On June 4 5, 2007, a workshop was held to discuss the development of unified software for monitoring and evaluation of activities related to HIV diagnosis, surveillance, testing, observation and treatment.

The workshop participants included representatives from the Federal Oversight Service for Consumer Rights Protection and Human Welfare, the Federal AIDS Centre, the World Health Organisation, the UNAIDS, the American International Health Alliance, the UNICEF and the Russian Health Care Foundation.

V.V. Pokrovskiy, Academician, Russian Academy of Medical Sciences, made a presentation to highlight the importance of developing unified software for monitoring and evaluation of activities related to HIV diagnosis, surveillance, testing, observation and treatment.

Representatives from the Krasnoyarsk Kray, Tyumen and Moscow Oblasts shared their experience in developing unified software for the said purposes, and informed the audience about the needs of these regions, advantages and drawbacks of their operating systems.

Then, selected projects and regions presented experiences they gained in this area in the Russian Federation.

A separate section of the workshop was dedicated to Terms of Reference for each of the software elements: M&E indicators and draft TOR for the development of unified software.

Another presentation was made by Yulia Brodskaya, Program Coordinator, RHCF, to inform the meeting about the development of a regional PLWH database model.


On May 29, 2007, D.A. Goliaev, Global Fund Project Director, had a meeting with Pavel Tsikolin, Drug Use and HIV Prevention Advisor to the Irkutsk Governor. The meeting took place in the Russian Health Care Foundation.

During the meeting, Pavel Tsikolin informed the RHCF management about the progress of the Program: Promoting a Strategic Response to HIV/AIDS Treatment and Care for Vulnerable Populations in the Russian Federation in the Irkutsk Oblast; he focused on harm reduction programs implemented by the Crossing of Seven Roads Autonomous Non-Commercial Organisation. In 2006 2007, the RHCF awarded grants to this organisation for its work with injection drug users under a Step to Help You Project. Over one year of its implementation, the project established a network of IDU-friendly physicians. They help to provide primary counselling before testing for HIV. Upon testing, project clients are referred to the city unit of the Dermatologic and Venereal Disease Clinic (Dispensary). Under the Step to Help You Project, its referred clients may go through testing for STIs and HIV free of charge and to get treatment recommendations. During the first quarter of 2007, the project covered 438 clients with 153 referrals and 38 patients tested in the Dermatologic and Venereal Disease Clinic and the AIDS Centre.

During the meeting, an emphasis was made on the program outputs in the Irkutsk Oblast and the impact of the Time to Live Tele-Marathon and the AIDS-Ambulance TV program on HIV and drug use prevention, as well as on related policies of the Irkutsk Oblast Administration.

E.g., on April 24, 2007, a meeting of the Interagency Coordination Council for the HIV Control in the Irkutsk Oblast was held and resulted into the decision to encourage the Mayors of Irkutsk and Angarsk to finance 100% of costs of the municipal targeted HIV/AIDS Control Programs. The meeting also discussed needed amendments to the Regional Social HIV/AIDS Control Program for 2006 2010 in view of the expected integration of the Ust-Ordynsky Buryat Autonomous Okrug into the region in 2008.

A training seminar for Irkutsk journalists is scheduled for June 2007 to raise their awareness of AIDS/HIV problems. The seminar will have extensive inputs of specialists from the AIDS Centre and representatives from non-commercial civil society organisations.

There is a Draft Resolution of the Irkutsk Oblast Governor to change the composition of the Interagency Coordination Council for HIV/AIDS Control.

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Reuters referred to the Global Fund to Fight AIDS, TB, and Malaria as a unique international organization called to combat the three most dangerous infections in the world, which managed to provide antiretroviral treatment to one million HIV-positive people, over the five years of its existence. The Global Fund was founded by the UN and the G-8 Group and is financed primarily by the European Governments and the US. Now, the Global Fund is declaring its intention to scale up its operations.

The organisation stated that by May 1, 2007, its efforts resulted into an increase in the number of people who began antiretroviral (ARV) treatment up to 1.0 1.1 million people from 544,000 people in the previous year. In addition, according to the GFs data, the number of TB cure cases doubled compared with the previous year, as did the number of insecticide-impregnated bed-nets distributed to prevent malaria. According to Dr. Michel Kazatchkine, Executive Director of the Global Fund, 1.8 million people are alive today thanks to the GF-supported programs, i.e. 3,000 human lives are saved every day.

