AIDS — dramatic surge in ex-Soviet Union, no respite worldwide, new data show

The Russian Federation and other parts of Eastern Europe are facing a major AIDS crisis according to the latest HIV/AIDS figures released last December by the Joint UN Programme on HIV/AIDS (UNAIDS). Although sub-Saharan Africa has still the highest number of cases, some of the largest recent increases have been in the Russian Federation, the UNAIDS report says.

Latest research suggests the number of people infected with HIV in Eastern Europe and the former Soviet Union has jumped to 700 000, a rise of nearly 70% in the space of a year. Most of the increase is due to injecting drug users. The worst affected countries, in descending order of numbers of people living with HIV/AIDS, are Ukraine, the Russian Federation, Belarus, Republic of Moldova, and Kazakhstan.

Vadim Pokrovsky, director of the Russian Centre for the Prevention of AIDS, predicts that one million Russians will be infected with HIV within two years: ‘‘Given the existing growth trend in the number of HIV cases, Russia will have millions of HIV cases in two to three years time,’’ he said.

For Neff Walker, epidemiologist with UNAIDS, ‘‘the big surprise is what has happened in Eastern Europe. To see the epidemic suddenly take off as it has in Russia was a shock.’’



Sub-Saharan Africa, however, has still by far the biggest AIDS problem. Nearly 9% of adults there are living with the infection or the disease, vs a worldwide adult prevalence rate of 1.1%. Former South African President Nelson Mandela warned in a World AIDS Day message: ‘‘We are facing a silent and invisible enemy that is threatening the very fabric of our society’’. But not all the news from Africa is bad. ‘‘For the first time, there are signs that HIV incidence may have stabilized in sub-Saharan Africa,’’ the report says. New infections there in 2000 totalled about 3.8 million vs 4 million in 1999.

Asia is a cause of growing concern. With 0.6% of the population living with HIV/ AIDS in South and South-East Asia, it is the most affected region after Africa. Dr Chris Beyrer, director of the Johns Hopkins Fogarty AIDS International Training and Research Program, says: ‘‘Now at risk are some of the largest human populations. The window of opportunity to respond to HIV in Asia is narrow and closing. The time for action is now.’’

The UNAIDS report says that industrialized countries are facing a different type of AIDS problem — complacency due to the mistaken belief that the disease can now be easily treated with drugs. The result is that ‘‘in high-income countries prevention is faltering,’’ the report says. ‘‘Risk behaviour is undeniably on the rise in some communities.’’

‘‘In the developed countries, people in some communities may engage in more risk behaviour because they have a mistaken belief that the new drugs will solve the problem,’’ commented Dr Walker in an interview. ‘‘But we don’t know how long these drugs will work and for some people they don’t work. The virus can also mutate and become resistant, so we don’t know what the long-term prospects for these treatments will be.’’

Roger Dobson,

World Health Organization Genebra - Genebra - Switzerland