HIV INFECTION IS SPREADING IN RUSSIA FASTER THAN IN AFRICA - 21 December, 2000

Russia paced at a truly high tempo towards the world day of combating AIDS, which is marked annually on December 1. If 10 years ago we considered AIDS to be some overseas African infection, now, according to the medical statistics, in some Russian cities (in Irkutsk, for example) there is no doorway without drug addicts injecting drugs and no street without an AIDS-infected person living in it.

Readers of a local newspaper write to the editorial office: "Who has made this bedlam here? Who has brought AIDS to Irkutsk? Is there any investigation underway?"

And everything turns out to be simple. The newspaper answers: "A blood sample has been recently sent to the D.I.Ivanov Moscow Institute of Virology to find out from whence AIDS came to Irkutsk. When they identify the type of our HIV, it will be clear where it was brought from: Ukraine, Byelorussia, Azerbaijan, etc. (a wide choice)".

Such touching artlessness of either journalists or the local AIDS-control bodies looks simply blasphemous.

At the parliamentary hearings "On Package Measures to Prevent and Control the Disease Caused by the Human Immunodefiency Virus (AIDS) in the Russian Federation" held recently in the State Duma, it was pointed out that, according to the WHO, now in the world there are about 33 million HIV-infected persons. Almost 6 million people from this amount, or about 20 %, got infected last year. Every minute 6 young people on the planet catch an HIV infection. The HIV situation that shaped in the Russian Federation should not be considered in isolation from what is happening in the world.

Here is what Academician of the Russian Academy of Medical Sciences (RAMS) Vadim Pokrovski, Head of the Federal Centre for Prevention and Control of AIDS, said:

Now in this country they register about a thousand new HIV cases every week. 40 thousand HIV-infected persons have already been identified since the beginning of the year. These are just registered cases, actually up to 10 thousand persons catch the infection every week. And now it is a task for a third grade pupil to count the number of the infected in this country. It makes about 430 thousand. In other words, from 400 to 500 thousand our compatriots are already infected with the human immunnodeficiency virus. In the USA the number of the HIV-infected is from 1 to 2 million people, and we habitually consider this to be a really serious problem in the United States.

In Russia, unfortunately, combating AIDS is still regarded only as medical problem, and doctors are considered guilty of spreading the disease.

As the author of these lines was told in an interview with Academician of the RAMS Sergei Kolesnikov, the State Duma deputy from Irkutsk, who also participated in the hearings, it is not doctors dealing with just a small tail of the AIDS problem in the form a geometrically growing number of the HIV-infected who should be responsible for the problem but the state in the person of its rulers. That is why, unless a national committee to control the epidemic is set up, the situation will further aggravate. Even those meagre funds, which are allocated, are frittered away. There is no integral strategy of combating AIDS. And today, as before, this problem is tackled practically only by doctors and law-enforcement bodies.

Irkutsk, the record holder for the disease growth rates, stands by itself among the Russian regions. With a population of 680 thousand people, this Siberian city is only 20 % behind the ten-million Moscow as for the number of the HIV-infected and has surpassed two times over the port city of Kaliningrad and the Krasnodar territory, which borders on the traditionally dangerous Caucasus. What is the reason for this Irkutsk phenomenon?

In the pinion of Sergei Kolesnikov, the matter is that the Irkutsk local health authorities have made a great number of mistakes and, as a result, let the epidemic situation out of control.

The management of the AntiAIDS Centre started tackling the tasks, which were of benefit to the Centre but not to the city residents. The most financially lucrative task is diagnostics, i.e. the application of test systems. When test systems are bought, the grateful companies help those who became their customers. The agents get their lawful 10 %. The second aspect for the Irkutsk specialists to concentrate their efforts on was anonymous examination. How can one keep record of funds that get to a certain establishment in cases of anonymous examination? And the issues of preventive work were given minimum attention at that. Though, as Sergei Kolesnikov says, in the first place there should be preventive work in the form of a sound youth policy, solutions to social problems and employment and leisure problems; in the second place — preventive work in the form of popularisation of hygienic standards and protection techniques; and in third place — diagnostics and treatment. To be exact, one may omit treatment in the conditions of Russia as it costs USD 10,000 per patient a year.

In Irkutsk, they have committed all their efforts to general diagnostics of the population. The head of the Centre, Nadezhda Zaznobova, acted as arbitrarily as she wished with the complete connivance of the authorities. Her incompetence was subject for telling legends in the city, but the administration, evidently, believed that the regional AIDS problem was attended to and, consequently, there was nothing to worry about.

The head of the AntiAIDS Centre has even convinced the administration to allocate money to build a separate huge building for the Centre in Irkutsk to where the inhabitants will come for diagnostics from the entire region occupying, by the way, 800 thousand square kilometres. A pretty penny was invested in the project, and then the authorities, as the saying goes, chose both of the two evils: the construction works were frozen. The centre is non-existent. And the money, which could be used for preventive measures, is now lying snow-covered as a procrastinated building project everybody is so well familiar with since the Soviet times.

The Irkutsk authorities, one should say, demonstrate somewhat queer methods of combating the AIDS epidemic. On the one hand, the Irkutsk government has forbidden the city blood transfusion station to accept donors under 30, thus trying to secure from spreading the infection. Such restrictions are not found anywhere else in Russia. On the other hand, the Irkutsk region, only because of its authorities' negligence, was not included in the international UN AIDS-control program comprising 19 Russian territories, which are much safer in comparison with Irkutsk.

One thing is absolutely sure, the Irkutsk phenomenon would not exist if this country's top leadership's treatment of the AIDS problem were different. At hearings, they made public the figures that our membership fee to the UN is greater than the funds allocated to finance the AIDS program in the Russian Federation. What can we talk about? May be about AIDS being absent in this country? There is no funding, so there is no problem.

By the way, academician Pokrovski said at a news conference recently that today the rates of spreading AIDS are higher in Russia than in Africa.

Inna Semionova