The number of people living with HIV/AIDS is more than doubling each year in the states of the former Soviet Union. Hardest hit is Russia, where researchers now believe more than one million people have been infected. Health officials say the leadership must recognize the scope of the problem, and take action soon.
The fight against AIDS is about numbers and time. It is the number of people who are infected with the HIV virus, and the rate at which they infect others. And it is the time it takes for the virus to emerge, which is up to 10 years for some people, and the time it takes for officials to deal with the problem.
In Russia and other countries of the former Soviet Union, the numbers are rising fast, and the time remaining to halt the alarming spread of the disease is falling. The head of the Russian Federal Center for AIDS Prevention, Vadim Pokrovsky, estimates that, if the government does not take action soon, there could be 3-5 million Russians infected with HIV in a few years.
Mr. Pokrovsky said, last year, there were 87,000 new cases of HIV registered in Russia. He says, in the past two years, the number of people newly-infected with HIV amounts to roughly the same number of cases since the virus first appeared here in 1995. He characterizes the infection rate as huge, and says the numbers will only continue to grow.
Officials say Russia's first HIV/AIDS cases were primarily among men sharing needles. But Mr. Pokrovsky says that profile is changing, with the virus being spread in the general population more and more through unprotected sex.
He says Russia's young people are paying the heaviest price, with 87 percent of new HIV infections found among people 15-to-30-years-old.
Mr. Pokrovsky sees a massive health crisis looming on the horizon, with significant implications for Russian society.
The head of the first international non-governmental organization to tackle HIV/AIDS in the former Soviet Union agrees. Rian van de Braak of the AIDS foundation known as East-West says, even the best health care system in the world would not be able to cope with the cost or the number of patients Russia will face.
"We're talking about one-to-two million infected now, and in 2005, we could be talking about five-million being infected, and these are realistic, even conservative figures. So, if we talk about treatment with triple-therapy drugs at this moment, here in Russia, it still costs, because of import costs, about $10,000 per person. As I said, there are already one million Russians infected, and those costs would already exceed the nation's total health care budget, if treatment were to be in place," Ms. Van de Braak said.
Ms. Van de Braak says there are also huge social, economic and security costs to consider, with a big part of the work force soon to be too sick to work. And she adds that, with nearly 90 percent of new infections among the young, replacement workers will be hard to find. Russia's military is already feeling the impact. Up to one third of prospective conscripts are deemed unfit for service because of HIV-related illnesses, and chronic hepatitis from drug use.
But according to Ms. Van De Braak, Russia has some advantages over other nations struggling to combat HIV/AIDS. "The advantage of Russia is that it has a much better infrastructure to act quickly, and inform people. (Most) Everyone here has a television, they can read, they all go to school. So, you can channel the information faster, because everyone is also educated here, and can absorb the information. So, you can really make a difference when (compared with) looking at other countries where HIV/AIDS has struck, like in Africa, or in Asia," she said.
But Ms. Van De Braak says the time to act is now. She says the rapid spread of the virus hit Russia about two years after Ukraine and Belarus. Many lives still hang in the balance, and the response so far, she says, has been inadequate. Ms. Van de Braak says top officials will quickly have to rise to the challenge.
Vadim Pokrovsky of the Federal AIDS Center is skeptical they will act in time. He says people in Russia, including government officials, do not realize the scope of the problem, and don't view it as a real threat, as they do terrorism. He says the fact that so few people have died of AIDS in Russia, so far, leads many to think the impact of the disease is small, compared to other threats. But, he warns, Russia will soon see tens-of-thousands of deaths from HIV/AIDS, perhaps as soon as 2007, and by then, he says, it will be too late for officials to control the problem.
Mr. Pokrovsky says, if the prime minister or president would say something, anything, about HIV/AIDS, it would help the society realize the importance of the issue. Swaziland's king participates in anti-AIDS activities, but not Russian leaders, says a visibly frustrated Pokrovsky.
So why is there such inaction by the government and the public in the face of such dire predictions? Moscow-based psychologist, Yelena Babievskaya, who treats HIV/AIDS patients, offers her answer.
Ms. Babievskaya says most people in the former Soviet Union don't care about AIDS. She says most worry more about whether or not they will face poverty in old age. She says, for most people, AIDS seems too remote a problem to factor into their everyday concerns or behavior.
Ms. Babievskaya also says, like people in many places, most Russians find it difficult to talk about AIDS and related issues, like drug use and sex. And, she says, people must recognize and address the issue, before there can be any hope of doing anything about it.