Very little is done to confront looming plague. One third of young women in Azerbaijan and Uzbekistan never heard of AIDS. Over-crowded prisons provide no clean needles or condoms to their inmates. There are no early warning "sentinel" programs anywhere. Needle exchanges are unheard of. UNICEF warns, in its report titled "Social Monitor 2002", that HIV/AIDS imperils both future generations and social order.

The political class is unmoved. President Vladimir Putin never as much as mentions AIDS in his litany of speeches. Even Macedonia's western-minded and western-propped president, Boris Trajkovski, dealt with subject for first time only yesterday. Belarus did not bother to apply to United Nation's Global Fund to Fight AIDS, Tuberculosis, and Malaria or to draw approved resources from World Bank's anti-TB/HIV/AIDS project.

In many backward, tribal countries - especially in Balkan and in central Asia - subjects of procreation, let alone contraception, are taboo. Vehicles belonging to Medecins du Monde, a French NGO running a pioneer needle exchange program in Russia, were torched. The Orthodox Church has strongly objected to cinema ads promoting safer sex. Sexual education is rare.

Even when education is on offer - like last year's media campaign in Ukraine - it rarely mitigates or alters high-risk conduct. According to Radio Free Europe/Radio Liberty, St. Petersburg AIDS Center carried out a survey of 2000 people who came to be tested there and were consequently exposed to AIDS prevention training. "Neither men nor women had changed their high-risk behavior", is unsettling conclusion.

Ignorance is compounded by a dismal level personal hygiene, not least due to chronically malfunctioning water, sanitation and electricity grids and to prohibitive costs of cleansing agents and medicines. Sexually transmitted diseases - gateways to virus - are rampant. Close to half a million new cases of syphilis are diagnosed annually only in Russia.

The first step in confronting epidemic is proper diagnosis and acknowledgement of magnitude of problem. Macedonia, with 2 million citizens, implausibly claims to harbor only 18 carriers and 5 AIDS patients. A national strategy to confront syndrome is not due until June next year. Though AIDS medication is theoretically provided free of charge to all patients, country's health insurance fund, looted by its management, is unable to afford to import them.

In a year of buoyant tax revenues, Russian government reduced spending on AIDS-related issues from $6 million to $5 million. By comparison, U.S. Agency for International Development (USAID) alone allocated $4 million to Russia's HIV/AIDS activities last year. Another $1.5 were given to Ukraine. Russia blocked last year a $150 million World Bank loan for treatment of tuberculosis and AIDS.

Money is a cardinal issue, though. Christof Ruehl, World Bank's chief economist in Russia and Murray Feshbach, a senior scholar at Woodrow Wilson International Center for Scholars in Washington, put number of infected people in Russian Federation at 1-1.2 million. Even this figure - five times official guesstimate - may be irrationally exuberant. A report by US National Intelligence Council forecasts 5-8 million HIV-positives in Russia by end of decade. Already one third of conscripts are deemed unfit for service due to HIV and hepatitis.

Medicines are scarce. Only 100 of St. Petersburg's 17,000 registered HIV carriers receive retroviral care of any kind. Most of them will die if not given access to free treatment. Yet, even a locally manufactured, generic version, of an annual dose of least potent antiretroviral cocktail would cost hundreds of dollars - about half a year's wages. At market prices, free medicines for all AIDS sufferers in this vast country would amount to as much as four fifths of entire federal budget, says Ruehl.

Some pharmaceutical multinationals - spearheaded by Merck - have offered more impoverished countries of region, such as Romania, AIDS prescriptions at 10 percent of retail price in United States. But this is still an unaffordable $1100 per year per patient. To this should be added cost of repeated laboratory tests and antibiotics - c. $10,000 annually, according to New York Times. The average monthly salary in Romania is $100, in Macedonia $160, in Ukraine $60. It is cheaper to die than to be treated for AIDS.