Dr. Kazatchkine informed journalists that the Global Fund had allocated US$ 3.5 billion to fight these three infections. About 30 % and 55 % of the funds come, respectively, from the USA, and EU countries. However, a lot is to be done yet, and the Global Fund needs additional US$ 6 billion by 2010. Grants of the Global Fund are received by 136 countries, including Russia.


May 18, 2007. On the eve of the International Memorial Day of People Who Died from AIDS, the RIA Novosti International Information Agency hosted a press-conference to launch the National Red Ribbon Award Initiative for fighting against AIDS.

The Red Ribbon Award was introduced by the Shaghi (Steps) Charity Foundation, and the Remarka Agency supported by the Russian Academy of Medical Sciences, the Ministry of Health and Social Development of the Russian Federation and UN agencies in Russia.
During the press-conference, journalists were informed about the award concept, nominations, symbols and participation conditions.

Journalists questions were answered by Igor Pchelin, Board Chairman, Shaghi (Steps) Charity Foundation, Marina Kolomiets, Director General, Remarka Agency, and Alexander Pankratov, Program Coordinator from the Russian Health Care Foundation.


An extract from V. Pokrovskys speech during the press-conference:

The HIV epidemic is growing in Russia. As May 15, 2007, HIV anti-bodies have been found in 402,000 Russian people, including 17,000 HIV-positive patients reported to have died, and 17,580 children born of HIV-positive mothers and now monitored to make final diagnoses.

Not only the total number of HIV-infected people keeps on going up in Russia, but also the epidemic growth rate, i.e. the number of new HIV infections. E.g., 35,861 new HIV-infection cases were registered in 2005, while in 2006, the HIV incidence increased to 39,589. Unfortunately, in 2007 the first quarter data show a further increase in the number of newly registered HIV cases by 8% - 10% compared with the same period of the previous year. Currently, 100 110 new HIV-infection cases are registered every day in Russia. The total number of HIV-infected Russian citizens (including HIV-infected individuals who have never been tested or registered) is estimated to exceed one million.

Such an expansion of the epidemic is accounted for by the fact that the continued HIV spread among drug users is now coupled with an observed rise in the number of infections through both heterosexual and homosexual contacts. In 2006, one third of the new HIV-infections was attributed to sexual contacts.

The contribution of heterosexual contacts into the HIV spread is increasingly growing which is proven by the increasing share of women among newly registered HIV-positive people. In 2006, the female share was already as large as 44 %, or almost half of new cases which is typical of an epidemic with prevailing transmission through heterosexual contacts. The growth in the number HIV-infected women may be explained by the extremely high risk of meeting an HIV-infected sexual partner. In Russia on the average, every 50th man is already HIV-infected, and in some cities, every 10th man is infected. So far, HIV-infected women are fewer; but the gap is being rapidly bridged.

It should be taken into account that sexual transmission does not necessarily occur through occasional sexual contacts women and men often get infected with HIV from their permanent partners with whom they have been for relatively long periods of time and, therefore, rarely use condoms.

The only effective approach to contagion prevention is education in sound sexual behaviour, including sensible choice of partners, appropriate abstinence or proper use of condoms. Unfortunately, a vaccine to protect against HIV is not existent, and will not exist within a foreseeable future. Therefore, only sound sexual behaviour can save people from HIV.

In 2006, the Russian health sector focused its resources and efforts on treatment of HIV-positive Russian citizens. However, antiretroviral therapy can delay the development of AIDS for many a year, but for this very reason, it promotes the spread of HIV-infection rather than contains it. This newly emerged treatment (but, alas, not cure) opportunity is viewed by some people as a permit to expose themselves to higher behavioural risks. But there are no pharmaceuticals which are absolutely safe human health, and in addition, we can talk only about a temporary effect of treatment, so far. There are also such still irremovable hurdles for medicine as continued complications (side-effects) from ARV therapy and eventual development of drug resistance. Moreover, mass-scale treatment is already resulting into transmission of drug resistant HIV strains. Administration of antiretroviral drugs reduces the risk of HIV transmission from treated patients, but at the same time, it increases the risk of transmission of drug resistant HIV strains from these very patients. Treatment of people infected with drug resistant HIV may turn to be ineffective.

