NEW YORK, 18 September 2002 - HIV/AIDS is spreading at a faster rate in parts of Central and Eastern Europe and the Commonwealth of Independent States (CEE/CIS) than anywhere else in the world, says UNICEF in a new report, The Social Monitor. The report, tracking the well-being of children and young people in the region, warns that HIV/AIDS is the greatest threat to their health as it moves - virtually unchecked - into the mainstream population in a number of countries.
"The implications for the region's economic growth and social stability - which are so dependent on its young people - are alarming," said Carol Bellamy, Executive Director of UNICEF. "HIV/AIDS has a young face in this region. Young people account for most new infections and their low levels of HIV awareness, combined with increasingly risky behaviour, herald a catastrophe. It is clear that the gravity of the situation has been underestimated and that precious time has been lost. Without immediate and radical action, there is little to stop the spread of the disease."
In the CIS, almost 80% of new infections were registered among people under 29 between 1997 and 2000. In Estonia, the report finds, 38% of newly registered infections are among those aged under 20, and 90% among people under 30 years of age.
The report, produced by the UNICEF Innocenti Research Centre in Florence, points to the growth in substance abuse, particularly drug injection, the earlier sexual activity of young people, and the growing numbers of sex workers as the underlying reasons for the rapid spread of the disease in some countries.
By the end of 2001, there were an estimated one million people with HIV/AIDS in the region, up from 420,000 in 1998. Newly registered cases increased more than five-fold between 1998 and 2001. Two countries, Russia and Ukraine, account for 90% of the region's estimated HIV/AIDS cases, but Estonia now has the region's highest rate of new HIV infections, with more than one in every 1,000 people infected in 2001 - almost 20 times the average EU rate. HIV is also spreading rapidly in Latvia and Kazakhstan, and the number of cases is rising again in Ukraine and Moldova. While data suggest little growth in HIV/AIDS in Central and South-Eastern Europe, there is no room for complacency.
The majority of infections in the region are among injecting drug users, but as The Social Monitor reveals, there is increasing sexual transmission in countries such as Belarus and Ukraine where HIV made its first appearance in the region. In Belarus, 8% of new infections in 1996 were attributed to sexual transmission. By the first half of 2001, that proportion had soared to 32%.
The high prevalence of other sexually transmitted infections, such as syphilis and gonorrhoea, suggest that conditions are ripe for the further spread of HIV. And the rising proportion of infections among women, who are less likely to be injecting drug users, is another sign of increasing sexual transmission. Women accounted for 25% of officially registered infections in the CIS countries between 1997 and 2000.
Meanwhile, says the report, awareness about HIV prevention remains far lower - even in the worst-hit countries - than in Western Europe. While a UNICEF opinion poll found that teenagers in the region mention condom use most frequently as a way to avoid infection, awareness of condom use as a means of prevention remains significantly lower than in Western European countries. Fewer than 70% of teenagers in Belarus, Ukraine, or Latvia are aware of condoms as a means of protection, compared to 97% in France and 87% in Germany. Where awareness of condom use as a means of prevention is low, awareness of other safeguards, such as sexual abstinence or the avoidance of injected drugs, is also low.
"We are seeing the spread of HIV/AIDS into the mainstream population in the countries that were first affected. Our fear is that we may be seeing the same scenario in other countries in the near future," said Bellamy. "We need immediate action, building on the good work that has already been done."
According to the Social Monitor, national responses to HIV in some of the worst affected countries, such as Russia, Belarus and Ukraine, have not had enough impact. But small-scale projects in these countries are changing the behaviour of those in high-risk groups and attitudes towards those affected and could provide models for future action. The most successful are tailored to the needs of those from high-risk groups and run in consultation with them. The report also cites countries such as Poland, Lithuania and Kyrgyzstan, which took early action to confront HIV/AIDS. Building on these experiences, the report highlights areas for immediate policy action to curb the spread of the disease:
Raise awareness of HIV and prevention, not only by informing young people but also by involving them in awareness-raising campaigns and peer education;
Ensure that schools address HIV more openly, including in life skills education;
Ensure a stronger gender focus and targeted policies to reach those from the most disadvantaged backgrounds;
Build accessible and youth-friendly health care and advisory services;
Create effective systems to track the epidemic;
Foster more inclusive attitudes towards those infected and those at high risk.
"The region has great assets in its fight against HIV/AIDS," said Bellamy. "It has projects that are making a difference, extensive health-care services and a literate population. We can build on these strengths and on the commitments made by world leaders just five months ago at the UN Special Session on Children. They pledged to support the fight against HIV/AIDS, which must be won if we are to build a world fit for children - a world based on the right of every child and young person to physical, emotional and economic well-being."
The Social Monitor also highlights recent economic and demographic trends in the region, with growing economies and falling child populations providing an opportunity to invest in education and to tackle child poverty, child institutionalization and social exclusion, as well as HIV/AIDS.
NOTE TO EDITORS:
Today sees the launch of the UNICEF CEE/CIS website, with information on every country in the region, including 'the big picture' of the overall situation, UNICEF programmes, latest statistics and a range of features. Go to www.unicef.org/programme/highlights/cee
Overcoming HIV/AIDS is an UNICEF priority, alongside girls' education, integrated early childhood development, immunization 'plus' and increased protection of children from violence, abuse, exploitation and discrimination.
For further information, contact:
Karuna Nundy, UNICEF Media, New York, e-mail: firstname.lastname@example.org, tel: + 1 212 303 7941
Angela Hawke, UNICEF Regional Office for Central and Eastern Europe and the Commonwealth of Independent States, e-mail: email@example.com, tel: (4122) 909 5607
Patrick McCormick, UNICEF Innocenti Research Centre, e-mail: firstname.lastname@example.org tel: (39 055) 203 3354