Russia Finds Money Alone Will Not Stem HIV

Despite allocating 20 times more money to HIV this year than last, Russia still faces administrative lags in making progress against the epidemic, nongovernmental organizations will tell the 16th International AIDS Conference meeting next week in Toronto. Russia formally recognizes HIV as a "national priority" and has invested $115 million to fight it, but years of official reticence have stunted its response, say critics.

By federal estimates, up to 1.5 million Russians have HIV, or over 1 percent of the population, at which point fighting the epidemic becomes increasingly difficult. The number of people officially registered with HIV is 341,000.

Drug shortages have caused some patients to die in the southern city of Rostov and the insurgency-embattled North Caucus city of Makhachkala, said Mikhail Rukavishnikov of the Association of People Living with HIV/AIDS.

In February, the federal health agency Roszdrav put out a formal contract request for businesses to provide antiretroviral drugs (ARVs), but procedural problems eliminated 14 of 26 drugs. The remaining 12 drugs could not be combined in any effective treatments, Rukavishnikov said. Provincial health administrations slashed internal financing of ARVs, expecting the federal funds.

A new request for ARV contractors has been announced, but the drugs will not arrive in the provinces until September at the earliest, said the Federal Center for Prevention and Combating HIV.

Discrimination and stigma, including by some local health care providers, are also hindering AIDS prevention and treatment. Many of those infected are ignorant about AIDS and the existence of treatments.

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