AIDS IS NOT A SENTENCE

In recent years the humankind has made progress in the fight against HIV/AIDS. The infection with this disease does not mean a sentence. New therapies, drugs, and prevention help to significantly improve the statistics of deaths from the disease, and reduce the number of the infected people.

The Azerbaijani Health Ministry's centre for fighting AIDS reports that as of 1 January 2013 года the number of registered HIV patients in the country stands at 3,784 people. Of these, 3,656 (96.6 per cent) are Azerbaijani citizens and 128 (3.4 per cent) are foreigners.

Dr Jean-Elie Malkin, Director of the UNAIDS Regional Support Team for Eastern Europe and Central Asia, courteously agreed to give an interview during his visit to Baku and answer some questions of R+ regarding this problem.  

A specialist in infectious and tropical diseases, Dr Malkin was one of the first physicians who faced the problem of HIV infection in a Paris hospital in 1982. He has many years of experience in the treatment of HIV-positive patients, particularly in the Paris-based Pasteur Institute medical centre.

- A global fight against AIDS has been under way for many years now. How do you assess its results: is the mankind prevailing, has the war against AIDS been lost, or is there a parity of sorts?

- I am quite upbeat on this matter. We first registered the beginning of the HIV/AIDS epidemic 30 years ago. Now we can see a considerable progress in the area of fighting the disease. We can say that we are on our way to tackle this problem. All positive changes have been achieved thanks to AIDS prophylactic measures. For instance, the curve of the diagram of new cases of HIV infection in some African countries, having reached its peak, has begun to decline. But this applies to the African region, which created and used quite effective medicines to prevent the transmission of HIV from an infected person to a healthy one. We have effective tools to ensure a reverse of the HIV/AIDS epidemic in the world.

But, unfortunately, it is impossible to say that Eastern Europe and Central Asia in this respect are the successful regions. So far in this region, which includes Azerbaijan as well, the epidemic is at the stage of increasing.

Therefore, we must make strong efforts with the governments of regional countries to convince them of the necessity of implementing those strategic directions that have proven effective in other regions. We know that large funds have been expended on fighting the disease. But in order to attain a sustainable effect in the future it is necessary that the state make more investments in the fight with AIDS.

- And how do you assess the AIDS situation in Azerbaijan? Have all mechanisms of struggle been utilized?         

- The situation in Azerbaijan is about the same as in other countries of the region. As they say, "the glass is both half full and half empty". We must note that many good results have been achieved in fighting HIV in Azerbaijan. Here it is necessary to point out the efforts of the Global Fund to Fight Tuberculosis, Malaria and AIDS. We got a good stock of progress on the program to prevent HIV transmission from mother to child. Good results have also been achieved in providing antiretroviral therapy to HIV-infected people. But this is not enough. Fortunately, Azerbaijan is not a country where HIV/AIDS has taken a threatening nature. If you follow the directions: proper testing for HIV, effective action for prevention among at-risk groups and appropriate costs to the state, the country will experience a significant success in the fight against HIV.

- It is clear that in Azerbaijan the state and society seek to get rid of the HIV threat. What steps must be taken first?

- The global community has now entered a completely new stage of fighting HIV/AIDS. The situation is drastically different from what it was 15-20 years go. Cheaper and more accessible treatment is now available. Proper testing strategy, that is, rapid diagnosis, implementation of necessary programs among at-risk groups, use of antiretroviral therapy - are the keys to success in the fight against HIV/AIDS.          

Of great importance is the methadone maintenance therapy, used to treat drug addiction. Azerbaijan was one of the first CIS countries to begin using the methadone program, but it was not taken further from here. Only about 150 people had the opportunity to take advantage of this program, while there are many more people in need of replacement therapy. However, this therapy is one of the most effective mechanisms for the prevention of HIV/AIDS. In general, all the tools to fight HIV are employed in Azerbaijan. To be successful in this undertaking we need to develop the mechanisms that have proven effective.

According to unofficial data, the number of HIV-infected people in Azerbaijan ranges from 8,000 to 9,000 people. Of course, it will be difficult, but still with the correct implementation of the said measures in a few years Azerbaijan will be able to achieve very good results in the fight against the AIDS epidemic. Otherwise, the situation would not be good, i.e. the epidemic will go beyond the risk groups and will gradually spread to the general population.

- Along with fighting HIV/AIDS UNAIDS also deals with a host of other issues that are conducive to the expansion of this epidemic: gender equality, fight with stigma and discrimination and so on. What is the situation in Azerbaijan with regard to tackling these problems?

- We can say that on balance the situation in Azerbaijan in this regard is not too bad. It is not the best, but also not the worst compared to other countries. In general, this issue in Azerbaijan is not a barrier for the fight against HIV. We must note that all countries of the world face the problem of stigma and discrimination of the people who live with HIV. The elimination of these negative phenomena plays an important role in the prophylactics of HIV/AIDS. Incidentally, the local civil sector and other international organizations make an important contribution to resolving these problems.

- When could we expect the invention of a means to completely treat HIV?

- Regrettably, this cannot be predicted. Twenty years ago the scientific community promised that in five years a vaccine against HIV will be invented, but it is still not there. What is clear is that the scientific community fighting the disease has entered a new era, a new stage. And we already have specific results of fighting against HIV.

- There have been lately reports on the internet that questions the results of research and the commonly accepted scientific explanation of the AIDS nature…      

- In all times there have been people who doubted everything. For example, there are peple who will question that the Earth is round. The mass media have the crucial mission to impart to the people correct information on HIV based on scientific data.

- How has the global economic crisis affected the fight against HIV/AIDS? Any fight with this disease demands large expenses…

- Due to the economic crisis, rich countries are showing less interest on investing not only in the fight against HIV/AIDS, but in general the assistance to social development in various countries. Therefore, we need to work more efficiently with the available or even fewer resources. At the same time, each state should adequately invest in the fight against HIV. I think that for Azerbaijan, with its stable economy, this issue is not particularly difficult.