Eastern Europe and Russia face world's fastest growing HIV epidemic

If governments in the region fail to coordinate health, law and order, public information measures, and humanitarian concerns to tackle the growing crisis, the epidemic will be a severe brake on their economic and social development, the report concluded.

The report was released ahead of a three day conference in Dublin last week called "Breaking the barriers: the fight against HIV/AIDS in Europe and Central Asia." It was organised by the Irish government, which currently holds the rotating presidency of the European Union.

The World Health Organization, the Joint United Nations Programme on HIV/AIDS (UNAIDS), and Unicef called on governments in the region to take urgent action to prevent the further spread of HIV across Europe, warning them that the world’s fastest growing HIV epidemic would soon be on the European Union’s doorstep after its enlargement on 1 May 2004.

The development programme’s report concluded that only a decade ago the countries of the former Eastern bloc had some of the world’s lowest prevalences of HIV infection and the "potential to reverse the trend with relative ease."

Governments failed to recognise that opportunity. Now rates of infection in the region threaten to overtake those in North Africa and the Middle East, it said.

Citing UNAIDS figures, the report said there were an estimated 280 000 new HIV infections in the region last year—bringing the total number of infected people to about 1% of the population, or between 1.2 million and 1.8 million people.

Ben Slay, director of the development programme’s regional centre for eastern Europe and the former Soviet Union, which is based in Bratislava, said that a prevalence of 1% was a "Rubicon" marking the point where infections spread from intravenous drug users and sex workers to the population at large.

"HIV has become a serious problem in this region: it is treated as a health problem by the health ministry, as a law and order problem where drug use is involved, or as a human rights problem—but there isn’t a holistic approach. There’s a fair bit of denial, and often it doesn’t get the attention it deserves," Mr Slay said.

The epidemic is most acute in Russia, Ukraine, and Estonia, where use of intravenous drugs and sharing of dirty needles have increased since the collapse of communism in 1991. Also, the region has become a major transit route for heroin couriers from Afghanistan.

Overcrowded and insanitary prisons in countries in the region are "incubators" for spreading HIV and tuberculosis, Mr Slay added.

He said the exception to the trend was Poland, where the Catholic church had organised a major campaign to destigmatise the disease early on. As a result Poland’s HIV prevalence is about 0.1%—one of the lowest in Europe.