The U.N. Development Program (UNDP) issued a warning February 17 about the potential for an expanding HIV/AIDS epidemic in the Commonwealth of Independent States and Eastern Europe. The report urges policymakers to take action before the epidemic begins to overtax social and health programs, drain resources and depress economic development.

Although the overall prevalence rate of HIV infection in the population of the region remains lower than in that of many hard-hit nations, various surveys have found that the virus has been spreading in the CIS and Eastern Europe at rates among the most rapid in the world.

According to a press release, the report -- "Reversing the Epidemic: Facts and Policy Options" -- underscores the socio-economic factors associated with the spread of the virus. HIV infection is rapidly spreading among groups that are on the fringes of society -- drug users, the poor, the incarcerated or the stigmatized.

The UNDP analysis urges regional leaders to take action to contain the epidemic before it becomes a devastating public health concern. The report urges policies rooted in tolerance, inclusion and treatment, rather than criminalization and exclusion.

The UNDP report is available in full at http://195.68.179.50/HIV_AIDS_report/english_version.htm

United Nations Development Programme
17 February 2004

New report warns East European and CIS policy makers about the risks of a generalized aHIV/AIDS epidemic

Eastern Europe and the Commonwealth of Independent States have some of the fastest growing rates of HIV/AIDS infection in the world. The impact is compounded by still insufficient public awareness, frequent stigmatization and lack of adequate policy instruments to cope with the disease. Nonetheless, the region also has success stories, from which valuable lessons should be taken.

Moscow, 17 February, 2004: In a new report released today, the United Nations Development Programme (UNDP) offers the first comprehensive profile of the HIV/AIDS epidemic in the 28 countries of East and South Eastern Europe, the Baltics and the Commonwealth of Independent States (CIS), and provides a platform for the discussion of policy options available to halt the spread of the disease.

The report, entitled "Reversing the Epidemic: Facts and Policy Options," offers HIV/AIDS profiles for the countries of the region, describes high-risk groups and the behaviours that make them vulnerable to infection, and discusses why human rights is an essential ingredient for fighting the epidemic. The report also touches upon the issues of decriminalising injecting drug use and undertaking comprehensive prison reform. The inclusion of marginalized groups in policy processes is also considered a key element in the response to HIV/AIDS.

Despite a comparatively low prevalence in the region, growth rates in new HIV infections reported over the last several years in Estonia, Russia and Ukraine are among the world's highest. Upwards of one out of every one hundred adults living in these three countries is now estimated to be carrying the virus-a threshold above which efforts to turn back the epidemic have failed in many other countries. Also, if not curbed, the disease will threaten development prospects in Eastern Europe and the CIS.

GDP growth affected by HIV/AIDS

Data from the region unambiguously points to the socio-economic and governance dimensions of the epidemic. Members of at-risk groups are often subject to social exclusion, poverty, stigmatisation, or incarceration. Also, the above-average prevalence of HIV in the region's over-crowded penal institutions-which the report calls 'real HIV incubators'-is a serious cause for concern.

According to the report, the disease threatens to affect the region's prospects for economic growth and human development. The epidemic will put new strains on already overburdened social protection systems. Premature morbidity and mortality in age cohorts with high productive capacities could reduce annual GDP growth by one full percentage point, a tremendous impact for any country. Increased health expenditures associated with treating people living with AIDS could consume one to three percentage points of annual GDP. These figures represent particular challenges for the poorest CIS countries.

Good Governance-a part of the response

The growing socio-economic threat posed by HIV/AIDS places increased pressure on policy makers-particularly in the Western CIS and the Baltic states-to avert what is becoming a devastating public health problem. The report supports a better policy balance between criminalisation and exclusion on the one hand, and tolerance, inclusion, and treatment on the other. Policy makers are also called to carefully consider the evidence-base for harm-reduction approaches as an effective means for reversing the spread of HIV among injecting drug users. In addressing HIV/AIDS, good governance includes expanding access to information, protecting the human rights of vulnerable groups, increasing the participation of civil society in decision-making processes and establishing partnerships between public authorities and civil society groups. For instance, the Advisory Council on HIV/AIDS at the Ministry of Health of the Russian Federation, comprised of government and civil society leaders and supported by UNDP, represents a successful example of such a partnership.

The risk of not responding decisively

Of the 80,000 people in the entire region who, according to WHO guidelines, currently require treatment for AIDS, only 7,000 now receive it. This comes despite dramatically expanded access to treatment and new initiatives to lower the costs of antiretroviral therapy. Some 70 percent of the approximately 3,000 people in CIS countries who are receiving antiretroviral therapy live in Russia. According to the report, extensive use of monotherapeutic antiretroviral regimens in this region increases the risk of generating a drug-resistant strain of HIV. This risk needs to be closely monitored by the appropriate authorities.

A number of countries in Central and South-Eastern Europe, such as Poland, the Czech Republic, and Slovakia have recorded important successes in halting or reversing the spread of the epidemic. They have been able to leverage progress in building vibrant democracies into effective responses to HIV/AIDS. At the same time, a relatively successful transition outcome does not in itself guarantee an effective response, as is apparent in the case of Estonia, which combines one of the region's most successful transitions with some of its highest HIV prevalence rates.

"All experts concur that delays are disastrous when dealing with HIV/AIDS. Just as in some CIS countries today, only twelve years ago South Africa too saw less than 1% of its adult population infected-now that rate is twenty times higher. It is already too late to speak of avoiding a crisis in Eastern Europe and the CIS. Nevertheless, there is still much that governments and civil societies can do to reduce the social, demographic and economic consequences of HIV/AIDS and even reverse the epidemic," said Kalman Mizsei, UNDP Assistant Administrator and Director for Europe and the CIS.

For more information, please contact Sandra Pralong, sandra.pralong@undp.org, + 421-908-729846, or Shombi Sharp, shombi.sharp@undp.org, + (7095) 787-2164; or 8916 380 8900.
UNDP is the global development network of the United Nations system. It advocates for change, and links countries to the knowledge, experience and resources their people need to improve their lives.