Russian Government Needs Immediate, Accelerated Response to HIV/AIDS Epidemic, Opinion Piece Says

The Russian government needs an "immediate, accelerated and significantly scaled-up response" to the country's HIV/AIDS epidemic or it "risks undermining, and even reversing, Russia's prospects for economic growth and human development," Cristina Galvin and Dr. Murray Feshback of the USAID Research Project HIV/AIDS Russia/Ukraine write in an Irish Times opinion piece (Galvin/Feshback, Irish Times, 8/23). Russia has one of the world's fastest-growing HIV prevalence rates; the World Bank estimates that the number of HIV cases could reach between 5.4 million and 14.5 million by 2020. However, official response to HIV/AIDS has been virtually nonexistent, as politicians are reluctant to associate themselves with the disease, which remains stigmatized by its association with drug users and prostitutes. Russia has officially registered about 282,000 HIV cases since June -- nearly 25% of the estimated total -- and only three federal-level staff members manage a $4 million HIV/AIDS budget. Currently, about 1,800 Russians receive AIDS treatment at a cost of $7,000 to $12,000 per patient annually, but officials estimate that 7,000 more people will be treated next year using a $240 million, five-year grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as loans and grants from the World Bank, the United States and other Western donors. However, the World Health Organization estimates that 71,000 Russians will need treatment by 2005 (Kaiser Daily HIV/AIDS Report, 8/16).

'Disturbing Trends'
There are "disturbing trends" in Russia's HIV/AIDS epidemic, including a "significant" rise in heterosexual transmission of HIV, Galvin and Feshback write. The disease disproportionately affects working-age people, and the epidemic could lead to "substantial" social and economic effects and accelerate population decline, Galvin and Feshback say. Although Ukraine has negotiated lower prices for antiretroviral drugs, Russia has been "slow to follow suit," Galvin and Feshback say, adding that Russia is currently treating only a "small fraction" of the 50,000 HIV-positive people who need antiretrovirals. There is an "entrenched intolerance" toward injection drug users, commercial sex workers and other "scapegoated" groups that has led to the "absence of high-level political commitment" to fight the disease in Russia, Galvin and Feshback say. They conclude that there is "no justification" for the Russian government's "deplorable" policy, which shows an "appalling disregard for the human tragedy unfolding in the country" (Galvin/Feshback, Irish Times, 8/23).