Russia: The Consequences of Ignoring AIDS

On a recent trip to Moscow, Dr. Peter Piot, executive director of the United Nations AIDS program (UNAIDS), spoke with the Moscow Times about AIDS.

Question: How would you describe the HIV/AIDS situation in Russia?

Piot: This country has the fastest-growing HIV epidemic in the world, and I believe that the situation in Russia and the CIS [Commonwealth of Independent States] is rapidly getting out of control.

Question: Is Russia unusual in that intravenous drug use is the main cause of HIV transmission?

Piot: ...In the south of Europe -- Spain, Portugal and Italy -- intravenous drug use is also the main cause of transmission. But in Russia it accounts for 90 percent of all HIV cases.

Question: How do you feel about testing foreigners for HIV?

Piot: ... From a public health perspective, it just doesn't work. HIV is already here. ... Such practices hinder [economic] development.

Question: What is the relationship between HIV and tuberculosis here, especially in the prison system?

Piot: When you are infected with HIV your immune system decreases and you become far more vulnerable to tuberculosis. And there is a real tuberculosis epidemic in [Russia's] prisons -- especially the multiresistant tuberculosis that is very expensive to treat.

Question: What do you say to people who believe that AIDS is totally preventable and therefore people with HIV deserve no sympathy?

Piot: The thing is, most people in the world have sex -- most adults do -- because it's a healthy part of life. ...Many people are in situations where they don't have control of their sexual activity. And then you have extreme cases: commercial sex workers... or heroin addicts who perform sex acts for money....

...If we say it's their own fault, then we should say the same about everybody who smokes or drinks too much vodka and refuse them medical treatment.... ... If AIDS was transmitted through eating, everyone would be sympathetic, but if it's sex, [they think] it's your own fault.

Question: What about the privileged status of AIDS among diseases?

Piot: I think it's a valid question and one we have to ask because money is limited. There is not enough money allocated to health programs in general. ... But, concerning AIDS spending, one of the lessons from other parts of the world is that the longer you wait to deal with the problem, the more expensive it becomes.

Question: Do you think Russia should put pressure on international pharmaceutical companies that make AIDS treatment to lower their price?

Piot: ...Our position is that only the wealthy countries should compensate the companies, while middle and low-income countries should benefit from the same drugs at much lower prices.

Back to other CDC news for April 16, 2002

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