HIV a crisis in Russia, U.N. warns
(WASHINGTON POST-February 18, 2004)

AIDS exploding in region, report says Urges action now MOSCOW—The United Nations warned yesterday that the spread of AIDS through the former Soviet Union and Eastern Europe has reached crisis proportions and beseeched complacent regional leaders "to wake up (and) take this threat seriously" before it overwhelms them.

While the epidemic largely spared the region as it ravaged other areas in the 1980s and 1990s, AIDS is now spreading faster here than anywhere in the world. One of every 100 adults in Russia and several other countries now has the virus that causes AIDS, a higher rate than anywhere but sub-Saharan Africa and the Caribbean, the U.N. reported.

Fuelled by intravenous drug use, the rapid advance of AIDS through the former eastern bloc has stymied governments and threatens to engulf overtaxed health-care systems and choke economic growth, the United Nations said.

The U.N.'s first comprehensive study of AIDS in the region estimated 1.8 million people were infected with the human immunodeficiency virus in the countries it studied in Eastern Europe and the former Soviet Union, with new infection rates highest in Russia, Ukraine, and the Baltic states of Estonia and Latvia. The report said the virus continues to spread quickly in Belarus, Kazakhstan and Moldova as well

It cited Poland, Slovakia and the Czech Republic as examples of countries that had halted or reversed the spread of the disease, but said a high infection rate in Estonia showed that economic growth did not necessarily mean beating the epidemic.

Mark Malloch Brown, head of the U.N. Development Program, described Russia and the region as "on the edge of disaster" and said he came to Moscow "to appeal to Russians — civil  society, ordinary people, government — to wake up, take this threat seriously and while there's still time to change the  trajectory of prevalence of HIV-AIDS.''

"Russia has always been at its best when the times are tough and critical," added Mikko Vienonen, head of the World Health Organization's office in Moscow, who joined Brown at a news conference organized with the state-run RIA-Novosti news agency. "The times are now tough and critical.''

Russia, which reported just 163 new cases of the HIV virus that causes AIDS in 1994, had an estimated 1 million people
with HIV as of the end of 2003 — more than the United States has with twice the population. Until recently, Russia's HIV-positive population has been doubling every six months; international experts discounted a reported one-time drop in new infections in 2002 as a statistical aberration.

According to forecasts included in the U.N. report, AIDS will accelerate Russia's already dramatic population decline, costing the country an additional 9 million lives by 2045 in the most optimistic scenario and 20 million lives in the worst-case projection. Under the pessimistic scenario, AIDS would reduce Russia's potential economic output by 4 per cent by 2010 and 10.5 per cent by 2020.

The Russian government, already afflicted by a major health crisis exacerbated by widespread tuberculosis, syphilis, heart disease and alcoholism, has done little to fight the AIDS problem.

President Vladimir Putin mentioned AIDS only once, in a single clause, in his annual state of the nation address last year. The annual federal budget for fighting AIDS is about $4 million (U.S.), about $1 million of which is  targeted for prevention.

Brown offered unusually blunt criticism of Russia's political leadership. "One speech is not enough and one  reference in a speech is not enough," he said. "There has to be strong leadership time after time to warn Russians that this is a threat.''

Vienonen pointed out that only 1,000 Russians get anti-retroviral therapy, which can cost $6,000 to $9,000 per patient annually here. "We always know that Russia is not Africa," he said. "In this respect, Russia is Africa.''

The Russian Health Ministry did not respond to a request for comment yesterday. But at a November news conference, Vadim Pokrovsky, head of the ministry's AIDS prevention centre, agreed that more needed to be done to fight the disease.