The effective measure of quarantining the HIV-positive inhabitants of the blighted region to prevent a calamity of medieval proportions is proscribed by the latest vintage of politically correct liberalism. The West can only help them improve detection and treatment. But this is a tall order.
East European medicine harbors fantastic pretensions to west European standards of quality and service. But it is encumbered with African financing, German bureaucracy and Vietnamese infrastructure. Since the implosion of communism in 1989, deteriorating incomes, widespread unemployment and social disintegration plunged people into abject poverty, making it impossible to maintain a healthy lifestyle.
A report published in September by the European regional office of the World Health Organization pegs at 46 the percentage of the general population in the countries of the former communist bloc living on less than $4 a day -- close to 170 million people. Crumbling and desperately under-funded healthcare systems, ridden by corruption and cronyism, ceased to provide even the appearance of rudimentary health services.
The number of women who die at -- ever rarer -- childbirth has skyrocketed. Transition has trimmed Russian life expectancy by well over a decade to 59, lower than in India. People lead brutish and nasty lives only to expire in their prime, often inebriated. In the republics of former Yugoslavia, respiratory and digestive tract diseases run amok. Stress and pollution conspire to reap a grim harvest throughout the wastelands of Eastern Europe. The rate of Tuberculosis in Romania exceeds that of sub-Saharan Africa.
The Joint U.N. Program on HIV/AIDS (UNAIDS) and the WHO just published their AIDS Epidemic Update. It states unequivocally: "In Eastern Europe and Central Asia, the number of people living with Human Immunodeficiency Virus -- HIV -- in 2002 stood at 1.2 million. HIV/AIDS is expanding rapidly in the Baltic States, the Russian Federation and several Central Asian republics."
The figures are grossly understated and distorting. The epidemic in Eastern Europe and Central Asia -- virtually on the EU's doorstep -- is accelerating and its growth rate has surpassed sub-Saharan Africa's. One-fifth of all people in this region infected by HIV contracted the virus in the preceding 12 months. UNAIDS says: "The unfortunate distinction of having the world's fastest-growing HIV/AIDS epidemic still belongs to Eastern Europe and Central Asia."
In the past eight years, AIDS has been suddenly "discovered" in 30 large Russian cities and in 86 of its 89 regions. Four-fifths of all infections in the Commonwealth of Independent States -- the debris left by the collapse of the Soviet Union -- are among people younger than 29. By July this year, new HIV cases surged to 200,000 -- up from 11,000 in December 1998.
In St. Petersburg, their numbers multiplied a staggering 250-fold since 1996 to 10,000 new instances diagnosed in 2001. Most of these cases are attributed to intravenous drug use. But, according to Radio Free Europe/Radio Liberty, 400 infected women gave birth in a single hospital in St. Petersburg in the first 9 months of 2002, compared to 149 throughout last year. About one-third of the neonates test HIV-positive within 24 months. The disease has broken loose.
How misleading even these dire data are is revealed by an in-depth study of a single city in Russia, Togliatti. Fully 56 percent of all drug users proved to be HIV-positive, most of them infected in the last 2 years. Three-quarters of them were unaware of their predicament. One-quarter of all prostitutes did not require their customers to use condoms. Two-fifths of all "female sex workers" then proceeded to have unsafe intercourse with their mates, husbands, or partners. Studies conducted in Donetsk, Moscow and St. Petersburg found that one-seventh of all prostitutes are already infected.
An evidently shocked compiler of the results states: "The study lends further credence to concerns that the HIV/AIDS epidemic in Russian cities could be considerably more severe than the already-high official statistics indicate." The region's governments claim that 1 percent of the population of countries in transition -- still a hefty 4 million people -- use drugs. But this, too, is a wild underestimate. UNAIDS itself cites a study that concluded that "among Moscow secondary-school students ... 4 percent had injected drugs."
Quoted in Pravda.ru, the Director of the Federal Scientific Center for AIDS at Russia's Ministry of Health, Vadim Pokrovsky, warns Russia is likely to follow the "African model" with up to an 80 percent infection rate in some parts. Kaliningrad, with a 4 percent prevalence of the syndrome, he says, can serve as a blueprint for the short-term development of the AIDS epidemic in Russia.
Or, take Uzbekistan. New infections registered in the first 6 months of 2002 surpassed the entire caseload of the previous decade. Following the war in Afghanistan, heroin routes have shifted to Central Asia, spreading its abuse among the destitute and despondent populations of Azerbaijan, Kazakhstan, Georgia, Kyrgyzstan, Tajikistan and Uzbekistan. In many of these countries and, to some extent, in Russia and Ukraine, some grades of heroin are cheaper than vodka.
Ominously, reports the European enter for the Epidemiological Monitoring of AIDS, as HIV cases among drug users decline, they increase exponentially among heterosexuals. This, for instance, is the case in Belarus and Ukraine. The prevalence of HIV among all Ukrainians is 1 percent.
Even relative prosperity and good governance can no longer stem the tide. Estonia's infection rate is 50 percent higher than Russia's, even if the AIDS cesspool that is the exclave of Kaliningrad is included in the statistics. Latvia is not far behind. One of every seven prisoners in Lithuania has fallen prey to the virus. All three countries will accede to the EU in 2004. Pursuant to an agreement signed recently between Russia and the EU, Kaliningrad's denizens will be able to travel to all European destinations unencumbered by a visa regime.
Part 2 of this analysis will run Tuesday. Send your comments to: email@example.com.
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