Since 2006, Russia has been providing ARV treatment on a mass-scale; this is undoubtedly a great achievement. But no matter how wide the up-to-date ARV therapy coverage is, treatment is aimed at mitigating the impact of the epidemic rather than at combating the epidemic itself. Nevertheless in Russia, 25 times more money is spent on treatment than on prevention (Rub 5.1 billion versus Rub 200 million in 2007). If more and more Russian citizens get infected with HIV, would be there money for drugs to treat them in future?

According to international guidelines, the share of prevention should be about 50% in the budgets of HIV/AIDS control programs, whereas now, HIV/AIDS control priorities coincide with vested interests of pharmaceutical business. Clearly, alongside with treatment, Russia should provide increased funding for public awareness and information/education.

Nowadays, what is done in Russia to prevent the disease is but formal efforts. A weekly TV program broadcast through the TNT Channel on Fridays, at 8:30 a.m. and several hundreds of booklets with questionable contents constituted all outputs of preventive activities funded from the federal budget in 2006. Still less attention is paid to prevention by local and regional authorities who (with rare exceptions) would not fund prevention activities at all. Many non-governmental and international organisations declare their successes in the area of HIV prevention, but the growing HIV incidence testifies to the effect that such declarations are premature.

Statistics are also available: according to the results of a representative survey commissioned by the Federal Oversight Service for Consumer Rights Protection and Human Welfare and undertaken in March 2007 by the Russian Public Opinion Research Centre (VTsIOM), only 20% of Russian citizens have correct ideas of how to avoid HIV contagion. Thereby, over 50% of the respondents had wrong ideas of HIV transmission ways, believing that mosquitoes were HIV vectors and that one could contact HIV through sharing meals with HIV-infected people. Such a low level of knowledge has not been found in any country since long ago. There is an opinion that funding from foreign sources is spent in Russia primarily for payments to the staff of various non-commercial and non-governmental organisations with no money left for prevention activities.

In Russia, there are also very active interest groups impeding normal preventive efforts. E.g., in Moscow, an active campaign is underway against the use of condoms, which is the only commonly accessible technical means to protect oneself from infection. And the ATV (Author Television) Team (airing through the TVTs TV Channel), has assumed the mission to arrange a talk-show which would prove that HIV/AIDS does not exist at all.

It should be taken into account that it is not sufficient to know the ways of HIV transmission, such knowledge should be translated into practice, and to this end, people should be motivated to protect themselves from infection; this means that public education must be long-term, systematic and detailed. Such education has as yet not been properly introduced in schools, but it is already belated because those who are exposed to the risk of HIV infection are already above the school ages.

Though Russia established a Government Panel for HIV/AIDS Control, HIV infection prevention remains a matter of secondary importance for the Russian society as a whole in spite of the adverse demographic and economic impact of the HIV epidemic, repeatedly proved by international and Russian experts.

So, at this stage of the fight against the epidemic, a most important mission for mass media is to guide the public opinion towards adopting less risky behaviours and to motivate authorities of all levels to develop and finance HIV prevention programs".


On May 15, 2007 (11.00 a.m.) the Central Journalist House (Nikitskiy Brd. 8-a, Moscow) will be the venue of a press-conference with Vadim Pokrovsky, Director, Federal AIDS Centre, Academician, Russian Academy of Medical Sciences. The event is associated with the International Memorial Day of People Who Died from AIDS which is May 20, this year.

Why is HIV/AIDS again on the rise in Russia?

Though HIV/AIDS control is an important component of the National Priority Health Project, the HIV incidence and AIDS mortality have been increasingly growing in Russia during the recent two years.

In 2006, on the average, 105 new HIV-infection cases a day were registered in Russia, and by May 2007, signs of HIV-infection were found in as many as 400,000 Russian citizens, with 17,000 of them reported to have died.

What are the reasons for the failure to stop the epidemic?
What and who prevent from counteracting the epidemic in an effective way?
What steps must be made to reduce the risk of infection?

These and other questions will be answered at the press-conference.


