01 July 2002 slide number EECA-1

The challenge of HIV/AIDS to health, The challenge of HIV/AIDS to health, security, and economic development in the security, and economic development in the

ECE region ECE region

Henning Mikkelsen

Europe Regional Coordinator

Joint United Nations Programme on HIV/AIDS

01 July 2002 slide number EECA-2

The appalling statistics do not begin to describe the magnitude of the destruction wrought by AIDS. AIDS is more devastating than any terrorist attack, any conflict or any weapon of mass destruction. It kills indiscriminately, and without mercy.

As cruel as any tyrant, the virus can crush the human spirit. It is an insidious and relentless foe. AIDS shatters families, tears the fabric of societies, and undermines governments. AIDS can destroy countries and destabilize entire regions.

Colin Powell, UN General Assembly, September 2003

00002-E-3 – 1 December 2002

Adults and children estimated to be living Adults and children estimated to be living with HIV/AIDS as of end 2002with HIV/AIDS as of end 2002

Total: 42 million

Western Europe

570 000570 000North Africa & Middle East

550 000550 000Sub-Saharan

Africa

29.4 29.4 millionmillion

Eastern Europe & Central Asia

1.2 million1.2 million

South & South-East Asia

6 million6 million

Australia & New Zealand

15 00015 000

North America

980 000980 000Caribbean

440 000440 000

Latin America

1.5 1.5 millionmillion

East Asia & Pacific

1.2 million1.2 million

27 January 2002 4

Adult prevalence rate 15.0% – 36.0% 5.0% – 15.0% 1.0% – 5.0% 0.5% – 1.0% 0.1% – 0.5% 0.0% – 0.1% not available

+ 1 300%

+ 60%

+ 160% + 100%

+ 30%

+ 40%

+ 20% + 20%

+ 20%

HIV: current prevalence and recent changes, 1996–2001

World Health Organization

HIV infections newly diagnosed:cases reported in 2002 per million population

WHO European Region

Data reported by 31 December 2002* Netherlands: new system, data for 1st 6 months of 2002 only; include many cases diagnosed in previous years

HIV cases per million

200 +

100 - 199

20 - 99

< 20

Not available

EuroHIV

Upd

ate

at

31 D

ecem

ber

20

02

11 13

91

2

6

9

5

49661

25

18

23

38

8

25

94

53

43

32

227108

74

2

31

49

74*

45

15

25615

351

37

211

33

1054

3

0

180

101

38

6NA

New reported cases of HIV infections by age group, Western Europe and Eastern Europe 2001

0

10

20

30

40

50

60

70

13-19 years 20-29 years 30-39 years

per

cen

tag

e

East

West

Unemployment among youth, 1998 (percent)

0 10 20 30 40 50 60 70 80

Czech RepublicSlovakia

PolandHungarySlovenia

CroatiaFYR Macedonia

FR YugoslaviaBulgariaRomania

EstoniaLatvia

LithuaniaRussia

GeorgiaAzerbaijan

KyrgyzstanTajikistan

Many occasional young injectors

Moscow 181Russia 136Siberia 166

HIV-infection prevalence (per 100,000 persons) in mining territories of Siberia (Russian Federation)

Altai krai96

Kemerovo oblast141

Tomsk oblast53

Khanty-Mansi AO447

Tyumen oblast157

Yamalo-Nenetsky AO118

Republic Buryatia153

Republic Tiva5

RepublicKhakassia

13

Krasnoyarsk krai127

Taimyr AO78

Evenki AO5

Chita oblast68

Irkutsk oblast465

The economic impact of HIV in Russia (World Bank 2001)

GDP in 2010 would be up to 4.15 percent lower , and in

2020 10.5%

Investment would decline by 5.5 percent in 2010 and

14.5 percent in 2020

HIV lowers productivity by 13 percent

Demographic and security impact

Life expectancy of men may drop 4 years by 2015

Russian Ministry of Defense: More than 5000 army

recruits found to be HIV infected in 2002

Male life expectancy at birth

50

55

60

65

70

75

1989 1991 1993 1995 1997 1999 2001

Czech Republic

Russia

HIV is a pressing problem for Russia, which goes through a serious demographic crisis.(Igor S.Ivanov, Minister of Foreign Affairs of the Russian Federation,UN General Assembly, September 2003)

Global Fund and World Bank in

Eastern Europe and Central Asia

GF : 12 countries approved (total US$ 227.2 million)

WB projects: 3 countries approved (around US$ 86 millions)

Figure 1. Required Funding by Activity

-

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2001 2002 2003 2004 2005 2006 2007

Mill

ion

s o

f U

S D

olla

rs

Policy/admin

ARV

Laboratory

OI prophylaxis

OI treatment

HIV Testing

Palliative care

Other populations

MSMs

Harm reduction

Mass media

PMTCT

Blood safety

Workplace

VCT

STIs

Condoms

Social marketing

Sex workers

Youth