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Eastern Europe struggles to combat quadruple epidemic

Friday, 18 October, 2013


The United Nations Secretary-General’s Special Envoy on HIV in Central and Eastern Europe, Professor Michel Kazatchkine, has raised the alarm about the growing HIV epidemic in Eastern Europe. Speaking at the European AIDS Conference in Brussels this week, Kazatchkine highlighted the quadruple overlapping epidemics faced by the Eastern Europe region – injecting drug use, tuberculosis (TB), hepatitis C and HIV. He called on governments to “bear responsibility for the human tragedy that is unfolding in their countries”.

The HIV epidemic in Eastern Europe continues to grow, while new HIV infection rates are dropping in many other parts of the world. The number of people living with HIV (PLHIV) has increased by 140 percent in the last ten years alone. A mere 30 percent of people who require antiretrovirals (ARVs) are on treatment – under new World Health Organisation (WHO) treatment guidelines this figure falls to below 15 percent – and Eastern Europe remains the only region globally where AIDS-related deaths are growing.

The intersecting epidemics of injecting drug use, TB, hepatitis C and HIV in Eastern Europe are fuelled by stigma, criminalisation and a lack of political will to address these issues. For example, harm reduction programmes to reduce HIV incidence among injecting drug users in the region are inadequate, and are largely funded by external donors. It is estimated that HIV incidence could be reduced by 63 percent over five years if opioid substitution therapy, needle and syringe exchanges, and ARV treatment were made available to all those with CD4 counts of under 350, and to half of those accessing drug services each year.

Kazatchkine urged the European Union to act now to address this situation, which “should be setting off alarms among donors and the European Union, and should lead to a re-thinking of how to support prevention programmes in middle-income countries.”