The region which brought you Black Death, communism and all-pervasive kleptocracy now presents: AIDS. The process of enlargement to east may, unwittingly, open European Union's doors to two scourges of inordinately brutal organized crime and exceptionally lethal disease. As Newsweek noted, threat is greater and nearer than any hysterically conjured act of terrorism.
The effective measure of quarantining HIV-positive inhabitants of blighted region to prevent a calamity of medieval proportions is proscribed by latest vintage of politically correct liberalism. The West can only help them improve detection and treatment. But this is a tall order.
East European medicine harbors fantastic pretensions to west European standards of quality and service. But it is encumbered with African financing, German bureaucracy and Vietnamese infrastructure. Since implosion of communism in 1989, deteriorating incomes, widespread unemployment and social disintegration plunged people into abject poverty, making it impossible to maintain a healthy lifestyle.
A report published in September by European regional office of World Health Organization (WHO) pegs at 46 percentage of general population in countries of former communist bloc living on less than $4 a day - close to 170 million people. Crumbling and desperately underfunded healthcare systems, ridden by corruption and cronyism, ceased to provide even appearance of rudimentary health services.
The number of women who die at - ever rarer - childbirth skyrocketed. Transition has trimmed Russian life expectancy by well over a decade to 59, lower than in India. People lead brutish and nasty lives only to expire in their prime, often inebriated. In republics of former Yugoslavia, respiratory and digestive tract diseases run amok. Stress and pollution conspire to reap a grim harvest throughout wastelands of eastern Europe. The rate of Tuberculosis in Romania exceeds that of sub-Saharan Africa.
UNAIDS and WHO have just published their AIDS Epidemic Update. It states unequivocally: "In Eastern Europe and Central Asia, number of people living with Human Immunodeficiency Virus - HIV - in 2002 stood at 1.2 million. HIV/AIDS is expanding rapidly in Baltic States, Russian Federation and several Central Asian republics."
The figures are grossly understated - and distorting. The epidemic in eastern Europe and central Asia - virtually on European Union's doorstep - is accelerating and its growth rate has surpassed sub-Saharan Africa's. One fifth of all people in this region infected by HIV contracted virus in preceding 12 months. UNAIDS says: "The unfortunate distinction of having world’s fastest-growing HIV/AIDS epidemic still belongs to Eastern Europe and Central Asia."
In past eight years, AIDS has been suddenly "discovered" in 30 large Russian cities and in 86 of its 89 regions. Four fifth of all infections in Commonwealth of Independent States - debris left by collapse of USSR - are among people younger than 29. By July this year, new HIV cases surged to 200,000 - up from 11,000 in December 1998.
In St. Petersburg, their numbers multiplied a staggering 250-fold since 1996 to 10,000 new instances diagnosed in 2001. Most of these cases are attributed to intravenous drug use. But, according to Radio Free Europe/Radio Liberty, 400 infected women gave birth in a single hospital in St. Petersburg in first nine months of 2002 - compared to 149 throughout last year. About one third of neonates test HIV-positive within 24 months. The disease has broken loose.
How misleading even these dire data are is revealed by an in-depth study of a single city in Russia, Togliatti. Fully 56 percent of all drug users proved to be HIV-positive, most of them infected in last 2 years. Three quarters of them were unaware of their predicament. One quarter of all prostitutes did not require their customers to use condoms. Two fifths of all "female sex workers" then proceeded to have unsafe intercourse with their mates, husbands, or partners. Studies conducted in Donetsk, Moscow and St. Petersburg found that one seventh of all prostitutes are already infected.
An evidently shocked compiler of results states: "The study lends further credence to concerns that HIV/AIDS epidemic in Russian cities could be considerably more severe than already-high official statistics indicate." The region's governments claim that 1 percent of population of countries in transition - still a hefty 4 million people - use drugs. But this, too, is a wild underestimate. UNAIDS itself cites a study that concluded that "among Moscow secondary-school students ... 4% had injected drugs".
Quoted in Pravda.ru, The Director of Federal Scientific Center for AIDS at Russia's Ministry of Health, Vadim Pokrovsky, warns that Russia is likely to follow "African model" with up to an 80 percent infection rate in some parts. Kaliningrad, with a 4 percent prevalence of syndrome, he muses, can serve as a blueprint for short-term development of AIDS epidemic in Russia.
Or, take Uzbekistan. New infections registered in first six months of 2002 surpassed entire caseload of previous decade. Following war in Afghanistan, heroin routes have shifted to central Asia, spreading its abuse among destitute and despondent populations of Azerbaijan, Kazakhstan, Georgia, Kyrgyzstan, Tajikistan and Uzbekistan. In many of these countries and, to some extent, in Russia and Ukraine, some grades of heroine are cheaper than vodka.
Ominously, reports European enter for Epidemiological Monitoring of AIDS, as HIV cases among drug users decline, they increase exponentially among heterosexuals. This, for instance, is case in Belarus and Ukraine. The prevalence of HIV among all Ukrainians is 1 percent.
Even relative prosperity and good governance can no longer stem tide. Estonia's infection rate is 50 percent higher than Russia's, even if AIDS cesspool that is exclave of Kaliningrad is included in statistics. Latvia is not far behind. One of every seven prisoners in Lithuania has fallen prey to virus. All three countries will accede to European Union in 2004. Pursuant to an agreement signed recently between Russia and EU, Kaliningrad's denizens will travel to all European destinations unencumbered by a visa regime.