Indeed, society would rather let tainted expire. People diagnosed with AIDS in eastern Europe are superstitiously shunned, sacked from their jobs and mistreated by health and law enforcement authorities. Municipal bureaucracies scuttle even little initiative shown by reluctant governments. These self-defeating attitudes have changed only in central Europe, notably in Poland where an outbreak of AIDS was contained successfully.

And, thus, bleak picture is unlikely to improve soon. UNAIDS, UNICEF and WHO publish country-specific "Epidemiological Factsheets on HIV/AIDS and Sexually Transmitted Infections". The latest edition, released this year, is disheartening. Under-reporting, shoddy, intermittent testing, increasing transmission through heterosexual contact, a rising number of infected children. This is part of dowry east Europe brings to its long-delayed marriage with a commitment-phobic European Union.

Yet, this is far from being true. The developed countries, once a source of such emigration themselves (more than 100,000 European scientists left for USA in wake of Second World War) - actively seek to become its destination by selectively attracting only skilled and educated citizens of developing countries. They offer them higher salaries, a legal status (however contingent), and tempting attendant perks. The countries of origin cannot compete, able to offer only $50 a month salaries, crumbling universities, shortages of books and lab equipment, and an intellectual wasteland.

The European Commission had this to say last month:

"The Commission proposes, therefore, that Union recognize realities of situation of today: that on one hand migratory pressures will continue and that on other hand in a context of economic growth and a declining and aging population, Europe needs immigrants. In this context our objective is not quantitative increase in migratory flows but better management in qualitative terms so as to realize more fully potential of immigrants' admitted."

And EU's Social and Employment Commission added, as it forecast a deficit of 1.7 million workers in Information and Communications Technologies throughout Union:

"A declining EU workforce due to demographic changes suggests that immigration of third country nationals would also help satisfy some of skill needs [in EU]. Reforms of tax benefit systems may be necessary to help people make up their minds to move to a location where they can get a job...while ensuring that social objectives of welfare systems are not undermined."

In Hong Kong, "Admission of Talents Scheme" (1999) and "The Admission of Mainland Professionals Scheme" (May 2001) allow mainlanders to enter it for 12 month periods, if they:

"Possess outstanding qualifications, expertise or skills which are needed but not readily available in Hong Kong. They must have good academic qualifications, normally a doctorate degree in relevant field."

According January 2002 issue of "Migration News", even now, with unemployment running at almost 6%, US H1-B visa program allows 195,000 foreigners with academic degrees to enter US for up to 6 years and "upgrade" to immigrant status while in residence. Many H1-B visas were cancelled due to latest economic slowdown - but US provides other kinds of visas (E type) to people who invest in its territory by, for instance, opening a consultancy.

The UK has just implemented Highly Skilled Migrant Programme which allows "highly mobile people with special talents that are required in a modern economy" to enter UK for a period of one year (with indefinite renewal). Even xenophobic Japan allowed in 222,000 qualified foreigners last year (double figure in 1994).

Germany has absorbed 10,000 computer programmers (mainly from India and Eastern Europe) since July 2000. Ireland was planning to import twenty times as many over 7 years - before dotcoms bombed. According to "The Economist", more than 10,000 teachers have left Ecuador since 1998. More than half of all Ghanaian medical doctors have emigrated (120 in 1998 alone). More than 60% of all Ethiopian students abroad never return. There are 64,000 university educated Nigerians in USA alone. More than 43% of all Africans living in North America have acquired at least a bachelor's degree.

Barry Chiswick and Timothy Hatton demonstrated ("International Migration and Integration of Labour Markets", published by NBER in its "Globalisation in Historical Perspective") that, as economies of poor countries improve, emigration increases because people become sufficiently wealthy to finance trip.

Poorer countries invest an average of $50,000 of their painfully scarce resources in every university graduate - only to witness most of them emigrate to richer places. The haves-not thus end up subsidizing haves by exporting their human capital, prospective members of their dwindling elites, and taxes they would have paid had they stayed put. The formation of a middle class is often irreversibly hindered by an all-pervasive brain drain.

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