The Emerging Security Threat of HIV/AIDS: Russia

I want to thank the East-West Institute, in particular John Mroz and John Tedstrom, for organizing today's important meeting. I wish to express my condolences to Chairman Mikhail Margelov, who, I understand, due to a death in his family, is not able to be with us today. I appreciate that Mr. Andrei Kozlov is able to join us. I also look forward to hearing from Dame Pauline Neville-Jones. It is vital to engage Russian leadership in the fight against HIV/AIDS and the establishment of the East-West Institute's Working Group Against HIV/AIDS is most welcome.

Today's session devoted to HIV/AIDS is very timely, coming on the heels of two recent meetings the State Department recently organized in Kiev and Moscow on this very issue. At those meetings, our embassy in Kiev and our embassy in Moscow brought together our ambassadors and health experts from the region and from the U.S. to strategize and brainstorm on ways we can help Eastern and Central Europe and Eurasia confront the threat posed by HIV/AIDS. We were pleased that the East-West Institute's Stephen Massey could attend and contribute to the meeting in Kiev.

This meeting comes exactly a month after President Bush announced his path-breaking initiative to fight AIDS, especially in Africa and the Caribbean, through commitment of $15 billion over the next 5 years. I was in South America when the President delivered his State of the Union speech and was struck by the positive reaction I heard to his initiative.

Rest assured that the focus on Africa and the Caribbean in his remarks in the State of the Union speech and later at his Advisory Council on HIV/AIDS does not mean the end to HIV/AIDS assistance programs in Russia and Eurasia. In fact, the President stated that our bilateral programs outside of Africa and the Caribbean will continue. He also stressed the continued commitment of the United States to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The President's proposal of $1 billion for the Fund and the selection of HHS Secretary Tommy Thompson as the Fund's chair underscore our unwavering support to make the Fund a major success.

HIV/AIDS, the President noted, poses a "severe and urgent crisis abroad." Secretary of State Colin Powell has called it one of the greatest threats we face in the world today. More than 8,500 people die from AIDS and its complications every day around the world. Twenty million people so far have died from AIDS. More than 40 million people are living with HIV/AIDS.

I commend the East-West Institute for focusing attention on the problem of HIV/AIDS in Russia. HIV/AIDS is indeed a security threat to Russia, as much as it is a threat to the country's political, social, and economic stability. It is a health problem and a humanitarian issue. It is all of these things rolled into one.

Official statistics list roughly 200,000 Russians as HIV positive. Academic and medical experts believe the number is much higher, probably between one and two million already. As UNAIDS has reported, the states of the former Soviet Union have the highest growth of HIV infections in any part of the world today.

Tuberculosis is a huge problem in Russia as well. AIDS patients often become incubators for tuberculosis and other dangerous diseases. In many cases, TB has become resistant to the drugs now used to treat it.

According to the National Intelligence Council in a report released last summer, Russia could have eight million new HIV infections in the next decade, equal to ten% of the Russian workforce. That is a truly staggering statistic. Russia already faces a decline in population; the emergence of a rapidly spreading AIDS problem will turn this into a crisis.

The good news is that many of the predicted eight million new infections can be avoided with proper education and prevention programs. The bad news is that not enough is being done in Russia to ensure that these infections are in fact prevented. The very fact that Russia has committed more money to the Global Fund than it spends on its own domestic AIDS programs -- $20 million versus less than $6 million -- reflects a prevailing view that the virus threatens other countries, not Russia. As you all know, this is not the case.

Moreover, there also seems to be a widespread belief, sadly, that HIV/AIDS affects those who deserve it, the dregs of society. This attitude is not unique to Russia, of course, but it is dangerous nonetheless. Because HIV/AIDS has been spread first and foremost among intravenous drug users in Russia and through the prison population, there is a mistaken theory that the virus can be contained to those so-called marginalized, undesirable segments of the population. Such views underestimate the ease with which the virus can spread to the general population through mother-to-child transmission, unsafe intercourse, and contaminated blood.

