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Ukraine: AIDS Declared National Epidemic

Ukraine has declared HIV/AIDS a national epidemic. The country was one of the forces behind next week's special session of the UN General Assembly on the problem. But one Ukrainian activist who will participate in the session says much more emphatic action is needed by his government and others in the region -- or the rate of infection will continue to rise. UN correspondent Robert McMahon looks at the challenges Ukraine faces in combating the epidemic.

United Nations, 22 June 2001 (RFE/RL) -- More than a quarter of a million Ukrainians are living with HIV/AIDS. The country represents one of the worst situations in a region UN officials say is experiencing the world's sharpest rise in infection rates.

The Ukrainian government was an early participant in the planning for next week's UN General Assembly special session on the HIV/AIDS pandemic. The government has outlined a national strategy for dealing with the crisis and is hoping to benefit from global initiatives on prevention and treatment of the virus.

But AIDS activists say more urgent action is needed to bring the epidemic in Ukraine and neighboring countries under control. Konstantin Lezhentsev is a Ukrainian physician who works on AIDS-prevention projects with the humanitarian group Doctors Without Borders in Odessa and Crimea. He says the government has been too slow in addressing the need for more affordable treatment for those infected with HIV, or Human Immunodeficiency Virus.

Lezhentsev tells RFE/RL that the vast majority of people living with HIV in Ukraine receives no treatment:

"In Ukraine, 99 percent of patients -- of people living with HIV/AIDS -- do not receive any treatment, including anti-retroviral treatment. [This] means that this is a crisis in access to medicines, and this point should be highlighted to the world community."

Lezhentsev is in New York to participate in the effort by Doctors Without Borders and other groups to raise awareness about the rapid spread of the AIDS virus in Eastern Europe and the former Soviet Union. The spread of the virus is connected to the worsening rate of intravenous drug use, and infected needles are the prime way the disease is being transmitted.

But experts also say there is a rising incidence of the virus being transmitted sexually in Ukraine. It is prevalent in closed populations in prisons, as well as among a more mobile segment of society -- sex workers.

The cocktail of drugs that has proven effective in extending the lives of people infected with HIV costs thousands of dollars per year per person in the developed world. Lezhentsev says the Ukrainian government has delayed taking action to provide cheaper, generic versions of these drugs.

He says a country worth emulating is Brazil, where a rising epidemic was reversed through concerted government action that helped provide both cheaper drugs for treatment and programs aimed at preventing infection among intravenous drug users:

"The main excuses of the pharmaceutical companies and sometimes of the governments -- and I foresee this in my country -- is that there is a poor infrastructure, [that] we should build the system capacity first, [that] the majority of the patients are not compliant because they are drug users or because they are homeless, which means discrimination against the poor and marginalized from treatment. So to avoid these excuses we should [follow] the Brazil model."

A diplomat at Ukraine's mission to the United Nations, Oleksii Holubov, told RFE/RL that his government has been doing the best it can under the circumstances to combat the epidemic.

He says continuing economic troubles, aggravated by the costs of closing the Chernobyl nuclear power plant, have caused a major burden for the government. But he says authorities have not been idle in terms of addressing the HIV/AIDS problem:

"We're not sleeping [on this issue]. The government is doing what is possible. The national commission on HIV/AIDS prevention was set up a year ago. The chair of this commission is a vice prime minister. It's a really high level for my country. It reflects the seriousness of the problem for us."

Holubov hopes next week's special UN conference will bring attention to the way HIV/AIDS has spread in Ukraine and throughout the region. Any global fund that emerges from the conference, he says, should include aid to help the region cope with the crisis.

Lezhentsev credits the Ukrainian government with including in its official delegation health experts as well as a prominent member of a Ukrainian non-governmental organization who is infected with HIV. He says he also hopes to arouse international concern about the swift rise of AIDS in his region:

"If you want to effectively combat the epidemic in the world, you should look to our region, to East Europe, if you don't want the next Africa."

UN officials say in the past year, HIV/AIDS has risen especially sharply in Estonia and Uzbekistan, while the virus has now been reported in 82 of Russia's 89 regions after appearing first in a few cities. UN health experts say that growing prostitution in the region, coupled with a new rise in sexually transmitted infections, could cause the virus to spread rapidly to the general population.