'Society Benefits from Strong Science': EECA INTERACT
The international EECA INTERACT scientific workshop will take place at the Bellevue Park Hotel in Riga on 13 and 14 December. The aim of the workshop is to strengthen scientific capacity and transnational cooperation in controlling HIV, tuberculosis, and viral hepatitis. This year, its topic is “Science for Action on HIV, Tuberculosis and Viral Hepatitis in Eastern Europe and Central Asia”.
Prof. Michel Kazatchkine, M.D. is the Special Advisor to the World Health Organization Regional Office for Europe (WHO/Europe), the Course Director at the Global Health Center, and the Graduate Institute of International Affairs and Development Studies.
Prof. Catherine Hankins, M.D. is Senior Fellow at the Amsterdam Institute for Global Health and Development (AIGHD), Department of Global Health, University of Amsterdam and Professor and Interim Chair of the Department of Global and Public Health, McGill University School of Population and Global Health.
What is the general idea behind this workshop? How did it begin?
Prof. Kazatchkine: The idea came in 2018 at the Amsterdam International AIDS Conference that had a strong focus on HIV in Eastern Europe and Central Asia (EECA). It was clear at that time that the EECA AIDS Conferences (EECAAC) organised every second year since 2006 in Moscow will not continue as an accepted "reference conference" on AIDS for the region.
Prof. Hankins: When Joep Lange was killed, I was asked to take over the INTEREST Conference, which is an HIV conference that is held annually in Africa. Its focus is on capacity building and sharing science. My AIGHD colleague Brandon O’Dell then said to me, "Why don't we do this for Eastern Europe/Central Asia, because the epidemic is really not under control there?"
Prof. Kazatchkine: From the beginning, Prof. Hankins, Frank Cobbelens, and I wanted to build on Joep Lange's legacy to support young investigators, ensure strong peer-reviewed science, and have a forum in English and Russian where Eastern and Western scientists would meet.
Prof. Hankins: The workshop is about sharing science for action. First of all, we want to show that evidence is important in informing policy, practice, and programmes, to encourage people to think scientifically, to conduct scientific studies, and to come and share their results and get feedback from their peers.
We're trying to support the creation of the next generation of scientists.
It's about building the capacity of young scientists and creating a space for dialogue between scientists, policy makers, programme planners, and people with lived experience.
What questions will be at the core of this specific scientific conference in Latvia?
Prof. Kazatchkine: At least the two following questions: a) multidrug-resistant tuberculosis (MDR TB), since the region is one of the highest-burden regions for MDR TB. There has recently been remarkable progress in diagnostic methods and treatment of MDR TB and the region has contributed to this progress; b) the war in Ukraine and its impact on health in Ukraine, in the broader EECA region, and in Europe (including the refugee crisis)
Prof. Hankins: We have a whole session on the impact of the war in Ukraine for the region, including disrupted drug supplies and access to antiretrovirals, strained health services in the countries receiving refugees etc. We are concerned about ongoing HIV transmission and the state of harm reduction in the region. We have talks on stigma and discrimination, and what can be done to overcome it, because it's such a barrier to treatment access for people.
Is the influx of Ukrainian refugees having an effect on the topics that you're focusing on?
Prof. Kazatchkine: Yes. A number of people with HIV, people with TB/MDR TB and people using drugs on opioid substitution therapy were among the millions who have fled Ukraine in the last eight months. There have been challenges to ensure continuity of treatment, but health systems and physicians have been communicating between Ukraine and host countries in Europe, and NGOs have provided remarkable support. Since most Ukrainian refugees to Western Europe are young women and children, the numbers of TB cases among migrants ended up being less than originally feared.
Prof. Hankins: Some countries are receiving thousands and thousands of refugees, so health care services, which were already stressed by the pandemic, are further burdened. There are now backlogs for the normal screenings that you would do for different cancers, as well as for surgeries and radiation therapy. Everything is being delayed. In addition, many healthcare workers are burned out and exhausted, so this, in combination with huge influxes of people that need care, is stressing health systems. We want to look at what's going on with health systems.
We will also focus on innovations that have been introduced. Not just to describe a dire situation, but also look at what some solutions could be, and how people are innovating to be able to address these challenges.
How are you working to de-stigmatise these diseases?
Prof. Kazatchkine: Stigma remains high in EECA societies and even in some health care settings. Several NGOs have been conducting work to fight stigma in the region but constraints on international funding (e.g. the foreign agent legislation in the Russian Federation) and pressure from law enforcement has been increasingly challenging their work in recent years.
What do you hope to achieve in Riga?
Prof. Kazatchkine: A scientific seminar where young investigators from the region can present their work and establish contacts with colleagues, including scientists from the West. We want to further consolidate INTERACT’s place as the leading scientific event on HIV, TB, hepatitis, and drug-related issues accessible to young investigators in EECA.
Why would you say that it is important that people attend this workshop?
Prof. Hankins: It's important for doctors to attend, hear the latest science, and share their own experiences, because they have a different kind of lived experience serving patients. It's important for NGOs to attend, because they can link up with other NGOs in the region that will be present to share expertise and find out what they're doing and how they're doing it. For policy makers, it's important for them to hear the latest science and think through the implications for various policies and programmes with a diverse audience. It's about creating what I would call a community of practice. People can hear how others go about things and they can get new ideas.
It's important for students to have mentors, to see examples of what a career looks like down the road.
INTERACT is about capacity building, role models, and the community of practice. We want to create conversations that often might otherwise not happen between doctors and NGOs, for example, and for policy makers to understand what scientific evidence there is, see if it's enough to act, and hear about lived experience from civil society representatives and health care workers to inform their decision making.
How does society benefit from this workshop?
Prof. Kazatchkine: Access to a broader scientific audience has long been an issue for physicians and scientists in EECA. One of the barriers has been language, even if younger generation scientists increasingly communicate in English. By encouraging trans-regional and international communication between scientists and physicians East-West, INTERACT contributes to open the region to the world.
Prof. Hankins: Society benefits from strong science and strong evidence, and the way that you get that is to have peers challenging your work and conversations that stretch your views, opening up possibilities and making you think.
