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HIV/AIDS in Eurasia: Context, Policy, Research

June 08, 2006 // 3:30pm5:30pm
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Maternal Health Initiative
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At a recent Kennan Institute talk, Senator Bob Bennett (R-UT); Craig Calhoun, President, Social Science Research Council; Jennifer Cooke, Co-director, Africa Program, Center for Strategic and International Studies; and Robert Heimer, Associate Professor, School of Public Health, Yale University discussed the threat of HIV/AIDS in Eurasia and efforts to understand and combat this threat.

Senator Bob Bennett discussed the context of U.S. assistance policy toward Russia. According to Bennett, the goals of U.S. assistance to Russia were established in a 1992 act, which stipulates that the three primary aims of U.S. assistance to Russia are: promoting Russia's transition to democracy; encouraging the development of a market economy, and ensuring U.S. national security, particularly by preventing the proliferation of Russia's weapons of mass destruction. However, Bennett noted that Russia today is a very different place than it was in 1992, thanks mostly to very high oil revenues. Russia is no longer impoverished, but it faces serious demographic and health problems. Bennett said that fertility rates in Russia are too low to maintain the country at its present population level, and immigration is not sufficient to make up the difference. In addition, Russia faces threats from infections diseases, such as HIV/AIDS and tuberculosis. These are very serious problems, Bennett said, and the solutions to them will have to come from within Russia.

Craig Calhoun stated that the problem of HIV/AIDS in Eurasia is extremely complicated. We tend to treat HIV/AIDS as a dire health emergency, he said, which leads us to focus on short-term, immediate responses. In fact, he contended, HIV/AIDS is a long-term public health problem, which requires long-term and in-depth study. Even in the unlikely event that an HIV vaccine becomes available now, he noted, eradication of the disease would take decades, at least. Current research tends to focus on HIV/AIDS as a disease that affects individuals. Equally important, according to Calhoun, is an understanding of how HIV/AIDS affects societies, and of how social processes facilitate or impede the spread of the disease. HIV/AIDS, Calhoun said, is a disease of poverty and inequality and is spread by migration, war, violence against women, and other social processes. Without an understanding of these processes, we will not be able to effectively treat and prevent HIV/AIDS.

Jennifer Cooke described the HIV/AIDS task force at the Center for Strategic and International Studies, which was established in 2001 with the support of the Bill and Melinda Gates foundation. Its primary function is to bring together senior-level experts on HIV/AIDS with policymakers. According to Cooke, the task force is carefully bipartisan and has attracted a great deal of interest at high levels of the U.S. government. Its original focus was on Africa, where the AIDS epidemic is most serious, but it has now expanded to include "second wave" states such as Russia, China, and India, where the number of people infected is currently small, but is likely to grow rapidly. The task force, Cooke continued, has recently begun sending delegations of U.S. officials abroad to educate them about the on-the-ground implications of the AIDS epidemic. The Russia task force, she explained, came up with several policy recommendations, including support for better studies of real prevalence rates, support for NGOs working with high-risk groups such as drug users and commercial sex workers, and the integration of HIV treatment facilities into the primary healthcare system.

Robert Heimer argued that the AIDS epidemic in Russia is following the path of the international heroin trade. According to Heimer, HIV infection rates were so high among injecting drug users in Russia that many people theorized that the unique characteristics of Russian heroin facilitated the transmission of the virus. Because Russian homemade heroin, called chernaia, is sometimes made with blood, it seemed possible that HIV was being transmitted through the heroin itself, and therefore harm reduction programs such as needle exchanges would be ineffective in Russia. However, Heimer's research indicated that HIV cannot be transmitted through the blood in chernaia, and, in fact, HIV prevalence rates are higher in those Russian cities where locally made chernaia has been replaced by commercial heroin. These results, Heimer said, indicated that needle exchange programs could be beneficial in preventing the spread of HIV/AIDS in Russia.

The seminar took place within the context of a four-day training seminar on "Public Health, Social Welfare Systems and HIV/AIDS in Eurasia," cosponsored by the Kennan Institute and the Social Science Research Council in New York. The seminar brought together eight advanced graduate students and junior faculty members from U.S. universities to work with leading professors and experts from academic, governmental, non-governmental and international organizations on issues related to public health in Eurasia. The goals of the seminar were to allow participants to discuss their research, develop networks within both academic and non-academic circles, and gain the skills and vocabularies to better tailor their work to a broader audience of academics, practitioners, and policymakers. Funding for the workshop was provided by the Title VIII Program of the U.S. Department of State.

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