Canada advances Russia's attitude toward AIDS

Russia has the fastest growing AIDS epidemic in the world, but it took help from Canadian AIDS experts to advance the issue on the political agenda, says a senior Russian AIDS specialist.

“The attitudes of our health care leaders at the highest levels have been changed,” said Dr. Larissa Dementieva of the Russian Ministry of Health.

Dementieva and her colleagues visited Canada in April as part of the Canada AIDS Russia Project. During the 3-year project, funded by a $2.3-million grant from the Canadian International Development Agency, Canadian AIDS experts travelled to Russia to help develop expertise in epidemiology, monitoring, laboratory diagnosis and clinical management of HIV-infected adults and children. Russian HIV specialists have also come to Canada for internship training. The Russian Ministerial Council on AIDS was created.

“Before, we were treating AIDS from a narrow medical perspective. Now we're establishing wider networks of not just treatment, but support and care,” said Dr. Oleg Yurin, a leading clinical specialist on HIV/AIDS.

Although 300 000 people are officially registered as HIV-positive in Russia, up from fewer than 10 000 cases 5 years ago, only about 2000 Russian receive treatment for HIV/AIDS. Officials estimate the actual number of HIV-positive Russians is closer to 1 million.

Cost is a major obstacle to treatment. In one Russian region, government health insurance programs spend about $1400 rubles (Can$70) per patient annually, Russian officials said. Last year, the federal health ministry spent only Can$4.4 million to buy AIDS drugs for the entire country of 145 million people.

The profile of the epidemic is changing in Russia. Two years ago, 85% of new HIV infections were among injection drug users. That proportion has fallen to about 75% as HIV has spread to the non-injecting heterosexual population, Dementieva said.

Russia has domestic capacity to produce only AZT and phosphazid, an AZT-like drug; all other drugs must be imported. A grant is pending from the Global Fund to Fight AIDS, Tuberculosis and Malaria to help pay for AIDS treatment, but requires Russia to negotiate with drug companies to bring down the prices of AIDS drugs. — Ann Silversides, Toronto.