Eastern European, Central Asian Nations Must Make Greater Effort in Fighting AIDS, World Bank Strategy Report Says

The governments of Eastern European and Central Asian nations must make a greater commitment to fighting HIV/AIDS in the region to prevent a "potentially catastrophic epidemic," according to a regional support strategy report released yesterday by the World Bank, BBC News reports. The region has the fastest growing number of HIV-positive people in the world. Currently, about one million HIV-positive people live in the region, but that number is expected to increase to more than eight million by the end of the decade, according to BBC News (Bamford, BBC News, 9/16). The report, titled "Averting AIDS Crises in Eastern Europe and Central Asia," identifies the potential costs of the epidemic, the current constraints on an effective response, possible means of resolving such constraints and the organization's plans for helping countries fight the epidemic as part of a multi-institutional effort. If left unchecked, HIV/AIDS could have devastating effects on health and development in the region, the report says. If HIV becomes widespread among the working age population, economic growth rates could decline by 0.5% to 1%. The effects of such a decline would be compounded by rising health care costs, which could increase by 1% to 3%, with greater impacts on the health budgets of poorer countries in the region, the report says. In addition, the dependency ratio -- the ratio of non-economically active people to economically active people -- could increase, which would substantially strain social systems, according to the report.

Recommendations
Large-scale HIV prevention and care programs will require that funding from all sources increase to about $1.5 billion in 2007, up from about $300 million in 2001, Olusoji Adeyi, lead health specialist in the ECA Region of the World Bank and lead author of the strategy report, said. The report stresses the need for generating epidemiological and behavioral surveillance information and estimates on the economic and social impacts of the disease, as well as resource requirements for prevention and treatment programs. Such information should be used in the design, implementation and evaluation of all prevention and treatment programs. The report also addresses the importance of prevention programs, especially those targeting blood safety, harm reduction among injection drug users and HIV transmission among sex workers and current and former prison inmates. The report also calls for the provision of sustainable, quality medical treatment for HIV-positive people and programs to control an epidemic of HIV-tuberculosis coinfection (World Bank release, 9/16). "It boils down ... to a very simple message," Adeyi said, adding, "We have a serious and rapidly growing epidemic that has the potential to develop into a very catastrophic AIDS crisis in many of the countries" (Hukill, U.N. Wire, 9/16).