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HEALTH-CENTRAL ASIA: Intravenous Drug Use Feeds HIV Pandemic

Lynette Lee Corporal* - IPS/TerraViva

COLOMBO, Aug 20 2007 (IPS) - The steep rise in HIV cases in recent years in Central Asia – at a pace faster than in other regions of the world – has set alarm bells ringing among government and non-government groups in the former Soviet republics.

At highest risk of getting HIV and AIDS among the 58 million people in the five Central Asian states of Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan and Kazakhstan are intravenous drug users (IDUs) who share needles. Intravenous drug use is considered among the most dangerous drivers of HIV.

"From what was a mere 500 officially reported HIV cases in 2000, the figure has blown up to more than 20,000 in 2006," Irina Savtchenko, coordinator for the Joint United Nations Programme on HIV and AIDS (UNAIDS) in Kazakhstan, said at a discussion on the HIV and AIDS situation in Central Asia at the 8th International Congress on AIDS in Asia and the Pacific (ICAAP).

There are some 50,000 people living with HIV in the Central Asian countries, the majority of whom got the virus through drug use. HIV, short for human immunodeficiency virus, affects the immune system and causes acquired immune deficiency syndrome (AIDS).

According to Savtchenko, HIV is prevalent among men aged 20-29 years old, poor and unemployed who are also IDUs.

In Uzbekistan alone, the number of HIV cases has increased 40 times in the last five years, reported the Capacity Project, a global initiative funded by the United States Agency for International Development (USAID).

"This is the reason why the Global Fund (to Fight AIDS, Tuberculosis and Malaria) increased its HIV and AIDS allocation to these countries five times in the last four years. Despite this, HIV cases are still increasing mainly because of low awareness and coverage of HIV and AIDS services, especially among drug users," said Anna Deryabina, deputy director for programme management and monitoring of The Capacity Project.

"The lack of NGOs working in the region is also another factor," she added.

Data from the 2006 Sentinel Surveillance Data, which provides information about the magnitude of HIV and AIDS, identifies the drivers of the pandemic in Central Asia as the overlapping cases of drug abuse and HIV and AIDS, sexually transmitted infections and tuberculosis, unemployment among the youth, imprisonment for drug use, overcrowding in prisons, and high levels of poverty.

As of Jan. 1, 2007, surveillance data for Kazakhstan reported 7,402 HIV cases, 73.4 percent of which involve IDUs. Kyrgyzstan reported 1,233 cases, 75.9 percent of which are drug users. In Tajikistan, 63.9 percent of 710 cases are drug users. Uzbekistan has a record 10,015 cases, 60.1 percent of which are drug users.

Savtchenko encouraged parliamentarians to get more involved and improve laws to protect the human rights, especially of those living with HIV. "Furthermore, there is a need to oversee the proper implementation of funded projects related to HIV and AIDS services, and to properly supervise the allocation of resources," she added.

Prof. Tilek Meimanaliev, executive director for the Regional Project Management Unit&#39s Central Asia AIDS Control Project (CAAP), said policymakers must take steps to address stigma and discrimination that people with HIV and AIDS have to live with.

At the same time, Meimanaliev says much can be improved even with Central Asia&#39s current resources. He is dismayed at the fragmented set-up among the seven critical health services in these Central Asian republics. "These centres do not have good coordination, which make the public health system in Central Asia virtually ineffective," he lamented.

He said he hopes that CAAP, which tries to bring together the government sector, non-government groups and mass media, will improve the way funds are being allocated to the projects related to HIV and AIDS prevention. "It is a must that we address the real problem and meet the needs of people living with HIV and also be able to sustain it if we want to prevent the spread of the pandemic in the region," he said.

The multi-pronged CAAP is made possible by a 25 million US dollar International Development Association grant from the World Bank, and a one million euro grant from the UK Fund for International Development. As of June 2007, 5.8 million dollars, or 21 percent of the total project fund, has been funnelled to various projects.

These projects, said Savtchenko, helped "draw attention of parliamentarians to the HIV pandemic and highlighted the urgent measures that the public and the private sectors need to take to be able to prevent the spread of HIV and AIDS in the region".

Efforts to mobilise the region&#39s huge Muslim population have also begun, with religious leaders being urged to participate and give their support to HIV-related projects. "We need to develop teaching materials and integrate it in religious institutions&#39 programmes. With the help of religious leaders, we hope to raise awareness among the population to pay attention to HIV-related issues hounding the youth," said Shifo Niayatbekov, a lawyer for CAAP.

Looking ahead, CAAP component coordinator Chinara Seitalieva said a computerised database of HIV cases should be ready by 2008 under a project with the U.S. Centres for Disease Control.

(*Terra Viva is an IPS Publication)