I believe tough news has to be faced squarely and challenges need to be met head on. It is alarming that the recent UNAIDS Report on the Global AIDS Epidemic found that the number of people living with HIV in Eastern Europe and Central Asia has nearly tripled since 2000 reaching an estimated total of 1.4 million people in 2009. This report should be a renewed call to action.
In contrast to the encouraging reports from other regions of the world, Eastern Europe and Central Asia have experienced the largest regional increase in HIV prevalence, with the Russian Federation and Ukraine accounting for nearly 90 percent of the newly reported infections in the region. The report also found a more than four-fold increase in the number of AIDS-related deaths from 2001 to 2009 in the region. In comparison, globally there has been a 20% decrease in new HIV infections over the past decade, and fewer AIDS-related deaths over the past few years due to anti-retroviral therapy.
The epidemic in Eastern Europe and Central Asia is concentrated among marginalized groups such as people who inject drugs, sex workers, their sexual partners, and men who have sex with men (MSM). There are many reasons that HIV infections continue to grow in Europe and Eurasia, from drug addiction to social or cultural stigma about sexual orientation. None of these should be insurmountable obstacles to working to prevent HIV infections.
USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) directly support HIV/AIDS prevention programs in Russia, Ukraine, and Georgia. In Russia, activities focus on providing technical assistance to local counterparts to design and implement effective prevention and care programs for those most at risk of HIV infection. In Ukraine, through the Sunrise Project, USAID funds a pilot program of methadone-based Medication Assisted Treatment to provide 300 HIV-infected male and female injecting drug users with access to a package of services that includes MAT and related medical, legal, social and psychological care. The SHIP Project in Georgia supported HIV prevention among high risk groups; through this intervention, the use of shared injecting drug equipment was reported to decrease from 79% in 2002 to below 43% in 2005.
Regionally, USAID and PEPFAR work to address the concentrated epidemic through a variety of activities, including the development of the Medication Assisted Therapy (MAT) Policy Toolkit. The toolkit will help to prevent HIV by providing information for advocates and policy makers working to support MAT implementation for injection drug users. Another regional activity supported a situational assessment of MSM and HIV in the region that reviewed data, information, and programs for MSM and identified gaps and potential activities to address some of these gaps.
As we celebrate the success of global efforts to prevent the spread of HIV and AIDS, we cannot forget about the most-at-risk populations in the Eastern Europe and Central Asia region. While USAID, PEPFAR, and the governments and NGOs in the region have HIV/AIDS prevention and treatment programs in place, we all still have much work to do in order to control the epidemic. We need to face the tough news and work together even harder to save more lives.