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. Last Updated: 07/27/2016

Slaying the AIDS Monster: No Time to Lose

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World AIDS Day on Sunday is a time to celebrate the gains made in treating and preventing HIV/AIDS as well as to highlight the need to protect the human rights of those living with the virus. It is also a time to remember the lives lost and to learn from past failings. And just as importantly, it is an opportunity to put the spotlight on the huge socioeconomic and human catastrophe in the making in Russia.

Despite its late start, Russia is currently experiencing the fastest growing epidemic in history. While there were only 1,000 HIV-infected people officially registered at the end of 1995, the number has more than doubled in each year since. In November there were 218,000 people in Russia with HIV/AIDS. National and international experts estimate that the actual number of cases is five to 10 times greater, which puts the number of Russians infected at 1 to 2 million. Current forecasts are that 5 million people will have HIV or AIDS by 2005.

These are terrifying figures. However, they are not just figures, but people -- young people, to be precise. More than 80 percent of those infected are under the age of 30. Without proper treatment, they will have no future by the age of 40.

Looking at the epidemic's economic consequences, it is clear that a disaster lies ahead. Recent estimates by the World Bank indicate that the HIV and tuberculosis epidemics, combined with widespread drug use, will reduce Russia's workforce by 900,000 people by the year 2005. As a result they estimate that in 2005, GDP will be 1.3 percent lower than it would otherwise be. Moreover, the uninhibited spread of HIV will lower the economy's potential long-term growth rate, knocking off half a percentage point annually by 2010 and a full percentage point by 2020.

Within a few years, millions of infected people will need intensive medical care. How will the healthcare system be able to cope financially and practically?

Russia produces only a few of the drugs that are needed to effectively treat HIV/AIDS, and consequently relies upon imported drugs. In Russia, effective treatment through a combination of antiviral drugs (called triple therapy) now costs $10,000 per person per year. The cost of treating only officially registered HIV-infected people would be in excess of $2 billion per year -- not including the costs associated with administering treatment, such as medical staff salaries and hospital resources.

Healthcare professionals are not prepared for the task that lies ahead. They do not have the experience or the capacity to deal with the wave of AIDS patients coming their way. Considerable time and money is required to expand and reform the healthcare infrastructure to cope with the imminent deluge.

Nevertheless, there is hope. Those of us who have been involved in setting up HIV/AIDS programs in Russia for the past couple of years have witnessed that lessons learned elsewhere in the world can be successfully applied in Russia. Many of those directly involved in fighting the epidemic are committed to turning best-practice examples from around the world into practical programs here. Russian professionals working in AIDS centers, drug treatment centers and inside the prison system are learning to work with nongovernmental organizations and self-help groups. A wealth of knowledge has poured into Russia over the past six or seven years and there are plenty of motivated medical professionals and NGO workers. They have been and continue to save lives every day. However, on their own they cannot reverse the tide of epidemic.

In September, First Deputy Health Minister Gennady Onishchenko spoke of the need to "intensify control" of the spread of HIV in the country and voiced concerns about the government's limited contribution on this front to date. The national budget for HIV/AIDS this year is only $5 million and much of the money still goes toward large-scale HIV testing, which Onishchenko considers an inefficient use of the meager resources available.

Currently, only about 500 people in Russia are receiving proper treatment. Additionally, there are no major HIV prevention programs for young people in general or those in high-risk categories, such as injecting drug-users, prison inmates and those working in the sex industry. Onishchenko has also stressed the urgent need to set up treatment programs for the growing number of HIV-infected pregnant women in order to prevent HIV transmission from mother to child, before or after birth (through breastfeeding).

However, dealing with HIV/AIDS is not solely the responsibility of the Health Ministry. HIV/AIDS touches on all aspects of society, and other ministries need to be involved in the design and implementation of a comprehensive program. But most important of all, there needs to be high-level commitment on the part of the political leadership to make the struggle against HIV/AIDS a priority -- this has proven to be a key factor in the few successful programs around the world.

Countries that have contained the spread of HIV/AIDS have done so largely through active programs with high-level backing to increase awareness, de-stigmatize the disease and treat those infected.

And what if we don't learn from other countries' experience?

Unfortunately, the AIDS problem is not simply going to go away. And neither will the epidemic be limited to the current high-risk groups. Although 90 percent of new cases of HIV are transmitted through injecting drug use, there are increasing numbers of cases being recorded of transmission to the general population through sexual contact. Only major, targeted action can prevent Russia from going the same way as countries such as Botswana and Zimbabwe, where more than a third of the adult population has HIV/AIDS.

Thanks to the delayed start of the epidemic in this part of the world, Russia still has a window of opportunity if it acts fast. Major action needs to be taken on the part of the government and NGOs to use the experience available inside and outside of Russia to avert disaster. The AIDS epidemic is a tragedy that can be prevented.

Rian van de Braak, general director of AIDS Foundation East-West, contributed this comment to The Moscow Times.