Furthermore, such views should not be tolerated, for those living with AIDS are not the enemy, the virus is. As the President said in remarks last month, "America believes deeply that everybody has worth, everybody matters." That should be a universal belief.

Secretary Powell, speaking before the foreign diplomatic corps last December to mark World AIDS Day, addressed the issue of stigma and discrimination most eloquently. "Like all great evils," he said, "AIDS feeds on ignorance and fear. When people lack knowledge of how infection can be prevented and when those infected are stigmatized and driven into the shadows, the virus thrives and hope withers. Consigning the disease to silence means condemning more and more of our citizens to death. All of us have a responsibility to send the message that the virus is the enemy, not the men, women and children who contract it -- that people living with AIDS should not be treated with cruelty and discrimination, but with dignity and compassion."

Our experience in other parts of the world indicates that successful public health programs to deal with HIV/AIDS, such as those in Thailand, Senegal, and Uganda, occur only when the head of government and the social, cultural, religious, and business leadership of the country actively lead the campaigns. As the first leader to pledge a contribution to the Global Fund in June 2001, President Bush stepped up to the plate again last month with his AIDS initiative.

We hope to see more said and done on the battle against AIDS in Russia. President Putin has discussed HIV/AIDS in public very rarely, if at all. The Russian Minister of Health has stated that the Russian government and people do not comprehend the danger of HIV, and the health system is unprepared to fight the pandemic. Regional officials and sports, entertainment, business, or religious leaders can and must do more to counter the epidemic and raise awareness.

When I was in Moscow to attend the embassy's meeting on HIV/AIDS, Ambassador Vershbow hosted a reception at his residence at which we had a most impressive turnout -- people from all walks of life were there. I took some comfort from the fact that so many people came to hear the message that the United States is concerned about the spread of HIV/AIDS in Russia and wants to help.

Indeed, our task is to help the Russian government and social leadership mobilize and begin to work against AIDS. Each of us here today has the power to act. The positions we hold give our voices resonance. We can and must convince people in Russia -- and everywhere around the world, for that matter -- of the urgency and gravity of this global problem. We should bring it up in every one of our contacts with our Russian friends in every part of the country.

Ambassador Vershbow personally has done a great job in raising attention to this issue. In a recent trip to Saratov, he participated in several events which drew attention to the epidemic. I was particularly impressed with his efforts to reach out to young people in discos who are at risk. A USAID-funded program in Saratov illustrates that local/regional programs can be very effective, and could be even more effective if they received more support from Moscow.

USAID and its sister agency, the Centers for Disease Control, already have several programs operating in Russia largely focusing on AIDS awareness and strengthening NGOs. USAID will spend $4.3 million on AIDS in Russia in 2003. Britain and the UN also have programs.

We are prepared to work more closely with Russia on the HIV/AIDS issue, both bilaterally and in multilateral fora. The Russian Government's contribution to the Global Fund is greatly appreciated. There are also untapped resources in Russia's private sector that could be targeted to the country's domestic campaign against HIV/AIDS. In addition, Russia, with its tremendous scientific talent, has much to contribute to the fight against AIDS through research for better treatments and even a cure. We must find ways to tap into Russia's talent pool and work together to find an end to this scourge. Our relationship with Russia need not be a one way street wherein we simply provide assistance. Russia has much to bring to the table as well. But all our efforts will have limited results until President Putin and the Russian government get behind the need to act.

I am also encouraged that the East-West Institute will be holding further workshops this spring in both Moscow and Washington on how to approach the HIV/AIDS problem. The Institute's role in this campaign is a perfect example of how, through public-private partnerships, we all can make a difference.

Thank you for inviting me here today and for brainstorming on ways we can make a difference in the fight against AIDS. On behalf of the Secretary, let me say that the United States remains committed to the fight against HIV/AIDS each and every day -- in Russia and around the globe. It is a critical part of our foreign policy agenda. As the President did last month with his new initiative, we must all rise to the challenge so that one day we can speak of AIDS only in the past tense.