HIV situation in south continues to worsen

Drug trafficking and addiction continue to strengthen the prevalence of HIV/AIDS in southern Kyrgyzstan. While a total of only 213 official cases have been registered in the three southern provinces of Osh, Batken and Jalal-Abad, health experts assess the real figure to be closer to 3,000. "The situation is clearly worsening," Tugelbay Mamaev, the head physician at the regional AIDS centre in the provincial capital of Osh, told IRIN, citing drug addiction and drug trafficking as the root causes. Of the total of 339 registered cases country-wide, almost 65 percent were found in the south, the vast majority in Osh, the region's most populous province. Of the total of detected cases in the three provinces, 196 were in Osh, 11 in Jalal-Abad, and six in Batken, he said. But what most alarms health experts is the prevalence among drug addicts. About 98 percent of all registered cases are drug addicts, 70 percent of whom are convicts or former convicts. "You know, Osh is close to the Pamir region of Tajikistan, which borders on Afghanistan, and one of the main routes of drug trafficking passes through Osh," Mamaev said. Adding to this was the fact that these figures were undoubtedly only the tip of the iceberg. According to Mamaev, as many as 2,750 cases could be found in Osh alone. Echoing his colleague, Dr Zair Kirgizbaev said the centre was detecting about five or six cases each month, with only four percent having been sexually transmitted. Whereas there is strong political commitment on the part of central and local authorities on dealing with the pandemic, given economic constraints in this impoverished Central Asian nation, it is clear that its resources to deal with the problem are insufficient. According to Mamaev, of the five Central Asian states, Kyrgyzstan was the first to initiate and implement a methadone-substitution programme, seen by experts as crucial in preventing the spread of HIV amongst drug addicts. Each day, some 100 people are receiving methadone in Osh alone.

Tugelbay Mamaev, chief doctor at the Osh AIDS prevention centre

Also provided by the regional centre is a needle exchange programme supported by the UN Development Programme, the Soros Foundation and the UN Population Fund. With six distribution points throughout the city, about 1,200 syringes are distributed free of charge each day. Although there are some 600 registered injecting drug users in Osh, Kirgizbaev estimates the true number of drug users to be closer 20,000, providing further evidence of the need for a larger programme. Meanwhile, Mamaev says, the need for greater awareness among the local population has never been greater, with mass media capable of playing a much greater role. Compared to other parts of this largely Islamic nation, southern Kyrgyzstan's population was more conservative than other parts of the country, including the capital, Bishkek, and efforts were now being made to work more closely with religious leaders in the area, he said.