Reversing the Tide: Priorities for HIV/AIDS Prevention in Central Asia

Reversing the Tide: Priorities for HIV/AIDS Prevention in Central Asia

Reversing the Tide: Priorities for HIV/AIDS Prevention in Central Asia

Reversing the Tide: Priorities for HIV/AIDS Prevention in Central Asia


Although the number of reported cases of HIV in Central Asia is still very low, the growth rate of the epidemic (about 500 cases in 2000 to over 12,000 in 2004) is a cause for serious concern. Central Asia lies along the drug routes from Afghanistan to Russia and Western Europe, and it is estimated that it has half a million drug users, of which more than half inject drugs. Without concerted action, we may expect to see the rapid development of an HIV epidemic concentrated among injecting drug users over the next four or five years, followed by the spread among the 15- to 30-year-old population, with sexual transmission as the predominant mode. This would follow the pattern of the epidemic in other regional countries such as Russia, Ukraine, and Moldova.Governments, NGOs, and international partners in the field have taken initial steps to avoid a major HIV/AIDS epidemic in Central Asia. All countries with the exception of Turkmenistan have put in place coherent overarching policies and strategies to control HIV, which were prepared with assistance from UNAIDS; and all countries have received grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM). NGOs are active in the region, and partner organizations and international NGOs have been providing significant technical and financial assistance. Despite growing regional commitment and resources to prevent and control the epidemic, there are, however, a number of issues that are not being adequately addressed. This study identifies critical gaps, and makes recommendations for further action that will ensure effective early prevention of HIV/AIDS in Central Asia.


The Global HIV/AIDS Epidemic

The AIDS epidemic has entered its third decade worldwide. The global HIV/AIDS epidemic killed more than 3.1 million people in 2004, and an estimated 4.9 million acquired the human immunodeficiency virus (HIV)—bringing to 39.4 million the number of people living with the virus around the world. There were around 42 million people globally living with HIV/AIDS at the end of 2002 (UNAIDS 2002). HIV/AIDS is now the leading cause of death in Sub-Saharan Africa, and the fourth main killer globally. Life expectancy has been cut by more than 10 years due to HIV/AIDS infection in several countries (UNAIDS 2001). The increasing speed of the spread of the epidemic increases the importance of the problem. Current projections suggest that an additional 45 million people will become infected with HIV in 126 low- and middle-income countries between 2002 and 2010, unless the world succeeds in mounting a drastically expanded, global prevention effort.

The ECA Regional Situation

In recent years, the Europe and Central Asia (ECA) region has seen the world’s fastest growing HIV/AIDS epidemic due to a sharp increase in injecting drug use (IDU). A number of recent studies have pointed at the urgent need for action to manage the spread of HIV/AIDS

4. UNAIDS (2004) provides estimates based on the best available information and gives boundaries within which actual numbers lie. Thus, the number of people newly infected with HIV in 2004 is between 4.3 and 6.4 million; the number of AIDS death in 2004 is between 2.8 and 3.5 million; and the number of people living with HIV/AIDS in 2004 is between 35.9–44.3 million.

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