AN IRON curtain of AIDS

worst-affected former Soviet state, Ukraine, at least 450,000 people are HIV positive - one per cent of the population, or 17 times the UK rate. 80-90 per cent of them caught it through

drug use. As a result, most also have hepatitis B and C. And most don’t know.
Even UNAIDS, who’ve seen it all before, betray shock at the figures. They are doubling every year, as HIV speads to the other states of the former Soviet empire.
So far the official reaction to HIV has been dismal. Back in 1997, Dr NF Gerasimenko of the Russian Medical Academy warned: “What we face is unprecedented, colossal.” But last year the Russian government spent the equivalent of £3 million on Aids care and prevention. That’s about a hundredth the UK budget for 20 times as many people with HIV. Most of that goes on very basic treatment. Maybe Septrin or TB drugs, as long as you don’t

Oleg Galochkin of the outreach programme ‘Marie’ provides condoms and syringes to a sex worker

have MDR-TB which circulates at the world’s highest rate among Russian prisons.
And anti-retrovirals, no chance. One recent survey could only find 733 people on HIV drugs among the one-and-a-quarter million people with HIV in the whole of Belarus, Russia, Moldova and Ukraine. That’s a lower proportion than in Africa.
Needle culture
The Russian and Ukrainian drug workers I talked to agreed that, though drug use had been a sizeable underground culture, it burst into an uncontrolled and virtually public phenomenon around 1996.
“Drugs are cheap in our part of the world, and Russia and Ukraine form a natural corridor for opium on its way from Afghanistan and its neighbours to western Europe,” says Ilona van der Braak. She has worked on HIV in Moscow for the last seven years at the Aids Foundation East West (AFEW), a non-governmental

organisation founded in 2001 by Médecins sans Frontières.
Then there’s a culture of medical needle use - “Using injections rather than pills is standard