The vast majority of the world does not fulfill its obligations to combat the spread of HIV, recognized experts of the joint UN programme on HIV/AIDS (UNAIDS) in its annual report. Of the approximately 200 countries obligated by the end of 2020 to identify 90% of people living with HIV, providing 90% of them medicines, this could only be done 14 countries. UNAIDS notes that HIV is spreading mainly in the countries of Eastern Europe and Central Asia, but Russia’s contribution can not evaluate: the Russian Federation did not provide data.The global aim of the countries was to achieve by the end of 2020 indicators, which would ensure a gradual eradication of infection: 90% of people living with HIV should know their status, 90% of them should receive antiretroviral treatment, 90% the latter must be suppressed viral load. By achieving these results, the international community hoped to defeat the HIV epidemic by 2030. However, the report (.pdf), called “do Not miss the moment”, it is stated that only 14 of the nearly 200 countries that support the Declaration of 2016 for the elimination of HIV has reached the targets by the deadline. Speech, in particular, Australia, Botswana, Cambodia, Ireland, Spain, Thailand and Uganda. “Due to the fact that progress has been unevenly distributed within countries and between countries, the global goals on HIV set for 2020 will not be met”— recognize in UNAIDS.The report noted that of the 38 million people living with HIV are receiving treatment 25.4 million patients: “This means that 12.6 million are still waiting.” The Executive Director of UNAIDS Winnie Byanyima noted that in 2019 the world was 690 thousand deaths from AIDS and 1.7 million new cases of HIV infection. “This is very far from the global targets set for 2020: at least 500 thousand deaths and at least 500 thousand cases of infection,” she said.Mrs. Byanyima pointed out that “the epidemic situation in many countries worsens”: “Since 2010, the growth of new infections was 72% in Eastern Europe and Central Asia (EECA), 22% — in the middle East and North Africa and 21% in Latin America.” In the classification of UNAIDS Russia included into the group of EECA countries, there is a number of CIS countries. In addition, a record compared to other countries the increase in incidence in this group is marked and the rise of deaths associated with HIV infection, 24%.Earlier, UNAIDS noted that Russia’s contribution to the morbidity among the EECA countries reaches 80%. Now the organization noted that, most likely, this percentage has remained the same, however exact figures are not possible. The report did not contain data about what Russia’s contribution to the increase in incidence in this group, also presented the progress of Russia in achieving the goals of the “90-90-90 target”. As explained to “Kommersant”, the acting regional Director of UNAIDS for Eastern Europe and Central Asia Alexander Goliusov, “for the formation of the global assessments used a special software which is supported by UNAIDS and adopted by more than 150 countries for reporting, including for Russia”: “the Last time Russia applied this methodology for 2017 — 2018”. “But for later years the data provided by Russia, unfortunately, did not meet the methodological requirements,— he noted.— The software uses to calculate the data of epidemiological surveillance, whereas Russia 2018 was to provide and calculate their data based on the so-called Federal register, which takes into account only the data of people living with HIV, who embarked on a clinical account”. Has not provided the necessary data also Bosnia and Herzegovina, Turkmenistan and Uzbekistan, only partial data was prepared by Belarus and Northern Macedonia. Leaders on the first indicator “90-90-90 target” among the EECA countries are Kazakhstan (77%) and Armenia (75%), the second — Georgia (87%) and Armenia (83%), the third — Ukraine (95%) and Montenegro (94%). The average target performance on all EECA countries who provided data to the end of 2019, made up 70-63-93.The report, however, notes that in the countries of the region, “especially in the Russian Federation, there is a large gap between HIV testing and treatment In the region, only 63% of people who know their HIV status, are on treatment, only 41% of all people living with HIV have a suppressed viral load”. The report indicates that the region insufficient attention is paid to risk groups, particularly drug users, with sex workers and LGBT people. Especially it is noted that in the region stigmatized and discriminerende the last group. “We need to make significant efforts to reverse current trends, ensuring including the wider provision of services for HIV at the level of at-risk groups such as HIV self-testing, the introduction of harm reduction programmes, pre-exposure prophylaxis”,— stated in the report.We will remind, in present in Russia is developing a new government strategy to combat the spread of HIV (see “Kommersant” on June 11). First draft criticized the relevant NGOs, as well as the head of the Federal scientific and methodological center for prevention and fight against AIDS Vadim Pokrovsky: this document, they noted, was largely duplicative of the previous strategy, which was mainly aimed at HIV prevention among the General population, not in high-risk groups. On 30 June the health Ministry held a meeting with representatives of NGOs, after which the Ministry has distributed�� new version of the document.”The fact that Russia has a strategy, is already very good,— noted in conversation with “Kommersant” Mr. Goliusov.— Progress, of course: significant testing coverage, increase the availability of antiretroviral drugs, the reduction of transmission of the virus from mother to child. But this is a rather modest success. And Russia, unfortunately, like most countries, this year is unlikely to reach the objectives that have been set, the 90-90-90 target. To say that the strategy has provided some kind of breakthrough, it is not possible”. “Achievements could be much more effective and meaningful if the emphasis was not on prevention among the General population, namely the core groups,”— said the expert. He stated that the draft of the new strategy (the Ministry of health has introduced its second variant) “more attention is paid to the target groups of the population — and this is extremely important today.” Also in the second embodiment, there are new item targets, which was not in the first, the number of new infections. “This is a correct epidemiological approach,” said Alexander Goliusov.Valeria Mishina
