At the end of May, Henry de Vries, dermatologist at GGD Amsterdam, paid a visit to Suriname. He was there together with mayor Femke Halsema and mayor Jan van Zanen, who is also chairman of the VNG. The main purpose of this mission was to promote cooperation in various areas. For example in the prevention of HIV.
Henry: “We see it in all pandemics: infectious diseases know no borders. To be able to cope with these, you have to work together at national and international level.” That is why a visit to the Lobi Health Center Foundation was on the agenda in Paramaribo. Henry: “We have been working closely with them for years. Lobi is the Surinamese word for love. The Lobi Health Center Foundation was established in 1968 and means a lot to society in the field of sexual and reproductive health. For example, they are very active in providing information about contraception and family formation. They also play a major role in preventing STDs and HIV.”
Widespread spread of HIV
The latter is also the reason for the recent visit. “HIV is much more widespread in Suriname than in our country. Everyone in the population has to deal with it,” Henry says. “With PrEP we can prevent infection with HIV, but this preventive agent is still hardly used in Suriname. People who want to use it now have to arrange it all themselves. Fortunately, the Ministry of Health in Suriname will soon start a six-month pilot to make PrEP available on a small scale.”
Pilot met PrEP
PrEP has been proven effective, but must be used properly. Good guidance and information is therefore necessary. PrEP users are regularly tested for HIV and other STIs, and their kidney function is also monitored. Henry: “We also started our PrEP study on a small scale at GGD Amsterdam in 2015. Thanks to good international contacts, we were the first in the Netherlands. We are happy to use our knowledge and expertise to help others as well.” The pilot in Suriname will last six months. “Of course you don’t want people who are on PrEP to have to stop taking it again. That is why we are investigating how we can make the result of the pilot more sustainable, so that participants can continue to use PrEP. As an NGO, the Lobi Health Center Foundation can perhaps play a role in this. Ultimately, you hope that PrEP will be included in the list of reimbursements for medicines in Suriname, as is already the case with HIV treatment.”
Frustrating
The fact that GGD Amsterdam is helping in Suriname does not mean that everything is well organized in our country. Henry: “We are also running into limits in the Netherlands. We cannot help everyone who wants to use PrEP. The waiting lists at the GGD are long, but there is as yet no more money for HIV prevention. That is very frustrating. For public health, it is smart to invest in prevention. People with HIV are dependent on care and the use of expensive resources for the rest of their lives. PrEP can prevent this, it really is a godsend.”
Identify, investigate and collaborate
Henry is proud of the role of the GGD. “The GGD is an executive organisation. As a result, we are really in the capillaries of society. When something is going on, like now with the monkeypox, we are often the first to notice. But in order to be able to perform this signaling function properly and then to be able to switch quickly, it is important that we as an organization are well equipped scientifically and that we work together with other organizations.” That is why Henry, in addition to his appointment at the GGD, also works at the AUMC.
“At the AUMC I work one-on-one with one patient. For the GGD, I look at prevention, groups of people and the health of the entire population. The horizontal approach of the GGD and the vertical approach of an academic hospital complement each other well.” This difference is also reflected in scientific research. “Research at the GGD often starts from a social problem. We use scientific instruments to investigate what is going on, what we can do about it and how we ensure that it does not happen again in the future. In a teaching hospital, research usually goes deeper into a small area. So we can complement each other well. For example, GGD Amsterdam is conducting a long-term cohort study into the effect of HIV on aging. We have been following large groups of men with and without HIV for years. Within this research, the AUMC is looking at specific aging processes, such as osteoporosis and cardiovascular disease.”
Henry de Vries works as a dermatologist at the Center for Sexual Health of GGD Amsterdam. He is also a dermatologist at the AUMC and professor of skin infections at the UvA. Henry recently won the Bio Art and Design Award 2022 with artist Kuang-Yi Ku for their innovative way of making anatomy lessons more inclusive.