But at the same time most of the participants including representatives of UNAIDS, WHO and Global Fund agree that there is still a long way to go to fight the epidemic. Especially the lack of political will and stigmatization of people living with HIV was mentioned as the main obstacles for progress. As one high level representative of the international community put it:
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“It is about social change. Aids programs in the region are working, but we need tolerance and compassion.”
| HIV and AIDS report |
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| Download the DCA report on HIV/AIDS in russia: UNAIDS estimates that between 560.000 and 1.6 million people are living with HIV/AIDS in Russia. The official statistics say 370.000. |
Peter Piot, Executive Director of UNAIDS, pointed to the problem in his opening speech of the conference: “For every person admitted to Anti Retro Viral Treatment (ARVT) in the region, 2.5 new persons are infected. Since 2001 the number of HIV infected persons has gone up with 150 %.”
As for the adequateness of the activities, G. Weiler from World Health Organisation (WHO) stated: “We are doing the right things, but we are not doing enough of it.” National programs are in place, but do not reach the groups most at risk of infection.
The conference showed that international organizations and European governments can play an active role in combating the spread of the epidemic. DanChurchAid (DCA) is concerned that the programs and policies of the Danish Government are not targeting HIV/AIDS in Eastern Europe and Central Asia.
Harm reduction
The hot topic of the conference has been Harm Reduction for Injecting Drug Users (IDU). The elements of Harm Reduction programs include access to information, access to sterile injection equipment, access to drug substitution treatment (e.g. methadone) and access to ARVT.
According to official figures 2/3 of new cases are among IDUs and many countries in the region, among them Kyrgyzstan where DCA is working, have increased prevention measures and introduced substitution therapy.
In spite of scientific evidence and good experience of neighboring countries, the Russian government still refuses to allow this kind of treatment. Local and international NGOs, including the WHO and UNAIDS, criticized the Russian Government for their position and the issue will be at the forefront of future debates.
Risk groups
Another big problem is the stigma and discrimination that still prevails towards the risk groups such as IDUs, sex workers, men having sex with men, street children and labor migrants. The Russian Government has developed national programs and has allocated funds for prevention and treatment activities, but NGOs point out that these do not reach the risk groups.
More than 20 million HIV tests were conducted last year in the Russian Federation, but only 2 % of them were conducted among IDUs, even though up to 85 % of all HIV positive are IDUs. NGO representatives raised concerns about the reliability of the official statistics.
NGOs have a bigger outreach to risk groups, but still meet resistance from the side of the authorities.
Currently the epidemic is still concentrated to risk groups, but there are signs that it is spreading to the wider population. For example 40 % of all new cases in the region are found among women, which is a new development. If the spread is not stopped, it will have catastrophic consequences for the whole region.
Geographical spread
Russia is a major recipient country of labor migrants from Caucasus and Central Asia. There is no evidence that immigrants carry the epidemic when they go to Russia. On the opposite, a growing number of migrants are bringing the epidemic from Russia to their home countries and thereby their families.
A representative of the Russian authorities stated that of all new cases of HIV in Tajikistan 2005-6, 56 % were discovered among migrants. These numbers are alarming because the epidemic will spread to the wider population if action is not taken now.
By Programme Officer Pia Dyrhagen ( pdy@dca.dk)