Doctors say the number of HIV infections in Eastern Europe is growing at an alarming rate and warn of "catastrophic" consequences within a decade unless patients are given easier access to life-saving treatments. AIDS specialists say the problem is most serious in Russia, Ukraine, and Belarus. They are calling on leaders in the region to admit the existence of the HIV problem and make political commitments to stop the spread of the disease.
Prague, 5 November 2003 (RFE/RL) -- A group of leading experts warns that Eastern Europe faces the risk of an AIDS epidemic over the next decade because of political indifference.
The European AIDS Clinical Society (EACS) says Eastern Europe accounted for more than 80 percent (250,000) of the estimated 280,00 to 300,000 new HIV infections across the continent last year. EACS also points out that of the 1.7 million to 2 million people infected with HIV/AIDS in Europe, up to 1.2 million of them live in the eastern part of the continent.
EACS says the abysmal situation in Eastern Europe strongly contrasts with the state of affairs in the western part of the continent, which has seen major progress over the past several years, with AIDS mortality rates currently at 2 percent, down from 25 percent in 1994 and 1995.
The president of EACS, Christine Katlama, says the situation is sometimes worse in Eastern Europe than it is in Africa when it comes to access to anti-retroviral treatments, which are crucial to prevent HIV-infected patients from developing AIDS.
The scale of the AIDS epidemic in Africa is currently much larger than in Eastern Europe. But the international community has taken steps under the Global Fund to Fight AIDS, Tuberculosis, and Malaria to help African countries deal with the problem.
B-y contrast, Katlama told RFE/RL that Eastern Europe's HIV/AIDS problem has gone largely ignored internationally. "Nobody is paying too much attention to the situation in these [Eastern European] countries," she said. "And right now, if you are an HIV- [positive] drug user or a heterosexually contaminated [patient], and you are living in Russia or Ukraine and if you have no money, you can't access the [anti-retroviral] drugs, and there is no policy [for HIV/AIDS], whereas the international community has taken the African problem into consideration. So, clearly, it probably is now more simple to have access to treatment in Dakar, Senegal, rather than in Moscow or other [Eastern European] countries."
To highlight the increasing danger posed by HIV to the region, EACS held its annual meeting this year in Eastern Europe for the first time. Katlama said the Ninth European AIDS conference in Warsaw (25-29 October) intended to sound the alarm about the situation in the former Soviet states.
"The HIV epidemic has been really rising in the last years, and there is really a lack of access to care in some of the Eastern European countries. So, by this conference, we wanted to point to this side [of Europe] because this is really a very dramatic situation, and it will still rise if nothing is done. It's the case in Russia, in Ukraine, in Belarus. We are very concerned by this epidemic and the absence in many places of access to treatment and care in HIV [cases]," Katlama said.
There are more than 4 million people in need of treatment in Africa. To fight the HIV/AIDS epidemic there, the international community is making efforts to provide African countries with low-cost versions of the same anti-retroviral drugs used in the West. EACS says Eastern Europe, where poverty levels are still high, could benefit from a similar arrangement.
But Katlama said many Eastern European governments refuse to acknowledge they even have an HIV/AIDS problem. "There is no reason why countries which pretend to be democratic and are talking with the G-7 or G-8 political group [should] deny the problem in their own country," she said. "There is either denial or they are not doing anything. We have discussed with many of these colleagues and activists from Eastern Europe, and there are really very, very few things [being done]. If you don't have a political commitment at the highest national level, then nothing is done."
EACS says government officials in Eastern Europe ignore the threat because the number of HIV-infected patients who develop AIDS is still small. But Katlama said that unless quick action is taken, Eastern Europe could be sitting on a time bomb.
"It will be terrible, because right now, the people are infected but not very many are sick, because between the infection and the time when you are very sick and you die there are approximately 10 years. So, clearly, if you are infected, you disseminate the virus, and you will really increase terribly the number of people [infected]. Right now, some authorities say, 'Oh, we have no problem [because] nobody is sick,'" Katlama said.
Former U.S. President Bill Clinton this week also warned that AIDS should be considered a security issue as important as terrorism. He said that if the number of AIDS cases reaches 100 million globally over the decade -- as has been predicted -- it will mean a "dramatic change in the political life of the former Soviet Union," threatening the young democracies in the region.
Clinton, who heads the Clinton Foundation HIV/AIDS Initiative, said in Oslo yesterday that the spread of the disease could lead to what he called "massive political instability."
The AIDS conference in Warsaw pointed to the success of Central European countries in fighting the spread of AIDS. It mentioned mainly the case study of Poland, where swift reaction in the early 1990s -- involving a combined effort to prevent and treat the disease -- managed to keep HIV at bay.
Polish HIV specialist Andrzej Horban told RFE/RL that Poland currently has fewer than 8,000 people infected with HIV out of a population of 40 million. He said it is much cheaper for a government to prevent the spread of HIV than to treat those already infected.
"We introduced two separate programs. One for prevention, and the second one for treatment. There are two special organizations created by the Ministry of Health. One is the office for the prevention of HIV, and they introduced and applied a lot of prevention programs. And second, we decided to create a limited number of centers which have been concentrated in big cities, open for every patient, and these centers should serve as wide as possible a number of services for these patients," Horban said.
EACS says that, unlike Africa, where HIV spreads mostly by sexual intercourse, the main means of infection in Eastern Europe is through infected needles among injecting-drug users.
Katlama said it rests with the European community to prod the Eastern European governments into taking action. "I think that one of the key things would be that the European community, Brussels, parliaments, really take this into consideration, maybe to push and to solicit the [Eastern European] countries to have really something [done] about the HIV [infections]. Very few things are done, and I think it's a shame," she said.
Katlama also warned that, despite important progress in the treatment of HIV, there is still no cure for AIDS. She said that safe sex and needle distribution programs for drug users remain the only real protection against HIV.