Russia confronts aids crisis

HIV/AIDS treatment in Russia is only available to one in ten

On the eve of World’s AIDS Day, leading Russian HIV/AIDS researchers, specialists developing new vaccines and drugs, doctors, and HIV-positive people met at a round-table organised by the International Science and Tech­no­logy Centre and the Informnauka (Informscience) agency. The discussion showed that what the scien­tists knew was just the tip of the iceberg.

Worse than Uganda

Russia still lacks complete statistics on the number of HIV/AIDS cases. Vadim Po­krovsky, director of the Federal HIV/AIDS Scientific Research Centre, believes that any official figure should at least be tripled.

If this is indeed the case, today there are about 1 million HIV-positive peo­ple in Russia. In the Irkutsk region, Khanty-Mansiisk, 0.8 percent of the population is in­fected – i.e., approximately one in 100 (official figure). It is not clear why this particular region has been hugely affected. It is known that HIV/ AIDS hits large cities, but why Irkutsk? Why is this chilling list topped by St. Petersburg and Yekaterinburg, while Moscow is somewhere near the middle? Dr. Pokrovsky had no immediate answer to these questions, saying that comprehensive analysis was required.

On the whole, the situation in Russia is far worse than in Europe and the United States. Furthermore, considering not only the percentage of HIV/AIDS carriers but also the dynamics of the past several years, it turns out that it is even worse than in Africa. Prof. Igor Sidorovich, head of the HIV/AIDS Institute Immunology depart­ment, gave this example. In the late 1980s, about 25 percent of Uganda’s population had HIV/AIDS. In the United States, there were 1 million HIV/AIDS carriers, but in Russia, only a handful. Today, in Uganda, the level has fallen from 25 percent to 7 percent; in the United States it is still 1 million (the situation has stabilised) while in Russia the number has increased dramatically.

Here is another disturbing fact: In Russia, HIV/AIDS affects younger age groups. Whereas in developed countries it is mainly the thirtysomething gene­ration, in Russia it starts around age 17. Until last year, most cases were linked to intra­venous drug use, but sexual transmission has now become the principal source of infection.

How to fight HIV/AIDS

AIDS is worse that the plague: People can recover from the plague and develop immunity to it, so traditional vaccination is possible. In the case of HIV/ AIDS, how­ever, an utterly different approach is needed. An HIV/AIDS vaccine has yet to be produced.

Still, much hope is being pinned on treatment.

“Thus far we are unable to fully destroy the HIV virus in the organism, but during the past nine years, great success has been achieved, with mortality rates falling by more than 70 percent,” Prof, Georgy Galegov, head of the Scientific Research Institute of Chemotherapy Department, said. He added that the wards for HIV/AIDS patients that were created in the United States in the middle of 1980s are now closing since the patients’ quality of life has improved dramatically – due to Com­­bination Therapy that was developed about 10 years ago: A combination of se­ve­ral different drugs prevents both the multiplication of the virus in the organism and the development of the resistant strains.

Incidentally, Galegov and his colleagues have produced a new drug called Niko­vir (Phosphazid). According to the professor, it also prevents the development of resis­tant strains of HIV. But it seems to be out of reach for many patients in Russia. “I know that the AZT company produces Nikovir and that the Health Ministry buys it, but I do not know in what volumes,” Galegov says.

Living with the Virus

Igor Pchelin, a leader of Shagi (Steps), a non-profit organization for HIV-positive people, eight years ago took part in the clinical trials for the drug. According to him, today, it is generally not administered to patients. “I was among the few lucky people who received a course of Combination Therapy treatment,” he says. “Today I’m well, but the effect was not produced immediately: Doctors had to use five or six different combinations of drugs: Some did mot work, while others proved too toxic. According to Igor, the main difficulty of living with HIV is the lack of information – about the disease, new drugs, patients’ rights, etc. Many HIV-positive people are not getting effective treatment, especially in the provinces.

Vadim Pokrovsky cited the follow figures. Today, the state can provide free treatment to just 10 percent of all HIV/AIDS patients, although under the law, it is supposed to fully meet these expenses, countrywide. Oftentimes therapy is refused on “legitimate” grounds – e.g. to a drug addict because he is unable to follow the regimen. HIV/AIDS treatment costs from $5,500 and $15,000 a year. Inci­dentally, according to Pokrovsky, there are HIV-positive people even among Health Ministry officials, but “unlike the greater part of the population, they can pay their own bills.”

Yelena Kokurina

The Moscos News 18/11/2008