OPINION: By Rian van de Braak and David Veazey
The St. Petersburg Times, News from Russia in English
St. Petersburg, Russia, November 21, 2003

All five countries have a major influence on their region and no doubt have the potential to affect the world. While the epidemic in these countries is still in its early-to-middle stages, they are led by governments that have not yet given the is-sue the sustained priority and attention that has been key to successfully controlling the epidemic elsewhere. Experience throughout the world has shown that only through active, high-level leader-ship to increase awareness, eliminate HIV-related stigma, and provide treatment (all of which help to change the behavior that leads to the spread HIV) can the scale of the epidemic be kept at a manage-able level.

Notably, for the very first time the emerging HIV/AIDS epidemic in Russia was a topic on the agenda of the summit between Presidents George W. Bush and Vladimir Putin in Washington this fall. The Bush administration clearly wants Putin to undertake rigorous action to prevent the socio-economic disaster that so many experts are predicting.

Analysis of the development of the HIV epidemic in the former Soviet Union shows that developments follow a clear pattern in each country. First Ukraine and Belarus took the lead, with Russia following one to two years later. Then one or two years after that, the epidemic began to take hold in the countries of Central Asia.

Some might argue that the main U.S. donor agency, USAID, has a hidden political agenda with its HIV/AIDS and other aid programs in the former Soviet Union. This may be true and it could do more, but at least the U.S. government appears to be taking a serious interest in the devastating impact this epidemic will have on the region. The United States recognizes that this impact will echo throughout the world.

What is the European Union's position vis-a-vis this disaster that is occurring on its doorstep? With the upcoming expansion of the EU to include the Baltic states and Central Europe, the EU will soon share a border with Russia, Belarus and Ukraine.

Looking at the EU's current response, it would be easy to conclude that there is very little concern at all. Some of its Tacis technical assistance projects now focus on HIV/AIDS (AIDS Foundation East-West is implementing some of them). However, sometimes these projects set unrealistic goals with a similarly unrealistic time frame and budget. They are also, in the broader scheme of things, nothing more than a drop in the ocean.

While some may say that a drop in the ocean is better than nothing, it is clearly not enough. If we look at Russia alone, a comprehensive national HIV/AIDS program incorporating prevention, treatment, care and support, would require an in-vestment of $160 million for 2003, increasing to $220 million in 2004.

Russia is the largest beneficiary of funds from the EU's Tacis program, yet the amount of funds pledged to HIV/AIDS is less than impressive. In Russia, Tacis currently funds a 2.5 million-euro program to fight communicable diseases in prisons near Russia's northwestern border. Projects are also in the pipeline for addressing the Russian HIV epidemic in two "phases." Both of these phases are small-scale advocacy, awareness raising and training projects limited to two of Russia's 89 regions. While these types of activities are needed, they are not of a scale equal to what European donors can contribute in this region.

To be fair, the EU has made one of the largest pledges to the Global Fund to Fight AIDS, Tuberculosis and Malaria, with 460 million euros pledged up to 2006. The member states of the EU have individually pledged just under 1.7 billion euros for the same period. If the EU and its member states are taken as a whole, it would be considered the largest single donor to the Global Fund. Yet only 6.4 percent of the approved Global Fund grants have been allocated to HIV/AIDS pro- grams in the former Soviet Union. That amounts to about 0.37 euros contributed per person currently living in the EU from 2001 to 2006. Is this a sufficient investment to turn around one of the fastest growing HIV epidemics just across the border?

Of course, the EU cannot take on all the needs of this region alone. The EU needs to work together with other G-8 countries to ensure an effective response. In the countries of the former Soviet Union, the governments themselves need to take more responsibility for stopping this epidemic in its tracks. Just as with the Global Fund, some EU members contribute to the efforts against HIV/AIDS in the region individually. These countries - notably the Netherlands, Britain and Sweden - actively and strongly support programs on the ground throughout the region.

But what is so evidently lacking is a common strategy and a clear position on which Europe can take a stand. Europe needs to team up with the United States to bring in resources and mobilize the political will to make HIV/AIDS a top priority in this region. Europe can also bring in valuable expertise, as well as a liberal and constructive attitude toward such sensitive topics as preventing HIV among injecting drug users or sex industry workers.

Maybe the EU could even be really daring and start up negotiations between the Paris Club of international debtor countries and Russia. Russia still owes more than $40 billion to the Paris Club for loans taken under the Soviet Union. One proposal that has been discussed is to retire these debts in exchange for greater spending on HIV programs by Russia (with possible benefits for all countries of the former Soviet Union). We need innovative proposals like this on the table to motivate Russia and the other countries in the region to work seriously on an epidemic that will soon be-gin to ravage an entire generation.

Sadly, the EU is losing precious time and may miss a unique window of opportunity to prevent this tragedy from happening.