#12
Moscow Times
November 30, 2001
Politicians Urged to Address AIDS
By Robin Munro
Staff Writer

Foreign and local AIDS experts are urging Russian politicians to do more about AIDS in the runup to World AIDS Day on Saturday.

"The public is really worried about HIV/AIDS, but for some reason the politicians are busy with other things," Vadim Pokrovsky, chief of the Russia AIDS Center, said at a news conference Thursday.

By the end of this year Russia, which has one of the world's fastest-growing HIV infection rates, is predicted to have 200,000 registered cases of HIV. According to a United Nations report released Wednesday, HIV is spreading faster in the former Soviet bloc than anywhere else in the world, with the numbers in Russia doubling annually since 1998.

Although as yet few in Russia are sick from AIDS, 99 percent of those infected are expected to die in the next 20 years. The loss, mainly of young men, would lower the nation's average life expectancy and the birth rate in a population that is already declining, Pokrovsky said. The economy is also likely to suffer.

Although politicians have often justified the scant resources to fight HIV/AIDS -- 120 million rubles ($4 million) in this year's budget -- by saying there was not enough money, funds always seemed available for other unexpected events, Pokrovsky said.

"There are many dubious expenditures by our government. In many cases money spent on HIV/AIDS could be more effective," he said.

"I spoke to Prime Minister [Mikhail] Kasyanov about it and he said, 'Yes, yes. We understand. It's a very important problem.' But there was no change in the HIV/AIDS budget.

"I doubt the president is even aware of it," he added.

The presidential press service had no comment on President Vladimir Putin's stance on the issue.

Pokrovsky said that money was not the answer to all the problems posed by the epidemic, and that attitudes could be changed relatively cheaply.

Peter Piot, executive director of the Joint UN Program on HIV/AIDS, agreed.

"We are not asking for the moon. These are things that don't cost a lot," he said as he outlined an anti-AIDS program for Russia.

AIDS should be addressed as a national security issue by the top political leadership, he said. "Human resource limitations are one of the obstacles to economic growth," Piot said.

In addition, every regional administration should have a program and a budget to fight HIV/AIDS. Special programs, probably best run by nongovernmental organizations, should address at-risk groups such as young people and drug users.

Russians are conservative when it comes to talking about sex, but the high rate of transmission of sexual disease shows that they are not inhibited in their sexual behavior, Piot said. "There should be a major effort in terms of openness about AIDS and everything else to do with it, including sex and drugs," he said.

While the breakdown of social support in Russia since the fall of the Soviet Union had undoubtedly contributed to the rise of drug abuse and the spread of HIV, the media had evolved to a point where it could have a powerful positive effect. "That also means influencing the opinions and attitudes of politicians. With AIDS, journalism can save more lives than doctors," Piot said.

"What I would like to see, and it's happening in some countries, is compulsory free television time for AIDS advertisements with these messages in prime time, not after midnight," he added. "That's how they started in Thailand 10 years ago and it made a big difference."

While no country has succeeded in stamping out addiction to heroin, which is the main drug injected in Russia, treatment programs using methadone, a synthetic analog of heroin, have been found to be the most effective in assisting drug users to get off heroin when used as part of a comprehensive treatment and prevention program, experts said this week.

Such programs cannot be launched in Russia because methadone use is illegal.

Stan Read, a member of the Canada AIDS team, said methadone is a syrup that can only be taken orally. People on the programs complain that it gives them no high; even if they find the cash to buy heroin it suppresses the heroin high, he added.

Addicts need no heroin, do not have to commit crimes to raise the money for their habit, and cannot receive HIV, hepatitis B or C, or tuberculosis by injecting, said William Flanagan, spokesman for the Canada AIDS Russia Project.

Like heroin, methadone is addictive, but it allows addicts to lead a relatively normal life, including going to work, Pokrovsky said. And while it is not a panacea, methadone is being considered as a treatment for HIV-positive drug users in order to stop them spreading their infection through sharing syringes.

Drug users are widely stigmatized in Russia, and needle-exchange programs, which offer users sterile equipment, have faced resistance from those who see them as aiding addicts.

The highlight of Saturday's World AIDS Day events in Russia is to be an anti-AIDS concert at Luzhniki, broadcast live on TV6.

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