Global Policy Forum

By Peter Baker

The United Nations warned Tuesday (02/17/04) that the spread of AIDS through the former Soviet Union and Eastern Europe had reached crisis proportions and beseeched complacent regional leaders "to wake up" and "take this threat seriously" before it overwhelms them.

Though the epidemic largely spared the region as it ravaged other areas in the 1980s and 1990s, AIDS is now spreading faster here than anywhere else. One in every 100 adults in Russia and several other neighboring countries now has HIV, the virus that causes AIDS, a rate behind only sub-Saharan Africa and the Caribbean, the United Nations reported.

Fueled by intravenous drug use, the rapid advance of AIDS through the former Eastern Bloc threatens to engulf overtaxed health care systems and choke economic growth, according to the report. The hardest-hit countries are Russia, Ukraine, Estonia and Latvia, while the virus continues to spread quickly in Belarus, Kazakhstan and Moldova, according to the first comprehensive U.N. study of AIDS in the region.

Mark Malloch Brown, head of the U.N. Development Program, described Russia and the region as "on the edge of disaster" and said he came to Moscow "to appeal to Russians -- civil society, ordinary people, government -- to wake up, take this threat seriously and, while there's still time, to change the trajectory of prevalence of HIV-AIDS."

"Russia has always been at its best when the times are tough and critical," said Mikko Vienonen, head of the World Health Organization office in Moscow, who joined Brown at a news conference. "The times are now tough and critical."

Russia, which reported 163 new cases of HIV infection in 1994, had an estimated 1 million people with the virus by the end of 2003, a number comparable to that of the United States, which has twice the population. Until recently, the number of Russians with HIV had doubled every six months; international experts discounted a reported onetime drop in new infections in 2002 as a statistical aberration.

According to forecasts in the U.N. report, AIDS will accelerate Russia's already dramatic population decline, costing the country at least 9 million people by 2045. More dire projections place that figure at 20 million, which would reduce Russia's potential economic output by 4 percent by 2010 and 10.5 percent by 2020. The Russian government, already facing a health crisis exacerbated by widespread tuberculosis, syphilis, heart disease and alcoholism, has done little to fight AIDS.

President Vladimir Putin mentioned AIDS just once, in a single clause, in his annual state of the nation address last year, and the Health Ministry reportedly has only four people working on the problem. The annual federal budget for fighting AIDS is about $4 million, about $1 million of which is targeted for prevention.

"One speech is not enough and one reference in a speech is not enough," Brown said. "There has to be strong leadership time after time to warn Russians that this is a threat."

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