InterPress News Service (IPS) - Wednesday, April 4, 1998
Sergei Blagov

New efforts are needed to strengthen support the fight against AIDS says the U.N. official leading the battle, Peter Piot, UNAIDS executive director Peter Piot.

"The goal of the World AlDS Campaign is to promote the participation of young people in HIV prevention efforts, raise awareness of this growing crisis, harness public and private resource and strengthen support for young people infected and affected by the epidemic."

The year-long initiative, 'Force for Change: World AIDS Campaign, is being led by UNAIDS and its co-sponsors -- the U.N. children's fund UNICEF, the U.N. Development Programme, the U.N. Population Fund, the World Health Organisation, UNESCO and the World Bank.

They are working in partnership with the Association Francois- Xavier Bagnoud, Education International, the International Federation of Red Cross and Red Crescent Societies, MTV International, Rotary International, and the World Assembly of Youth.

"HIV infection among young people is increasing at an alarming rate," Piot told reporters in Moscow. According to the UNAIDS agency's latest report, released Wednesday, more than half of all new HIV infections acquired after infancy occur among young people.

Some 2.6 million young people worldwide acquire the virus each year, including 700,000 in the Asia-Pacific area alone; one third of the 30 million persons with the HIV virus, at least a third are young people. More than 90 percent of HIV positive people live in the developing world.

The campaign aims to ensure that young people's voices are heard, Dr Ezio Gianni Murzi, UNICEF representative in Moscow told IPS. "We also plan to convene a conference of Russian mayors, as their support is crucial for the campaign," he added. UNAIDS and the other agencies came to Moscow to highlight the increasing proportion of new HIV infections recorded in Eastern and Central Europe.

"Over the last three years, there has been an astronomical growth in the HIV infection rates in Eastern Europe," Piot said. "This report is a wake-up call to the world that we must quickly expand action to combat HIV in Eastern Europe, or we will face a potential new HIV epicentre in coming years."

Until the mid-1990s, most of the countries of Eastern Europe were spared the kind of infection figures recorded elsewhere. The entire region had diagnosed just 30,000 cases of HIV among its combined population of 450 million people. But in the last few years, the former socialist countries of Eastern Europe and Central Asia have seen infections rise around six-fold to 190,000 cases. Belarus, Moldova, the Russian Federation and Ukraine have all registered skyrocketing growth in HIV infection rates over the last three years, most of it related to intravenous drug abuse.

Ukraine is now the worst-affected country in the region. In 1994, only 44 people tested positive for HIV, roughly the same number as in 1992 and 1993. But the number of diagnoses shot up over 30-fold in 1995, and by 1996 had topped 12,000.

In 1997 the total had reached 15,000. These figures cover the tested only. U.N. experts believe that up to 110,000 Ukrainians may be carrying the virus, the majority unknowingly.

While the numbers are smaller, a similarly rapid take-off has been seen in Belarus and Moldova. In the states of the Baltic and the Caucasus the rise is slower. Only the Central Asian Republics have seen their infection rates remain stable.

The former Soviet states still constitute a single area in health management terms, and the governments plan to sign a multilateral AIDS prevention treaty before the end of this year, said Guennady Onischenko, Russia's first deputy health minister.

"I would expect that an explosion of AIDS epidemic may happen in Russia, but we still have time to stop it," added Murzi. The rate of HIV infection is soaring in Russia, with an almost 12 fold increase in new cases in 1996 compared to the year before.

In 1997 some 3,900 more people had tested positive for HIV, the infection which can lead to AIDS, according to Russia's health ministry. Since HIV was first confirmed in Russia in 1987, a total of 7,900 HIV cases have been reported in Russia -- 3,900 in 1997 alone. Over the past 11 years 264 Russians, including 103 children, have seen the HIV infection develop into full-blown AIDS.

Kaliningrad, a Russian enclave between Lithuania and Poland tops the crisis list with 2,070 HIV cases, followed by the Russian region of Krasnodar, with 1,200 cases. Paradoxically Moscow, Russia's largest urban centre with a population of about ten million people and a major hub of international contacts, has recorded only 800 HIV-positive people so far.

The combined effect of widespread prostitution and drug abuse has fueled the situation in Kaliningrad, an enclave that is effectively a giant military base. Of a small sample of 103 sex workers arrested on the streets of the Russian city of Kaliningrad, for instance, a third were known to be intravenous drug users living with HIV.

The city reported that four out of every five women treated for HIV-related illness at the regional AIDS centre were full or part time sex workers. But awareness of the problem is growing.

"There has been a definite shift in attitude to AIDS prevention in recent months," said Alec Khachatryan who works with the French medical aid group Medecins Sans Frontieres on a Moscow- based project working to stem the spread of the HIV virus among drug users.

"Initially nobody wanted to hear about AIDS and the drug addicts used to say: 'Even if I die, so what?"' he told IPS. "But later on they started to find HIV infected people among their friends, and we (were able to reach) some 3,000 people with AIDS prevention message in 1997."

Some Russian experts argue that unless urgent measures are taken to curb the infection rate, notably among drug users, there will be five million HIV-positive Russians by 2000, including one million children.

UNAIDS argue that the true number of infections is far higher than official figures suggest. They work on the calculation that in the Russian Federation there are around six infected people for every one person who has actually tested HIV-positive. That means around 40,000 people may currently be living with HIV.

But Onischenko is not so sure. "At the moment millions of people are tested in Russia every year with very small percentage testing HIV-positive," he says. "I guess there could be more than 7,900 infected Russians, but I do not think the number amounts to tens of thousands."

According to the Russian Health Ministry, the rapid spread of HIV across Russia over the past two years is caused by infection spread by shared needles by intravenous drug users, rather than through sex. Currently 90 percent of registered AIDS cases are drug addicts.

Up to this year however, the main method of transmission was sexual, experts say.

However this only underlines UNAIDS' point that young people are especially at risk. There are up to one million drug addicts in Russia, mainly young people, who will be the worst hit by HIV, said Onischenko.

"We must do everything to prevent young people of today from becoming the AIDS statistics of tomorrow," Piot said.

Human Immuno-Deficiency Virus (HIV) is the infection that leads to AIDS, which destroys the body's immune system, leaving it defenseless against infection. An estimated 30 million people around the world are infected with HIV -- but fewer than than five percent of them know it, according to UNAIDS. (END/IPS/SB/RJ/98)

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