Region struggles to cope with growth of HIV

Despite efforts by countries in the region, Central Asia has experienced an alarming growth of HIV over the past three years, mainly among injecting drugs users, according to an official from the UNAIDS programme in Kazakhstan. "It is necessary to construct a reliable barrier against the transmission of HIV," Alexander Kossukhin, UNAIDS national programme officer, told IRIN from the Kazakh commercial capital, Almaty. "If such barrier was constructed then the number of HIV cases [in the region] wouldn't increase so dramatically." His comments follow the publication on Tuesday of the UN Global AIDS report for 2004 which highlights the fast-growing AIDS epidemic in the region and notes that the former Soviet republics were unprepared to deal with the spread of the disease. According to the UN agency, some 50,000 people in Central Asia are HIV-positive, while the US Centres for Disease Control and Prevention (CDC) estimates the figure to be as high as 90,000. World Bank sources say the number of officially registered cases increased from 50 in 1996 to over 8,000 in 2003. "In Kazakhstan alone, the number of HIV cases registered in 2002 was approximately 25 percent higher than in 2001 and in 2003 it was 25 percent higher than in 2002," Kossukhin asserted. And while all the Central Asian states, except Turkmenistan, have developed strategic programmes to combat the spread of HIV/AIDS - focused on prevention among vulnerable groups including the youth, and addressing people who were already affected by HIV/AIDS - Kossukhin maintained that this was inadequate. "There is a strong need to build governments' technical and institutional capacities to deal with HIV/AIDS, especially in prevention," he said, noting that the Central Asian states had the resources to do this thanks to the recent grants received from donors. Better coordination among government bodies to effectively address the HIV/AIDS spread, not only through the health sector, and the need to cover people living with HIV/AIDS by antiretroviral treatment, are two other critical areas that need to be improved, according to the UN official. "Unfortunately, this treatment has been introduced only in Kazakhstan," he said, noting that the programme covered only 5 percent of those with HIV/AIDS. Kossukhin explained that injecting drug usage remained the main mode of HIV transmission in the region, and called upon governments to promote educational programmes aimed at preventing the transmission of the virus, including awareness raising and needle exchange efforts. "There is a need to provide drug dependent people living with HIV with methadone or with substitution therapy as most of the infected people are injecting drugs users," Kossukhin stated, conceding that methadone programmes were only available in Kyrgyzstan. The UN official stressed that the fight against the growth of HIV cases among intravenous drug users required a strategy based on stemming illegal drug trafficking from Afghanistan, as well as a parallel effort inside the countries, given that some Central Asian states had also their own production areas. "Governments are trying to create barriers to the transit of heroin from Afghanistan, but locally produced drugs, as [for example] in Kazakhstan and Kyrgyzstan, are even more dangerous than heroin because during the preparation of such drugs human blood is often used for sedimentation of some ingredients," he asserted. According to the UNAIDS global report, an estimated 4.8 million people were newly infected with HIV in 2003 worldwide, more than in any previous year. The "2004 Report on the Global AIDS Epidemic" also revealed that some 37.8 million people are now living with AIDS and 20 million have died since the first cases were identified in 1981. [For a complete copy of the UN report see www.unaids.org]