Fighting HIV where no-one admits it's a problem
- 20 May 2015
- Magazine
The phrase "Aids epidemic" awakens distant memories in most of Europe, Australia or the Americas, where infection rates have generally been in decline for years. But as former UK Health Secretary Lord Fowler explains, the phrase is not used in Russia either - despite failed policies that have allowed infection rates to soar.
For years Russia has remained remarkably silent on the challenge it faces from HIV and Aids. Now that silence has been broken by an epidemiologist who has been working in the field for more than two decades - and he calls the situation "a national catastrophe".
Vadim Pokrovsky, the softly spoken head of the Federal Aids Centre in Moscow, has watched as the figures have climbed remorselessly upwards.
There are about one million people living with HIV today in Russia and year on year the rate of infection is rising, unlike sub-Saharan Africa where the rate of increase is slowing. This is according to Russia's official figures, which almost everyone agrees are a substantial underestimate of the true position.
Last year some 90,000 Russian people contracted HIV, compared with fewer than 3,000 people in Germany, which has one of the lowest rates of HIV infection in Europe. Germany's population may be half the size of Russia's but the difference here is a factor of 30.
"We need to spend 10 times more on prevention," Pokrovsky told me recently. "We need many more resources and we need some political decisions - and changes in the law in connection with methadone and the private lives of individuals."
The trouble is that his diagnosis goes smack against the current ideology of the state and the increasingly powerful Russian Orthodox Church.
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In an interview this month with Agence France-Presse he was even blunter, saying the Kremlin's policy of promoting traditional family values had failed to halt the spread of the virus. "The last five years of the conservative approach have led to the doubling of the number of HIV-infected people," he said.
When Pokrovsky argued for the introduction of sex education in schools - a step resolutely opposed bypresidential children's rights commissioner Pavel Astakhov - the head of Moscow City Council's health committee, Lyudmila Stebenkova, called him a "typical agent working against the national interests of Russia".
Pokrovsky's approach, she told the Russian newspaper Kommersant, would only increase children's interest in sex and lead to a surge of HIV and other diseases.
"Instead of distributing condoms we should be promoting sexual fidelity and healthy families - that is much more effective," she said.
Yet the figures suggest otherwise. Pokrovsky has warned women that their chances of marrying an HIV-positive man are high.
"There are 80-100 cases of HIV infection among women a day. This is no joke - a day. They are mostly young women, aged from 25 to 35 years and they are the main new risk group," he told me.
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