UNAIDS: The First 10 Years

UkraineUkraine139Ukraine has the highest HIV prevalence in all of Eastern Europe and Central Asia: it isestimated at 1.5%, about 410 000 people living with HIV by the end of 2007 1 . AnnualHIV diagnoses have more than doubled between 2000 and 2005. The epidemic ispredominantly concentrated among groups of people who are most at risk – injectingdrug users, sex workers and men who have sex with men – but infection rates amongwomen are also increasing rapidly. More than 45% of new HIV infections reported inthe first half of 2007 were among injecting drug users 2 .The sudden increase in HIV infection in Ukraine in the late 1990s was not predictedbut there is clearly a link to the process of economic transition following the demise ofcommunism.The former Director of the Regional Support Team for Eastern Europe and CentralAsia, Henning Mikkelsen, explained: “… the rise in infections was very much areflection of what people went through in that process of economic transition therebecause, if you look at these places, all of them are characterised by the fact that therewas one monopoly industry then suddenly all these new countries [were] establishedand all the trade links, and so on, brought together, then these industries, they wentdown; there was nothing left there. There was really no future, and so, what did you do?Well, you went out to the poppy fields and got some poppy … and you could cookyour heroin with your friends and you shoot up. But that was not something that wehad foreseen at that point in time, the global intelligence didn’t see that this was goingto happen there, so we were – I was really taken by surprise there”.In seeking to explain the Ukrainian and other epidemics in the region, Mikkelsentries to look at underlying reasons: “We don’t really understand the whole dynamicsof why this occurs – I mean, some people say that it’s because now so many peopleare very poor and there’s a lot of unemployment and so on, but I don’t think that’s thewhole explanation. There are other societies where people are poor and unemployedbut they don’t start to shoot up drugs, so you cannot explain everything with thiskind of terminology there. I think it reflects a lot that, after the Soviet Union brokedown, of course, there was a very difficult economic situation that altered the wholeuniverse of social, moral values, which existed under communism … so many peoplewere completely disoriented in terms of how should they define themselves and theirlife there. And, in particular, young people, they cannot look back on their parents and[say], ‘Well, this was how they were living; I will do it the same way’. That has no value1UNAIDS (2007). Global Report 2007. Geneva, UNAIDS.2UNAIDS/WHO (2007). Fact Sheet Eastern Europe and Central Asia, 2007. Geneva, UNAIDS; UNAIDS/WHOAIDS (2007). Epidemic Update, 2007. Geneva, UNAIDS/WHO.