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HIV/AIDS in Europe and Eurasia -situation, response, opportunities and challenges. By Henning Mikkelsen, Senior Adviser, UNAIDS Secretariat. Irkutsk, Siberia.
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HIV/AIDS in Europe and Eurasia -situation, response, opportunities and challenges By Henning Mikkelsen, Senior Adviser, UNAIDS Secretariat
Irkutsk, Siberia “There are about 13,500 HIV-carriers in Irkutsk Region. Nearly 8,000 of them live in the city of Irkutsk, chief medical doctor of the regional anti-AIDS centre Yuliya Rakina told ITAR-TASS. Every school and college in Irkutsk has HIV-infected students.”
Age distribution of reported HIV cases in Estonia 2001 (as of 27 September 2001)
Reported HIV prevalence (per 100,000 persons) in mining territories of Siberia (Russian Federation) Yamalo-Nenetsky AO 118 Taimyr AO 78 Krasnoyarsk krai 127 Evenki AO 5 Khanty-Mansi AO 447 Tyumen oblast 157 Chita oblast 68 Tomsk oblast 53 Irkutsk oblast 465 Kemerovo oblast 141 Altai krai 96 Republic Tiva 5 Republic Khakassia 13 Republic Buryatia 153 Moscow 181 Russia 136 Siberia 166
Prevalence of injecting drug use in Central and Eastern Europe and Central Asia (per 1000 population, 1999 estimate) >7 6-7 4-5 2-3 < 2 no data g g g g g g
The fastest growth ever…. • The scale: Drug use and casual sexual relations involve/affect very large parts of the population • The dynamic: • injecting drug use, prostitution and casual sexual relations rapidly on the rise • the drug injectors are young and highly sexually active • high proportion of young people who occasionally inject drugs and/or involve themselves in sex trade • Only the beginning - immediate and very high risk for development of larger scale sexually transmitted HIV epidemics
The impact • Socio-economic: By 2010, GDP cut by 4% in Russia (World Bank 2002) • Demographic: • hits young people in particular • will accelerate the population decline • Security: • Death toll • Reinforces instability and social unrest • Armed forces and police are highly vulnerable
Urgent need for a comprehensive response • To reduce the vulnerability of young people • to enable and empower young people to reduce their sexual and drug injecting risk behaviour • Additionality: attention to highly vulnerable groups and to vulnerable young people • Link prevention and care
Growing commitment and partnerships at country level • CIS Programme for Urgent Response to HIV/AIDS • Russia: • Lead role in the CIS on HIV/AIDS • First national NGO meeting hosted by government • Public statements on HIV/AIDS by Heads of States in Ukraine and Romania • Negotiations on ARV price reductions • Around 15 countries have applied for the Global Fund to Fight AIDS, TB and Malaria: • Country coordination mechanism established • Partnership with people living with HIV/AIDS and other civil society organizations
The “Checklist” in Europe as of end 2001 –30 countries assessed
International assistance by main programme areas, end 2001 Total: US$51.8 million
Growing resource opportunities • Global Fund to Fight AIDS, TB and Malaria • World Bank projects • Increasing bilateral support • European Commission?
Changing gear in a changing context • Expand the framework to support comprehensive responses by governments and civil society • Ensure effective coordination with government and other country actors • Support countries to be accountable through good monitoring and evaluation • Assist intercountry sharing of experiences (e.g. through CIS)
Reminder • The global total for AIDS is $3 billion. We need 10 billion! • International aid overall is going down • The Global Fund is additional