Now, dirty syringes shall be collected from drug-addicts and destroyed at a cement plant in Angarsk (Irkutsk Oblast). Today, the first portion (12,000 syringes) was burned there in boilers. Drug users collected the dirty syringes on their own to exchange them for new ones. This campaign is funded by the Russian Health Care Foundation under a harm reduction project for injection drug users titled A Step to Help You. The project is implemented by the Crossing of Seven Roads Non-Commercial Organisation (Angarsk, Irkutsk Oblast).

Wednesday (afternoon). They meet in a settlement called Magistralnyi, near the city of Usolye. This mini-van is well-known by local drug-addicts who wait for it every week. Volunteers have brought new syringes, water and alcohol-impregnated wipes. But all these are provided only in exchange for dirty injection tools to preclude their re-use and prevent new HIV-infections.

"The first quarter of this year alone yielded as many as 12,000 dirty syringes withdrawn from usage only in Angarsk and a small part of Usolye. But the situation remains tough, says Pavel Tsikolin, Drug Use Prevention and HIV Control Advisor to the Irkutsk Governor (from the Crossing of Seven Roads Centre).

In Usolye, drug use is a particularly acute problem. Heroin is sold like sunflower seeds in the streets. The retailers are not confused even by the presence of the filming crew. Olesya and Sergey watch such a drug retail sale picture every time they come here to implement this needle exchange campaign. It is impossible to change the situation. And the law enforcement bodies seem to fail to see it. Drug-addicts agree to be reached by volunteers. For the sake of clean syringes, they may bring up to 40 dirty ones, but they will be exchanged for no more than 5 new syringes; because spare syringes are too likely to be sold for a dosage of drugs.

The Angarsk Cement Plant. All collected syringes go into bubbling boilers. This is the first run of the syringe destruction at the enterprise. It costs us next nothing. The operation is not costly because we burn them in recuperators where the temperature is as high as 400aC. It is quite sufficient, says Tatyana Golovina, Chief, Industrial and Labour Safety Unit.

The enterprise will destroy dirty syringes in future as well in the hope to burn the last drug-addict syringe, some day.

Apart from needle exchange, distribution of condoms, disincentives, ampoules with water for injections, the project will provide medical and psychological care, supply HIV and other sexually-transmitted infection prevention information products, render information and legal support to PLWHA self-help groups to reduce discrimination and improve tolerance to PLWHAs problems.


This Monday, Michel Kazatchkine, France's former Global Ambassador for HIV/AIDS and Communicable Diseases, took over as the new Executive Director of the Global Fund to Fight AIDS, TB and Malaria.

In February, the Global Fund announced that the organization's board had selected Kazatchkine to replace Richard Feachem, the founder and former Executive Director of the Global Fund, whose contract ended in March. As the Global Fund executive director, Kazatchkine will lead a financing organization that has committed $7.1 billion over five years to 136 countries.

According to Kazatchkine, his early goals include quadrupling donations to the Global Fund to $8 million annually by 2010; developing stronger ties with other organizations working against HIV/AIDS, TB and malaria; and committing to "full accountability and transparency" of Global Fund operations.


The Advisory Council approved the results of the tender to select recipients of grant funds for establishing multi-professional teams to provide counselling and support for ARV treatment adherence stimulation and maintenance in the regions of Year 2 under the Program: Promoting a Strategic Response to HIV/AIDS Treatment and Care for Vulnerable Populations in the Russian Federation, and the grants were awarded the following organizations:

Kemerovo Regional AIDS and Communicable Disease Control Centre;
Kuzbass Against Drug-Use Regional Civil Society Organisation;
Bashkortostan Regional AIDS and Communicable Disease Control Centre 2 grants;
Rostov Regional AIDS and Communicable Disease Control Centre;
Ulyanovsk Regional AIDS and Communicable Disease Control Centre;
Anti-AIDS-Prikamye Charity Foundation;
Open World Tolyatti
MedVAZ City Clinical Hospital # 5, City AIDS and Communicable Disease Control Centre
Anti-AIDS Territory Regional Civil Society Organisation (Rostov)
Young Leaders Army (Children and Youth Organisation)

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A tender is announced to select contractors for establishing multi-professional teams for adherence stimulation for the regions of Program Year 2.
All interested organisations are invited to participation.

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