Dealing with costs of preventing AIDS epidemic in its early stage

Date: 02/12/04

By Helen Morris

Governments in the Baltic states are too late to halt an AIDS epidemic in its early stages. They must now concentrate on dealing with the social costs, preventing the further spread of the disease and developing effective treatments.

Intravenous drug use still accounts for the largest proportion of newly reported cases of HIV in the Baltic states but sexual transmission into the wider population is gaining ground, according to the AIDS Epidemic Update from the World Health Organization (WHO) and the joint United Nations Programme on HIV/AIDS (UNAIDS).

But little is known about the spread of HIV in groups that do not engage with authorities carrying out testing. In eastern Europe and central Asia 80% of those infected are below the age of 30, compared to 20% in western Europe. The WHO report suggests that, while adequate funding is available, efficient programme coordination and management is needed to reach the often marginalized or stigmatized sections of society most in need of support.

Estonia has enjoyed one of the most successful economic transitions in the region but, according to the United Nations Development Programme (UNDP), this is coupled with one of the world's fastest growth rates for HIV infection. Government figures last month recorded 4,288 HIV positive cases and 58 cases of full-blown AIDS among a population of just under 1.4 million. Unofficial estimates put the incidence twice as high with the UNDP suggesting that as many as one in every 100 adults may be infected. The incidence of HIV infection in western Europe averaged 0.3% by the end of 2003.

While the spread of HIV in Estonia has been strongly related to intravenous drug use, the disease is now spreading to the wider population with a particularly rapid increase among young women who have never injected drugs. International finance is being sought to supplement inadequate public funding for HIV/AIDS programmes. In 2005, the Estonian national programme plans to spend EEK11.85m (e760,000) and the Global Fund to fight AIDS, tuberculosis and malaria is contributing e1.6m.

Governments in the region have been criticized by the UNDP for showing lack of leadership over the issue of HIV/AIDS. The European Commission notes that: “It has been particularly devastating when political leaders have not acknowledged and confronted the HIV/AIDS threat in a timely manner.”

Latvia is experiencing an HIV prevalence of 0.4%. By August 2004, there were 257 AIDS cases and 2,961 of HIV with around 83% of these cases attributed to intravenous drug use. The Latvian AIDS Prevention Centre states that the proportion of women among those testing positive for HIV has increased considerably over the past five years with women now making up 35% of all cases in Latvia.

In December 2004, the Commission will host an open debate among all interested parties to develop an EU-wide umbrella information campaign. Getting the prevention message across as well as improving healthcare will be crucial.

• Helen Morris is a Brussels-based freelance journalist.

Article suggests that Governments in the Baltic states, especially in Estonia and Latvia, were too late to halt an AIDS epidemic in its early stages and that they must concentrate on dealing with the social costs, preventing the further spread of the disease and developing effective treatments. The UNAIDS 2004 Epidemic Update reports alarming figures for the Baltic States.

UNAIDS: December 2004 epidemic update http://www.unaids.org/wad2004/report_pdf.html

---