by Emil Avdaliani
Although the spread of HIV has gone down in much of the world, including in African countries, in Russia the rate of HIV infection is rising every year
Tilda Swinton with rainbow flag in Red Square,
photo by Sandro Kopp via Christian Hodell on Twitter
BESA Center Perspectives Paper No. 842, May 22, 2018
EXECUTIVE SUMMARY: Russia
is experiencing an ever-growing number of reported HIV cases since the
breakup of the Soviet Union. An estimated 1.5 million HIV cases are
accompanied by a general decline in the Russian population that is
expected to continue over the next several decades. A diminished
population will directly affect Russia’s army, its military
capabilities, and its economy, and thus its ability to position itself
as a world power.
In 2016-17 Russia’s AIDS epidemic reached a
dangerous level, with the threshold of registered HIV-positive people
reaching the 1 million mark. The real numbers could be even higher, as
many people tend not to divulge this problem. Some unofficial reports
claim the true figure could be some 1.5 million, or almost 1% of the
Russian population.
Drug use is no longer the main cause of growing
HIV rates in Russia. The disease is now increasingly spread via sexual
contact. If earlier the majority of HIV patients were lone drug users,
these days they include entrepreneurs, workers, housewives, students,
and other active members of the population.
Although the spread of HIV has gone down in much
of the world, including in African countries, in Russia the rate of HIV
infection is rising every year. Since 1987, when these figures were
first recorded in the Soviet Union, 204,000 people have died of HIV in
Russia. The fall of the Soviet Union in 1991 and the relative openness
of borders, particularly through the Central Asian region, made heroin
and other injectable drugs easily accessible to Russians. In the late
1990s and onward, through trafficking routes from Afghanistan, infection
rates across Russia steadily rose.
There are numerous reasons why the Russian
government has not been as successful as the European states or the US
at battling this problem.
Central to HIV is the use of opioid substitution
therapy (OST), which replaces intravenous drug usage with an
opioid-based oral medication. This medication can be methadone or
buprenorphine, both of which are prescribed by a physician. It has been
shown that through the use of OST, drug addicts can enjoy a more stable
life, thereby reducing the transmission of HIV.
Needle exchange programs are another way to
decrease HIV transmission. Though they have saved lives in programs
around the world, they have been largely neglected in Russia.
The persistence of the problem in Russia is
surprising, as almost all of Russia’s neighbors have made significant
progress in reducing HIV transmission. For example, China and Iran have
both established methadone maintenance programs. Even the countries of
the former Soviet space are faring better.
Russia has lagged significantly behind what other
countries usually spend on similar problems. For instance, in its most
recent move, the Russian government budgeted just $297 million for the
treatment of AIDS-infected individuals. Unfortunately, this only allows
for the proper treatment of up to 300,000 people, or a maximum one-third
of the entire pool. Moreover, there will be no funding increase for
this purpose until 2019.
In September 2016, Russian healthcare officials
announced they would be replacing foreign HIV medication with drugs
produced in Russia. Many think locally produced medical solutions are
not of the same quality and will only create more difficulties; others
disagree. In either case, the central problem is that treatment is not
available to everyone in need. Drugs are not accessible in remote towns.
If a person from a Russian province is currently living in Moscow, he
or she will be expected to return to their provincial doctor to receive
treatment.
The broad reach of HIV is directly linked to the
power of the Russian state. More than one million infected people means
that almost every 140th Russian has the infection. According to some
statistics, these people are in the 18-50 age range, their most capable
period in life. Considering the poor healthcare conditions, their
prospects are not bright, limiting the country’s workforce.
High numbers of HIV cases and the resulting high
mortality rate go hand-in-hand with the general trend in Russia of a
gradually decreasing population. Various statistics, including those
published by the UN, claim the Russian population is set to decrease by
more than 10-15 million people by 2050. The decrease could influence the
success with which Russia manages to project its power beyond its
borders. The trend of population decrease is widely observable both
inside and outside the former Soviet space, with Poland and Germany
suffering a similar problem. But while European countries are investing
more in technology and are developing telerobotics to uphold their
industrial growth, Russia lags.
A less competitive economy and a smaller
population would inevitably have an impact on the Russian projection of
direct military or economic power in the former Soviet space. Bearing in
mind how Russian influence has continued to diminish since the breakup
of the Soviet Union, by remote 2050, the process might accelerate
dramatically.
It has always been a hallmark of Russian history
that its large population served as a bulwark of the strength of the
state. World wars and foreign invasions of the heartland were blocked by
large armies. The Russian population decrease along with the high and
growing HIV percentage will directly influence Russia’s military power
and thus its ability to project its influence abroad.
BESA Center Perspectives Papers are published through the generosity of the Greg Rosshandler Family
Source: https://besacenter.org/perspectives-papers/hiv-crisis-russia/
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