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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)
0
100
200
300
400
500
0-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49
Moscow 181Russia 136Siberia 166
Reported HIV prevalence (per 100,000 persons) in mining territories of Siberia (Russian Federation)
Altai krai96
Kemerovo oblast141
Tomsk oblast53
Khanty-Mansi AO447
Tyumen oblast157
Yamalo-Nenetsky AO118
Republic Buryatia153
Republic Tiva5
RepublicKhakassia
13
Krasnoyarsk krai127
Taimyr AO78
Evenki AO5
Chita oblast68
Irkutsk oblast465
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
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
0
5
10
15
20
25
NationalStrategic
Framework
Implem. Plan Costed Plan M&E Plan Coord.Mechan.
International assistance by main programme areas, end 2001
28%
16%
4%
17%
24%
11% Injecting drug use
Young People
Other vulnerable groups
STI/condomprogrammingCare
Advocacy, programmedevelopment
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
Projected HIV/AIDS resource availability 2002-2005.
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
Unmet Need
GFATM
International
Private
National
* Assumes continuation of 2002 budget levels.