Inter Press Service - September 16, 2003
Miriam Kagan
'Averting AIDS Crises in Eastern Europe and Central Asia' was presented at a panel discussion at World Bank headquarters in Washington.
According to Bank statistics, over 1.2 million people in the region are infected with HIV/AIDS.
More worrying is the increasing rate of infections. Last year, 250,000 new infections were recorded, an increase of more than 20 percent from 2001, according to the World Bank.
In comparison, the prevalence rate for the United States was 0.6 percent in 2001, according to Family Health International.
While "nearly all countries (in the region) are in economic recovery after a difficult period of transition, the preconditions exist for a rapidly moving AIDS epidemic to take away these gains", Annette Dixon, the Bank's director of regional operations for Europe and Central Asia, told reporters.
The World Bank's strategy for the region encompasses countries from Eastern and South Eastern Europe (including the Balkans) as well as the Russian Federation, the Baltic Republics, and Central Asian countries that are former Soviet Republics.
Although 99 percent of the region's population is not infected with HIV/AIDS, the panel warned that unless serious and quick action is taken immediately, the epidemic is likely to spread to the general population.
Government involvement will be essential to stemming infection rates, they added.
Unlike in Africa, where 25 million people live with AIDS, the main engine of HIV/AID transmission in the region is intravenous drug use.
According to Dixon, some governments in the region "live in the belief that the epidemic won't reach the general population, while the epidemic is rapidly moving from an epidemic among drug users to the population at large".
The panel urged governments to stem rates of infection by ensuring blood used in transfusions is safe, deterring illicit drug and sex trades, and formulating treatment programmes for drug addicts.
Estonia, the Russian Federation and Ukraine lead the region with the highest HIV/AIDS prevalence rates (number of infected people divided by general population) as well as in absolute terms.
Slovenia, the Czech Republic, and Uzbekistan all appear to have relatively low prevalence rates, but experts cautioned that those statistics were based on officially reported cases, while many more unreported cases might exist, particularly in countries with poor record-keeping histories.
The panel also emphasized that governments must work against stigmatisation of the HIV/AIDS population and to educate the public about the disease.
The stigma of AIDS prevents effective reporting and treatment of HIV/AIDS patients in the region. It also leads to a general misunderstanding of the disease among the general population.
"Destigmatisation is key to fighting this epidemic," said Dr. Olusoji Adeyi, a leading expert on Europe and Central Asia at the World Bank. "The intellectual and political elite need to show leadership so the general population can take a cue."
Because of the high level of human movement in the region, countries will have to cooperate to stem the epidemic, said the report.
It says 30 percent of sexual workers in Albania are infected with HIV/AIDS. While the country has been at the forefront of fighting the disease, the flow of sex workers through its borders from neighbouring countries is hurting the government's efforts.
The panel pointed out that because of the range of economic development in the region, some countries require monetary aide, while others need assistance with logistics, planning, and implementing programmes.
World Bank efforts in the region include a 60-million-dollar loan to the Ukraine for an AIDS and Tuberculosis project, 150 million dollars approved for the Russia Federation's tuberculosis and AIDS control programme, and a 5.5 million-dollar grant for AIDS control in the former Soviet republic of Moldova.
Dixon expressed concern with Belarus, a former Soviet republic with a high HIV/AIDS prevalence rate, where World Bank officials have been negotiating with the government for several years to develop an AIDS programme.
While the Bank is ready, "the presidential leadership of Belarus has been stalling", she told IPS.
In response to the delay, the Bank plans to make a forthcoming development package for Belarus dependent on implementation of an AIDS strategy, added Dixon.
World Bank projections estimate that an AIDS epidemic would cause a 0.5-1 percent decline in yearly gross domestic product (GDP) across the region.
In Africa, GDP is expected to decline 0.6-1.5 percent from 1990-2025, due to AIDS, it adds.
The cost of intervention will reach 1.6 billion dollars by 2007 if current HIV/AIDS prevalence rates remain static, it adds.
"The sad part of the HIV story," said Dr. Debrework Zewdie, programme director of the Global HIV/AIDS Programme, "is that regions don't learn from regions, countries don't learn from countries. The (Eastern Europe-Central Asia) region is where Africa used to be 10 years ago".
"We want to try to show that the consequences of the epidemic are beyond health: development problems and security problems are also endemic, but Eastern Europe and Central Asia can avoid this fate by taking lessons and acting quickly," urged Zewdie.
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+World Bank
(http://wbln0018.worldbank.org/ECA/ECSHD.nsf/0/D9F7F54DD0D0668E85256C910061A9BC?Opendocument)
+United Nations Children's Fund
(http://www.unicef.org/newsline/02pr53monitor.htm)
+Canadian Public Health Association
(http://www.cpha.ca/english/intprog/hiv_prev/europe_e.htm)
(END/IPS/EU/AP/HE/IF/SD/MK/ML/03) .
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