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East: Rise In Syphilis May Worsen AIDS Epidemic

London, 3 April 1998 (RFE/RL) -- The World Health Organization (WHO) says large areas of the former Soviet Union are threatened with an AIDS epidemic because of an unprecedented rise in the rates of sexually transmitted diseases, particularly syphilis.

A WHO statement yesterday says there has been a 50-fold increase in syphilis in Russia and other areas of the former Soviet Union in the past seven years. Other countries seriously affected include Belarus, Kazakhstan, Ukraine and the Baltic states.

WHO experts fear that the "dramatic rise in syphilis during the 1990s could soon lead to a surge in the number of people infected with HIV -- the virus believed to cause AIDS.

So what's the link between syphilis and HIV? Studies show that the HIV virus is more easily passed by an infected person to a partner during intercourse if either has another sexually transmitted disease (STD). This is because STDs cause skin lesions, making it easier for HIV to penetrate the body.

The statement issued last night by the European regional office of the World Health Organization in Copenhagen says large areas of the former Soviet Union, including Central Asia, are threatened by what it calls a "substantial and immediate HIV epidemic."

The statement says that syphilis rates in the worst affected countries are more than 200 times higher than in western Europe -- and, in some regions, they are 500 times higher.

Health experts link the spread of syphilis to changes in sexual behavior and attitudes, and to a rise in prostitution, poverty, and unemployment. Increased travel since the break-up of the Soviet Union and the lifting of closed borders is also a factor.

A WHO graph illustrates the sharp rise in syphilis cases in four newly-independent countries -- Belarus, Kazakhstan, Russia and Ukraine. The graph shows that the rate of syphilis has risen steeply in every year since 1990 (when the rate was negligible).

The graph suggests that one in every 400 people in Russia -- the worst hit country -- were suffering from syphilis in 1997.

Although usually transmitted through sexual contact, syphilis can be passed on at birth by an infected mother. The disease can be relatively benign but, if left untreated, it can be incapacitating or fatal, attacking almost every part of the body.

Nikolai Briko, an epidemiologist at Moscow Medical Academy, says the situation in the Russian capital is "grim". He says doctors are especially anxious about a 40-fold rise in syphilis cases among Russian children and teenagers, and a 30-fold rise in congenital syphilis -- that is, mother-to-infant infection.

Belarus also has major problems. Leonid Barabanov, of the Institute for Advanced Medical Training in Minsk, says his government does not have enough financial, technical or human resources to fight the epidemic of sexually transmitted diseases.

He also says that health care programs in the new independent countries that emerged after the break-up of the Soviet Union are "too few and fragmented" to curb the syphilis and other epidemics.

Now, in a drive to tackle the problem, the WHO and the Joint UN Program on HIV/AIDS are to set up an international task force to help the eastern countries fight the spread of STDs.

Jo Asvall, WHO regional director, says the challenge is a huge one, but the recent international and national fight against a diphtheria epidemic in the newly-independent eastern countries, showed that "joint action can succeed."