Russia to lose tens of millions of dollars in AIDS

Russia stands to lose tens of millions of dollars in international AIDS funding because it has been reclassified by the World Bank as an upper middle income country, just as it faces an escalating epidemic. Non-governmental organizations which rely largely on the Global Fund to Fight AIDS, Tuberculosis and Malaria to finance their efforts to combat an explosion in HIV cases warn that the lack of new grants will make anti-AIDS efforts dangerously dependent on the Russian government.

Although the global fund between now and 2011 will disburse more than US$200 million ( Ђ 157 million) of existing funding for AIDS and Tuberculosis programs in Russia , it cannot issue any new HIV-related grants for Russia , said its spokesman Jon Liden. "The country would need to have a large-scale epidemic in order to ask for more money," he told The Associated Press by telephone from Geneva .

" Russia , being a G-8 nation with substantial economic growth, wouldn't want to be a recipient anyway," he said. Russian President Vladimir Putin, who is to host a summit of the Group of Eight major industrialized nations in July at which AIDS will be a dominant theme, ordered a 20-fold increase in AIDS-relating spending this year, to more than US$100 million ( Ђ 78 million).

But even the country's top AIDS official, Vadim Pokrovsky, has criticized the government's program as badly coordinated, tied up in bureaucracy and failing to include non-government organizations, which are carrying out most of the prevention and education work. Russia officially has 334,000 officially registered HIV- or AIDS-infected people, but the UNAIDS agency puts the figure at nearly 900,000 and many others say the real number is likely well above 1 million, around 1 percent of the country's population.

The disease is rapidly spreading beyond the traditional risk groups drug users, gay men and prostitutes into the wider population through heterosexual sex, with young people particularly vulnerable. Experts warn that Russia 's decrepit health system is unable to cope and that AIDS could have a devastating impact on the already plummeting population and the economy, currently enjoying an oil-fuelled boom.

"After the G-8 summit it's possible that this issue will return to the back burner and will no longer be so prominent," said Alexander Pankratov of the Russian Health Care Foundation, which distributes grants from the Global Fund. "If they cut off future access to international aid, this will not help NGOs to pursue their activities fully. If grants continued, this would guarantee a more stable environment for NGOs," he said.

This week, hundreds of activists, AIDS officials and health workers gathered in Russia for a major conference at which participants hailed growing funding and attention by Russia to the problem, but said the government was giving contradictory signals on its plans for fighting the disease. Natalya Ladnaya, an employee of Russia 's government-run Federal AIDS Center , said the international aid had been intended only to jump-start the focus on AIDS.

"The political support of the government does now exist, so the task has been largely achieved. Moreover, many of these grants have another four or so years to run. I don't see anything alarming in this decision," she said. But Yekaterina Militskaya of the AIDS Foundation East West, a Dutch-based nonprofit group that receives Global Fund financing, expressed concern. "We believe that every possible effort is required to fight AIDS at the moment," she said.

"It is good that the government has taken interest in this problem but it is not clear what this influx of government money will achieve. So much more needs to be done, especially by the NGOs," Militskaya added. Africa is the destination of 60 percent of aid from the Global Fund, but Russia is currently one of the largest single recipients. The fund finances prevention programs to increase awareness of HIV/AIDS and to reduce transmission of HIV as well as treatment, care and social support to people living with HIV that includes provision of antiretroviral drugs, reports the AP.