A national strategy for HIV?

Does Russia need
to develop a national strategy for combating HIV?


Andrei Zlobin, chair of the executive of the
international organisation Association of People Living with HIV, said at a
forum on Millennium Development Goals-6 (MDG-6) that Russia was planning to
take the leading role in the Commonwealth of Independent States for the purpose
of achieving MDG-6.


This means Russia helping other countries with the
HIV/AIDS epidemic in its capacity as a donor to the global fund for combating
HIV/AIDS, tuberculosis and malaria. Mr Zlobin welcomed the intention of the
Russian government to become a donor to the global fund but considered that the
priority should be to resolve domestic problems connected with treating HIV and
tuberculosis. He thought it premature to help other countries to deal with
social diseases when the state was not giving adequate attention to the
resolution of internal issues. He suggested that the money allocated by the
government to combat HIV internally could be spent more effectively. In his
opinion the Russian Federation (RF) was allocating massive funds for the
purpose but the financing arrangements were fragmentary as they did not cover
the whole country. They were also short-term as the government allocated finance
on an annual basis, meaning there was no guarantee that programmes would
continue to be implemented. Mr Zlobin considered that Russia needed to work up
a national strategy for combating HIV which would enable effective, tried and
tested measures to be extended to the whole country. Such a strategy would need
to be developed in partnership with state agencies, business and NGOs. It
should specify activities aimed at prevention as well as treatment, care and
support for those with HIV.


Mr Zlobin stressed that the government was declining
to seek financial contributions from abroad for dealing with the HIV and
tuberculosis epidemics, maintaining that it was ready to take on all the
expenses of resolving these problems itself. He thought that this stance would
be acceptable if the government were to involve the NGOs and introduce
effective programmes. He said that at present 160 people a day became HIV
positive and that the death rate from tuberculosis continued to be high. Mr
Zlobin emphasised that imprisonment for a term of even two years amounted to a
death sentence for those with HIV or tuberculosis because there was no
guarantee that they would receive treatment in the longer term.




According to the Central Research Institute for Public
Health of the Ministry of Health and Social Development of the RF, the number
of new cases of tuberculosis in 2010 numbered 91,678. 161,576 cases of
tuberculosis were registered as being under treatment including 27,783 in the
prisons. According to the Federal Consumer Protection Service, tuberculosis
continues to be directly responsible for over half the number of deaths where
HIV is present.


In an address delivered last February to colleagues,
the director of the federal service for the enforcement of penalties stated
that the penitentiary system was holding 819,200 people, of whom 4.7% had
tuberculosis and 6.7% were infected with HIV.


According to the World Health Organisation (WHO), in
2009 Russia occupied eleventh place out of 22 countries with the highest
incidence of tuberculosis whilst Russia ‘contributed’ 36% of the number of new
cases in WHO’s European region. In recent years Russia has been one of three
world leaders for the incidence of multi-drug resistant tuberculosis. The death
rate from tuberculosis that is resistant to treatment continues to grow,
reaching 3.2 per 100,000 of the population in 2009.




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