HIV rising fastest in Eastern Europe, Central Asia

Nowhere in the world is the HIV virus spreading faster than in Eastern Europe and Central Asia, where more than 80 per cent of those infected are under 30 years old, Unicef said on Monday.

"Eastern Europe and Central Asia are the only parts of the world where the HIV epidemic remains clearly on the rise," it said in a report published on Monday at the 18th International AIDS Conference in Vienna.

In parts of Russia, the rate of HIV infections has gone up by 700 per cent since 2006, said the report, "Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia”.

And a third of new infections in the whole region affected teenagers and young adults between 15 and 24, the UN's child protection agency noted.

One of the main causes for this drastic increase was drug use and the sharing of needles in a region that counts 3.7 million injecting drug users: about 25 per cent of the world's total, said the report.

And the drug users were starting as early as 12 years old, it added.

Sexual transmission had also turned recently into a major cause of the HIV spread: some 80 per cent of sex workers in Eastern Europe and Central Asia were young people, said Unicef.

Many of them were selling sex to support their drug habit.

The report thus painted a picture of those most at risk being young, marginalised people uncared for by their families or living in the street.

And according to Unicef, this figure amounted to some 1.3 million children in the region.

Compounding the problem was the fact that many did not seek treatment for their condition because of the social stigma associated with HIV: they feared being judged or even facing criminal prosecution.

And that pushed them further into the margins of society, the report noted.

A young interviewee from Tajikistan told researchers she had only visited an HIV prevention and treatment centre after being taken there by a social worker: until then, she did not believe the medical check-ups and condoms would be free, fearing it was just a police trap.

Traditionally authoritarian attitudes in the post-Soviet countries of Eastern Europe and Central Asia gave little attention to marginalised groups and young people, Unicef noted.
The report called for more prevention and treatment centres, and friendlier services to respond to the epidemic.
"This report is a call to protect the rights and dignity of all people living with or at risk of exposure to HIV, but especially vulnerable children and young people," Unicef chief Anthony Lake said in a statement.
"We need to build an environment of trust and care, not one of judgment and exclusion."
"Only by reversing discrimination against people living with HIV, can Eastern Europe and Central Asia begin to reverse the spread of the epidemic."

Meanwhile, Bill Clinton and Bill Gates sounded an austere note at the world AIDS conference on Monday, rebuffing activists clamouring for leaders to throw open the funding spigot despite recession.

"I completely understand why the advocates for greater AIDS funding have loudly protested. But I do not think it is either fair or accurate to say the US President Obama has gone back on his promises as if this was a callous walking away," Clinton said in a keynote speech.

New figures point to an ever-widening gap between resources and needs for helping the 33.4 million people with AIDS or the human immunodeficiency virus (HIV).

The worrying shortfall is being blamed on donors' cutbacks after the 2008 economic crisis - but also from the spiralling cost of putting more poor people on lifesaving, but also lifelong, drugs to repress HIV.

Clinton's appeal for cost and efficiency gains was echoed by Gates, who with his wife Melinda is the world's biggest single private donor on AIDS, contributing $2.2 billion (Dh8bn) since 1999.

"Right now there simply isn't enough money to treat our way out of this epidemic," Gates warned.

"If we keep spending our resources in exactly the same way that we do today, we'll fall even further behind in our ability to treat everyone."

The philanthropist called for further efforts to ratchet down drug prices, a shift to lower medical costs by transferring some tasks from doctors to nurses and promoting male circumcision as a proven method of shielding men from HIV.

From 2002 to 2008 donations from rich economies for poor countries surged from 1.2 billion to 7.7 billion dollars, but fell back last year to 7.6 billion, according to an analysis by the Kaiser Family Foundation and UNAIDS.

That left a funding shortfall last year from all sources of more than $7 million.

The widening gap threatens the goal of providing universal access to AIDS drugs and may even disrupt supplies to those already on the lifeline therapy, say some experts.

A total of 5.2 million people had access to the drugs at the end of 2009, a rise of 1.2 million in a single year, the World Health Organisation (WHO) said on Monday.

Experts said that this amounted to roughly half of the badly-infected people who need the treatment - and to just a third, if the WHO's brand-new recommendations for earlier treatment were considered.

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