Integrated HIV prevention and treatment programmes are urgently needed. Photo: Corbis/RD
23 FEBRUARY 2004 | DUBLIN -- AIDS is rapidly spreading in Eastern Europe and is on the rise again in Western Europe because integrated prevention and treatment programmes have not been sustained or do not exist. Countries in Eastern Europe, home to the fastest-growing epidemic in the world, will soon be on Europe’s borders following the European Union’s enlargement on 1 May 2004. The Baltic States, which will soon be part of the EU, are also experiencing a rapid rise in HIV infections.
Leading UN agencies, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the World Bank are calling on European Ministers to urgently take decisive action to prevent the further spread of AIDS across Europe and to treat those in need. They warn that young people and other groups, such as sex workers, men who have sex with men and injecting drug users, are particularly at risk of HIV infection. The agencies are participating in a Ministerial Conference hosted by the Irish EU Presidency, “Breaking the Barriers - Partnership to fight HIV/AIDS in Europe and Central Asia”, which opens today in Dublin.
"Europe and Central Asia are at the centre of the fastest-growing HIV epidemic in the world. There is no time to waste - European Ministers must urgently scale up and roll out effective HIV prevention and treatment programmes," said Dr Peter Piot, UNAIDS Executive Director. “Given that the EU will form the biggest trading bloc in the world, covering more than 500 million people, it is in the EU’s best interest to prevent the AIDS epidemic from crippling Europe’s social and economic development.”
Although most people in Western Europe now have access to free treatment through national health systems, many governments have not focused as much on prevention as they did in the 1990s. Infection rates are once again on the increase. Integrated prevention and treatment programmes are also urgently needed to ensure that life prolonging treatment is not seen as a cure and to ensure that people living with HIV/AIDS continue to protect themselves and their partners.
Over 1.5 million people are living with HIV in Eastern Europe and Central Asia, compared to only 30,000 in 1995. Young people, who make up 40% of the population in the region, account for the majority of HIV infections among injecting drug users. A large number of them also engage in unsafe sex, increasing the risk of HIV. There is also evidence that people are having sex at a much younger age without protection. The percentage of people reporting premarital sexual relations more than doubled between 1993 and 1999, from 9% to 22%. Only 10% of girls in Tajikistan have ever heard of HIV/AIDS.
"Schools are the best defence against HIV infection," said Carol Bellamy, Executive Director of UNICEF. "They offer the best mechanism to deliver HIV prevention information, as well as the long term educational and social skills that protect against infection. With knowledge so critical in the fight against HIV/AIDS, the best defence against the epidemic is keeping vulnerable young people, especially girls, in school."
In Eastern Europe and Central Asia, only 7000 people receive antiretroviral therapy for HIV, which is 9% of those in need in the region. For many, the treatment is too expensive or simply not available. To address this imbalance, the World Health Organization and UNAIDS have launched an ambitious challenge to get three million people on antiretroviral treatment by 2005 in developing countries and emerging economies. Dr LEE Jong-wook, WHO Director-General said: “Treatment saves lives. Without treatment, the millions of people living with HIV will die prematurely. Prevention must go hand in hand with treatment. Europe cannot divide over the issue of AIDS treatment, and only provide treatment in the richer countries. Treatment should be a right for all, including for sex workers and injecting drug users.”
In many countries of Western Europe, there are increasing rates of sexually transmitted infections, indicating resurgence in unsafe sex, primarily among young heterosexuals. In 2003 alone, between 30,000 and 40,000 people became infected with HIV, raising the number of people living with HIV to between 520,000 and 680,000. “The enlarged EU and its neighbours could rapidly be faced with a more vigorous phase of the epidemic unless political leaders transform their verbal commitments into concrete action on the ground,” said Lars Kallings, the UN Secretary-General’s Special Envoy for HIV/AIDS in Eastern Europe, speaking at the conference.
“Data from the region unambiguously points to the socio-economic and governance dimensions of the epidemic. Members of at-risk groups are often subject to social exclusion, poverty, stigmatisation, or incarceration-factors which actually heighten the spread of the disease,” said Kalman Mizsei, Assistant UNDP Administrator and Regional Director fro Europe and the CIS.
In addition to increased AIDS funding from national governments, the World Bank and European Union, the Global Fund to fight AIDS Tuberculosis and Malaria has approved over US$ 400 million in funding over five years for 22 programs in 16 countries in Eastern Europe and Central Asia. Most of these funds are earmarked for HIV prevention and treatment programmes, along with programmes to control tuberculosis, the biggest killer of people living with HIV. Dr Richard Feachem, Executive Director of the Global Fund said: "Swift implementation of programmes is possible, as our experience in Estonia has shown, moving from grant signing to first disbursement to implementation of targeted prevention and treatment programmes in just 12 weeks. Urgent action is needed throughout the region to turn the tide of the disease”.
“Effective HIV/AIDS prevention and care programs will require that funding from all sources increase to about US$1.5 billion by 2007. But money alone is not the issue. It is crucial to improve the information base for programs, to support what works against HIV/AIDS, and to break down the policy and social barriers to effective actions across the region,” said Shigeo Katsu, World Bank Regional Vice President for Europe and Central Asia.
