Two major Washington policy research institutes say Russia's AIDS problem is much larger than the country's leaders acknowledge. They recommend that the United States expand its assistance to Moscow to help prevent a potentially destabilizing situation.

The number of Russians infected with HIV is unknown. UNAIDS says about 300,000 are registered, but a joint report from the Center for Strategic and International Studies and the Brookings Institution says credible estimates put the number at one million, or one-percent of the adult population. Peter Piot, Executive Director, UNAIDS says, "By any standard, Russia has a serious AIDS epidemic."

Speaking at the Center for Strategic and International Studies, the report with the Brookings group says Russia's top leaders have been inattentive to the growing AIDS problem and have not developed a policy to respond.

Dr. Piot says this is because the driving force behind the epidemic has been injecting drug users. "I think it has been one of the major obstacles for political leadership, because which political leader wants to be associated with something that is mainly driven by injecting drug use, behavior that is not appreciated in any society."

 But Dr. Piot says Russia's HIV epidemic is probably entering a new phase, expanding into other parts of society because of sexual transmission. The new report says the problem is still manageable, but notes that the only way to prevent it from destabilizing the country is for Russian leaders to make AIDS a national priority.

The president of the Center for Strategic and International Studies is John Hamre, who visited Russia earlier this year as part of a bipartisan AIDS investigating group co-chaired by two U.S. senators.

Remarking on the timing for the government to act is now, "It is absolutely crucial now that the government embrace this as a national problem and move on the problem. The country is willing and ready to move."

The report says that a few regional and local governments in Russia, U.N. agencies, international foundations, and non-governmental organizations are running small anti-AIDS programs. Russian scientists, activists, and health officials have been working to prevent HIV spread within high-risk groups for years.

The U.S. observers say these activities provide the basis for a fully developed national response. But they point out that AIDS is competing with many other pressing political, economic, social and health problems.

The joint report suggests Russian leaders are on the verge of addressing the problem. There are signs the ministry of health may boost its HIV spending. In March, Deputy Defense Minister Zhukov identified AIDS as a threat to Russian security. Soon after, President Putin put the HIV issue on the agenda for a forthcoming meeting of the country's security council.

Mr. Piot optimistically says, "This is the first time that AIDS is discussed where it should be. I think this sends a very strong message, just the fact it is happening. I've learned to be cautious working on AIDS, but this is for me a breakthrough."

The Center for Strategic and International Studies and Brookings task force calls on the United States to help Russia's AIDS awakening. It urges Washington to enlarge its AIDS assistance to improve the country's disease monitoring, increase health care training, expand collaboration on vaccine and drug research, and support non-governmental groups working on HIV.

The report predicts that President Putin will come under increasing domestic and international pressure on the issue as he prepares to host the 2006 summit of leading industrial nations, the so-called G-8.