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1 Octobre 2001 by John Sparrow and Ilmira Gafiatullina in Almaty A fresh crisis is unfolding as HIV prevalence in Central Europe and Central Asia shows unprecedented growth, Red Cross and Red Crescent National Societies are warning. With official rates in some countries increasing threefold and fourfold annually - and reality thought to be much worse - an explosive epidemic would seem to be underway. The spread of the AIDS virus was showing a "threatening new trend", a meeting of the European Red Cross/Red Crescent Network on HIV/AIDS (ERNA) was told in Almaty, Kazakhstan, last week. Said Dr Massimo Barra, the network's chairman, "We are not on the verge of a crisis. We are in one." Worst hit are the countries along the "heroin highway" that extends from Afghanistan, north through Central Asia to Russia, then west into the Baltic region and Central Europe. Intravenous drug use is the major cause of HIV growth, and in Kazakhstan where 250,000 drug addicts are registered, some 40 per cent carry the virus. Said Sholpan Ramazanova, Kazakh Red Crescent and Red Cross Health Co-ordinator, "No one knows the real numbers. The registered addicts are those who have sought medical assistance but generally addicts are unwilling to register in this country." Aware of mandatory HIV testing and the lack of confidentiality, they keep a distance from medical authorities, she says. "I am afraid to think what the true picture may be but the figures could be double the official ones." While Kazakhstan has the greatest numbers, more than 800,000 drug addicts have been recorded across the Central Asian region, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS), and young people are taking an ever more prominent position among them. More than 90 per cent of HIV cases are drug-related, UNAIDS told the Almaty meeting, and, regionwide, HIV prevalence has already increased threefold this year. The scale of the Central Asian crisis already resembles that of Africa in the early 1980s, and additionally the flow of drugs is ever greater. Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan all face growing traffic and abuse, a fact reflected in the narcotics that authorities manage to seize. In 1992, Tajikistan confiscated 38 kilos of poppy paste; since January this year they have seized nearly seven tons. The picture is no less alarming in the Baltic region. While prominence has been given to neighbouring Russia's epidemic that has seen more than 129,000 new cases of HIV infection over a period of 18 months, Estonia and Latvia reveal an upward spiral. The figures are modest by comparison but the size of the increase is dramatic. The ERNA meeting heard that through the second half of the 1990s, Estonia was averaging 10 new cases a year. In 2000 the figure lept to 390, and the first eight months of this year brought 1,131 new cases. Latvia has seen a rapid increase since 1998, when the number of reported HIV cases jumped to 163 from 25 the year before. In 1999 there were 241 cases, in 2000 there were 466, while by September this year 547 cases were recorded. As in Estonia, the increase is mainly drug related. Commented Latvian Red Cross adviser, Dr Inga Upmace, "Some 82 per cent of new cases are found among intravenous drug users which makes prevention, needle exchanges and methodone distribution programmes, absolutely vital. We must do more." The Latvian Red Cross is already collecting 6,000 used syringes a month from addicts in the capital, Riga. By the end ofthe year there will be up to eight new services in the countryside. Even in countries where no upward spiral is evident, there is realisation of an urgent need for expanded prevention. Dr Veneta Mihaylova Vassileva of the Bulgarian Red Cross is concerned the 300 official cases of HIV in her country give the population a false sense of security. Specialists believe the real figure is at least 10 times that, and she commented, "The figures I am hearing in Almaty are frightening because one day they will be reported from Bulgaria, too. The Balkans may not be at the epicentre now but that does not mean we will be passed by." Back in Central Asia, the Uzbekistan Red Crescent is also calling for more resources for preventive measures. Three years ago, three cases of HIV were registered. Today there are more than 300, linked particularly to an outbreak in the industrial city of Yangiyul near Tashkent. The backdrop is familiar: a socially disadvantaged community with a high incidence of intravenous drug use. ERNA currently comprises 22 Red Cross and Red Crescent National Societies whose prime HIV/AIDS focus is on awareness raising and prevention programmes, particularly among young people. Peer education is central to these efforts. "We have found it to be the most efficient way to tackle youth on the risks," said Zaure Abdraimova, youth leader of the Kazakh National Society, which is working in schools and plans to expand its activity through youth clubs across the country. Innovation is called for, said Marcel Stefanik, President of the Slovakian Red Cross Youth, "If we want to get the message across we have to go beyond tedious lectures and discover new approaches." The Almaty meeting - the network's fifth annual conference - was attended for the first time by Red Cross Red Crescent Youth representatives and two days were set aside for a youth peer education workshop. Also present was the European Network of People Living with HIV/AIDS (ENP+). ENP+ is the European arm of the Global Network of People Living with HIV/AIDS, with whom the International Federation has formed a partnership to fight stigma around those who have the virus. |
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