Further action is needed against the HIV/Aids pandemic in Europe. The international focus has been on the apocalyptic situation in some African and Asian countries, but the infection is also spreading fast in certain European states, notably in the Russian Federation, Ukraine, Estonia and Moldova. The disease has generated a severe public health crisis as well as urgent human rights problems.
UNAIDS, the agency co-ordinating the United Nations programmes against the pandemic, has estimated that 940 000 persons are living with the infection in Russia and 410 000 in Ukraine. In western Europe, the highest rates have been recorded in Spain, Italy, France, Switzerland and Portugal.
HIV/Aids is changing the demographics in all affected countries. Given that the hardest-hit section of society is the 15 to 30-year age group, HIV/Aids has a deep impact on birth rates, while for instance in Russia and Ukraine the disease is likely to become an obstacle to economic growth.
Many of those affected have had their human rights undermined. Ignorance about how the disease spreads has bred prejudices which, in turn, has stigmatised or marginalised those who carry the virus.
Such discrimination must be combated and governments should seek co-operation with non-governmental support groups, not least with those that have been organised by HIV carriers themselves and their relatives.
A large section of the infected population does not receive the necessary anti-retroviral treatment or psychological support. Also, carriers often become victims of discrimination in areas of medical assistance, education, as well as labour market opportunities.
Particularly vulnerable are the growing number of children born to HIV positive mothers. Some of them may be infected themselves, some risk becoming orphans – they all have the right to special support.
Prevention is certainly a key priority. Research aiming at an effective vaccine may not produce results for many years. However, governments which have invested in available methods have had encouraging results.
First, and most important of all, governments must openly recognise the full scale of the problem. Until recently, HIV/Aids was not high on the government agenda, and in Russia and Ukraine, for instance, funds allocated to both prevention and treatment were meagre. Attitudes are now changing and in Russia the authorities have admitted that the actual infection rate might be four times as high as the official figures.
Systematic information campaigns about safe sex combined with making condoms available have had a positive impact where tried. Unfortunately, religious leaders have not in all cases been supportive of these important endeavours.
Part of the strategy has to be directed towards the particular risk groups:
• Drug injection remains a key factor in the growth of the pandemic in both Russia and Ukraine, as well as in Estonia and Moldova. In Ukraine more than 45% of the new infections reported this year related to injecting drug users and in Moldova as many as 84% of the registered injecting drug users had contracted the virus.
• Prostitution – often combined with drug abuse – is clearly dangerous. In Kiev, 8% of the females drawn into prostitution were found to have contracted HIV in 2005.
• Prisoners also tend to have a higher infection rate. In Russia, HIV prevalence is estimated to be four times higher inside prisons than with average Russians.
It is estimated that a majority of those who live with the virus today are unaware of this fact and may not therefore take care to avoid infecting others. More has to be done to promote blood testing and to give support to newly discovered carriers of infection.
Comprehensive prevention strategies can stop the disease from spreading further. There is a need for effective national action plans – programmes which are underpinned by broad-based awareness-raising and strong educational components. It is absolutely essential that governments take strong action against the illicit drug trade and trafficking of human beings.
This is a heavy agenda. Although Russia, Ukraine, Estonia and Moldova have a serious HIV crisis, other European countries are affected as well.
As the virus, by its nature, spreads across borders, the pandemic must be a concern for all citizens of the world, including us Europeans.
Thomas Hammarberg