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World: Expert Says HIV/AIDS Spread Due To Lack Of Hope

A report recently presented to the World Bank and the International Monetary Fund shows what it calls an "alarming" rise in HIV infection in Eastern Europe and Central Asia. A population expert tells RFE/RL's Andrew F. Tully that this is evidence that many young people in the region have lost hope.

Washington, 25 April (RFE/RL) -- An expert on Russia's declining population says young Russians seem to have a death wish that is reflected in the growing spread of HIV/AIDS in that country.

Murray Feshbach, a professor of demographics at Georgetown University in Washington, has long warned of a dangerous drop in Russia's population since the fall of communism.

Six months ago, he told a gathering of reporters at RFE/RL's Washington offices that he believes Russia's population will decline by nearly half to as few as 80 million people. Among the reasons he gives are a higher death rate in Russia, a lower birth rate, and a rise in the incidence of diseases like AIDS and tuberculosis.

On Monday, RFE/RL asked Feshbach about a report on HIV/AIDS that was presented recently to the World Bank and the International Monetary Fund (IMF). The study pointed to what it called "a worrisome trend" -- the spread of the virus in Eastern Europe and Central Asia.

The report says people in this region, particularly in Russia, know how to avoid spreading AIDS, but are not changing their behavior.

Typically, the document says, AIDS is spread by intravenous drug abusers using unclean hypodermic syringes. Once these people are infected with the virus, they spread it to sexual partners.

The report's conclusions were drawn from statistics gathered by the UN's World Health Organization (WHO). For instance, the agency says 40,000 people in Russia, or 0.05 percent of the country's population, were known to be infected with HIV in 1997, the last year for which such figures are available. In Ukraine, it was even worse -- 110,000 people infected, or 0.43 percent of the country's population. But in the Czech Republic, that figure was 2,000 or 0.04 percent of the population.

In the interview with RFE/RL, Feshbach focused on Russia, which is his area of expertise. He says the risky behavior of young Russians eventually could be catastrophic for their country as it tries to emerge from 70 years of communist rule.

He says young Russians are making a choice that leads to a series of effects -- like falling dominoes.

"It's a choice which will lead to premature mortality, which will lead to a decline in the population, lead to a decline in reproductive health among the young females involved, which will reduce family stability, which will take away from people available for the labor force, etc., etc., it goes on and on."

Feshbach was asked why people would not change their behavior even if they knew how to keep from being infected with HIV. The professor uses young Russians as an example of the entire region. He says they do not seem to care.

"Not giving a damn. 'I'll just enjoy today, I'll drink myself to death, or I'll shoot myself up with heroin.'"

Feshbach says the reason for this behavior is in part the frustration among young people that they are not sharing in Western prosperity, in part because they became addicted early to illicit drugs, and in part because there are few other activities to engage them. Ultimately, he says, he believes young Russians have lost hope.

"That's a very serious issue. And the issue of hope is very tricky to say that this is sociologically, psychologically, thoroughly widespread among the young people. It would appear that it is there, but I don't know how to prove it."

Feshbach does not attribute the problem entirely to attitude. Another major factor, he says, is the weakness of the country's medical infrastructure.

"Not because of the doctors themselves, per se, but because they're not getting paid, they don't have enough medication, don't have enough sanitation, literally -- I don't mean the doctors themselves, but the institutions. They may not have hot water, idle things like that which are very serious and can contribute to the spread of disease within medical institutions as well."

Not everyone agrees with this appraisal. Anders Aslund, a former economic adviser to the governments of Russia and Ukraine, says many observers vastly overstate the HIV/AIDS threat in Eastern Europe and Central Asia. In fact, he told RFE/RL in an interview last week that there are very few cases of the disease in the region.

"AIDS is very rare throughout the former communist-bloc states. But this has been, ah, far overdramatized for a long time."

The sense of alarm about HIV/AIDS in Eastern Europe and Central Asia is based on isolated outbreaks, according to Aslund, who is now an expert on the region at the Carnegie Endowment for International Peace, a Washington think-tank.

Aslund says the WHO has been issuing what he calls "alarmist" reports on HIV/AIDS in Eastern Europe and Central Asia for the past decade. He says he's unclear why the UN health agency would exaggerate the threat, but had this observation:

"People normally think what they deal with is very important, and that it should be given more attention."

Aslund says the best way to assess the threat of HIV/AIDS in Eastern Europe and Central Asia is to look at the very numbers issued by the WHO. He notes that the rate of HIV infection in Russia, for instance, is far lower than in the United States, where 820,000 people are infected, or 0.76 percent of the population. This is more than 15 times the rate in Russia.

In fact, Aslund says he believes that the countries of Eastern Europe and Central Asia have the least risk in the world for succumbing to HIV/AIDS.