Tomorrow (Friday) is World AIDS Day, a United Nations-sponsored observance established in December 1988 by the World Health Organization. It is meant to serve as the focal point of the UN's annual anti-AIDS campaign. Washington correspondent K.P. Foley reports that this year, AIDS experts are particularly concerned about the spread of the disease in the former Soviet Union.
Washington, 30 November 2000 (RFE/RL) -- The United Nations, the World Bank and other international organizations renew their annual anti-AIDS campaign tomorrow (Friday) with the observance of World AIDS Day, and this year, experts report they are particularly alarmed about the spread of AIDS in the former Soviet Union and the infection that leads to its development.
AIDS is the English language acronym for "acquired immune deficiency syndrome." HIV is the English language acronym for "human immunodeficiency virus." AIDS is caused by infection with HIV. HIV destroys the body's ability to fight infections and certain cancers by killing or damaging cells of the body's immune system. People diagnosed with AIDS may develop life-threatening diseases called opportunistic infections.
The United Nations and other international institutions say some 5.3 million new HIV infections have been reported this year. An estimated 36.1 million people worldwide are living with HIV or AIDS. Since the worldwide epidemic began about 15 years ago, about 21.8 million people have died of AIDS.
The UN's office for coordinating the worldwide fight against the disease, UNAIDS, says the European and Central Asian regions of the former Soviet Union were previously characterized by a very low prevalence of HIV and AIDS. However, a UN report released this week says several of the former Soviet republics are witnessing a sharp rise in the number of people living with HIV and AIDS.
According to the report, the number of people in the region living with HIV and AIDS has risen from 170,000 in 1997 to about 700,000 today. The AIDS coordinator for the World Bank, Debrework Zewdie, says, "the epidemic literally has exploded in Russia." She told a press briefing in Washington this week that during the past year, an estimated 50,000 new HIV infections were recorded by Russian Federation health authorities. She says this figure is more than the total number of infections registered in Russia between 1987 and 1999.
The main reason for the rapid spread of HIV infections, says Zewdie, is the sharing of contaminated needles and syringes by people using illegal drugs.
"The major transmission for HIV/AIDS in Eastern Europe is injection drug use. More men than women are affected through this, and the epidemic is spreading into the general population because the men bring it to the women."
Zewdie also blames health authorities and governments in the region for refusing "to accept that this is an epidemic which would explode." She says the steep rise in infections, "is the result of inaction."
The World Bank says the HIV/AIDS epidemic is believed to have started in the Eastern European and Central Asian regions in the early 1990s. The bank says infections spread rapidly from 1995, notably among drug users. Increases were seen in Ukraine, Belarus, Russia, Moldova, and Kazakhstan.
The Bank says that by the end of 1999, the number of infections in the entire region -- that includes former Soviet states in Europe and Central Asia -- is estimated to have reached 360,000. The greatest number of cases continue to be found in Ukraine, Belarus, Russia, Moldova, and Kazakhstan.
According to the Bank, the national rates of HIV prevalence are all less than one half of one percent within the general population. This figure is considered low by international comparison. However, the Bank says that, "the particularly worrisome aspect is the high rate of increase in the number of cases in the past few years."
UNAIDS officials say the potential for the further spread of HIV and AIDS through illegal drug users is enormous. In its report for the year 2000, UNAIDS notes that Russian authorities estimate that some two percent of the population -- between 1.5 million and 2.5 million people -- are injecting drug abusers. UNAIDS Executive Director Peter Piot says, "clearly, hundreds of thousands of drug users and their sex partners are at immediate risk of infection."
The World Health Organization (WHO), a UN agency, says that despite the rapid spread of HIV in Russia, Russia's epidemic is still at an early stage. WHO Executive Director Gro Harlem Bruntland says Russia has an opportunity to curb the spread of AIDS through effective interventions.
However, she warns that while the Russian epidemic has been mostly among drug users, "a second wave of HIV infections spread by sexual contact could follow the current drug-driven epidemic." In three to four years, she says, "Russia may well have a generalized epidemic."
The UNAIDS report says Ukraine remains the most severely affected country in the region, although it notes that some uncertainty surrounds the epidemic there.
According to the report, the annual number of new cases registered in Ukraine seems to have declined since 1997, but, it says HIV appears "to be making inroads into the general population."
In Ukraine, UNAIDS says the annual number of diagnosed HIV infections jumped from virtually zero before 1995 to around 20,000 a year from 1996 through 1999. In addition, UNAIDS notes that -- in contrast to Russia -- the proportion of HIV diagnoses in injecting drug users dropped sharply, suggesting that an increasing number of Ukrainians are becoming infected through unsafe sex.
The situation is grim but not hopeless, international experts say. UNAIDS says increased efforts are being made throughout the region to raise awareness about AIDS. The agency cites Belarus as one example of a strong government response and it says prevention efforts among teenagers have been especially successful in Belarus.
In Kazakhstan, UNAIDS says a team of prevention officers delivers safe sex information and condoms to prostitutes and others engaged in the sex trade. In Ukraine, UNAIDS says a new law has endorsed the principle of voluntary HIV testing and AIDS education.
The World Bank's Zewdie says a number of steps can be taken to restrict the spread of HIV and AIDS.
"There is nothing to date which beats prevention. So that is one thing that could be done."
However, she adds that there must be a drastic change in attitudes among people who refuse to accept the reality of the HIV/AIDS crisis. For example, she says that if drug users "are stigmatized and forced to go into hiding," there will be no way to control the epidemic.