV positive people have responsibility to not pass the infection along. But non-tested people and HIV-negative people have exactly as much responsibility to protect themselves from becoming infected.

We need to have a discussion about this, in terms of medical ethics, and then develop concrete measures toward primary prevention in Germany.

Jennifer Abramsohn interviewed Luis Carlos Escobar Pinzon