Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.

Reuters NewMedia - Friday, November 29, 2002
Andrew Hurst

Christof Ruehl, the World Bank's chief economist in Russia, said on Friday that although there are 220,000 registered cases of HIV infection in the country, the real number of people who are infected with the deadly virus could be more than a million.

"According to our estimates 800,000 to 1.2 million is roughly the range of where it (HIV infection) is," Ruehl told Reuters.

HIV infection has spread like wildfire among Russia's large population of narcotic drug users through needle-sharing for intravenous injection.

Russia's top AIDS specialist, Vadim Pokrovsky, earlier this week warned that at least half a million Russians will die from AIDS by 2010 -- even though only about 800 people have so far been diagnosed as suffering from the disease.

A report prepared by Ruehl on the likely economic consequences of Russia's looming AIDS crisis paints a bleak picture of an economy continuing to grow but straining to pay for public medical treatment as the epidemic spreads.

Russia's biggest challenge will be to offer expensive anti-AIDS drugs free to patients in a country where most people are far too poor to pay for them out of their own pockets.

"You will see people dying in Russia on a massive scale after 2005-06 if they don't get the drugs," said Ruehl.

"The fiscal costs will blow the budget at current retroviral treatment prices."

Foreign anti-AIDS drug treatments sell in countries like China, which also faces an HIV crisis, for about $10,000 a year while locally produced cocktails sell for a few hundred dollars.

Ruehl estimated that treating the HIV-infected population at a cost of $900 per person per month would soak up more than 80 percent of Russia's current annual federal budget. However, if treatment can be provided for only $30 per month per patient, the cost would eat up less than 2.72 percent of the budget.

Since the collapse of the Soviet Union in 1991, Russia's health service has steadily deteriorated due to lack of funds, and the sick often pay to receive adequate treatment.

The AIDS threat to Russia's economy is particularly acute because low average life expectancy among men is driving down the nation's total population by about 800,000 a year.

"This combination of high HIV transmission rates and a decreasing population really aggravates the problem," he said.

Many African countries have suffered devastating AIDS epidemics but their populations have continued to grow because of high birth rates, said Ruehl.

Infection rates in Russia have fallen off in recent months but Ruehl said it would probably take another six months to determine whether infection was really in decline or not.
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