Feature - Eastern Europe/central Asia: Region Facing Major Economic and Social Challenge as HIV on the Up
The AIDS epidemic in Eastern Europe and Central Asia shows no signs of abating, according to a December 2003 "AIDS epidemic update" from UNAIDS, the Joint United Nations Programme on HIV/AIDS. The report - released in the run-up to World Aids Day on December 1 - finds that some 230,000 people were infected with HIV in 2003, bringing the total number of people living with the virus to 1.5 million. AIDS claimed an estimated 30,000 lives in the past year. Worst-affected are Russia, Ukraine, and the Baltic States (Estonia, Latvia and Lithuania), but HIV continues to spread in Belarus, Moldova and Kazakhstan, while more recent epidemics are now evident in Kyrgyzstan and Uzbekistan. It is now estimated that around 1 million people aged 15-49 are living with HIV in Russia, although various estimates from that country put the figure at between 600,000 and 1.5 million.
Funding, NGOs and the EU.
The fight against HIV/AIDS in Estonia and Russia in particular was the subject of a press conference in Brussels on November 26, hosted by French MEP Didier Claude Rod (Greens/European Free Alliance). Ruta Kaupe, the Executive Director of the one-year old DIA+LOGS HIV/AIDS support centre in Latvian capital Riga, which depends on international financing, drew attention to a "very difficult" financing situation. Donors organisations were "closing" their funding, she reported, because Latvia was entering the European Union. Mr Kaupe was "really worried" about what would happen after EU entry: "Who will stay I can't stay".
Arnaud Wasson-Simon, of the French organisation AIDES, added that the situation was "quite complex" for the EU applicant states - an NGO-centred European programme against AIDS that got underway in 1996, he recalled, had ended in 2002, before applicant countries had had the chance to benefit from it. European Parliamentarians had fought to make sure that the new public health programme of the European Commission's Health and Consumer Directorate (DG SANCO) would include the fight against HIV and AIDS as a priority: "But up to now we really have no idea how this wider programme will be capable of enabling the targeted response that's needed to have an impact against HIV and AIDS".
Kaupe and Wasson-Simon also underlined the importance of involving non-governmental organisations (NGOs). Ms Kaupe appealed for help in encouraging applicant country governments to trust NGOs more and to co-operate with them. Most of Latvia's strategy and budget, she pointed out, were devoted to governmental institutions. The right to organise as an NGO was still very new in the applicant countries, Mr Wasson-Simon noted. Unlike in France, where there were significant funds from the French state, "most of the applicant countries have yet to learn how to work with NGOs, and so they are really missing that essential local support".
UNAIDS had the following to say about AIDS/HIV in Eastern Europe and Central Asia:
"Driving these epidemics is widespread risky behaviour-injecting drug use and unsafe sex-among young people. Extraordinarily large numbers of young people regularly or intermittently engage in injecting drug use, and this is reflected in increasing HIV prevalence among injecting drug users throughout the former Soviet Union. Condom use is generally low among young people, including those at highest risk of HIV transmission in Eastern Europe and Central Asia. According to one survey in the Russian Federation, fewer than half of teenagers aged 16-20 used condoms when having sex with casual partners. The percentage of sex workers reporting consistent condom use has seldom topped 50%, while, among injecting drug users, fewer than 20% on average report consistent condom use.
A relatively new phenomenon in these countries, injecting drug use has taken hold amid jolting social change, widening inequalities and the consolidation of transnational drug-trafficking networks in the region. …