Ministry of Health's new HIV strategy does not meet WHO recommendations
The Ministry of Health has developed a draft strategy to combat the spread of HIV until 2030. The document was sent for approval to the federal executive bodies.
The current version of the strategy, Kommersant writes, does not comply with WHO recommendations.
The previous strategy, the implementation term of which ends this year, was developed in 2016. It appeared after the head of the federal center for the prevention and control of HIV infection Vadim Pokrovsky announced a national disaster - as he called the situation with the spread of HIV in Russia in 2015. According to him, the number of infected people will exceed 1 million at the beginning of 2016.
The current strategy was criticized by experts. They drew attention to the fact that among the priority preventive measures were given to "family and moral values, rejection of risky behavior models, as well as the harmfulness of bad habits". The document also spoke about the role of NGOs that have access to risk groups, about “involving civil society in solving problems associated with low adherence to diagnosis and treatment in people living with HIV infection”.
The project noted that during the implementation of the strategy the annual dynamics of improving the epidemiological situation in the country was recorded.
- In the period 2006-2015, there was an increase in the number of newly diagnosed cases of HIV infection by almost 10% annually, and in recent years the number of people diagnosed with HIV infection for the first time has been declining annually from 85.8 thousand people in 2017 up to 83.4 thousand people in 2019, the project says.
The aim of the new strategy is “to prevent the spread of HIV infection in the Russian Federation by achieving a continuous reduction in the number of new infections… so that by 2030 this disease will no longer be a threat to public health”.
Note that by May of this year, according to Rospotrebnadzor, 1,087,050 citizens with a laboratory diagnosis of HIV infection live in Russia.
To achieve this goal, the authors of the document suggest "raising the awareness of citizens of the Russian Federation," "providing a comprehensive interdisciplinary approach in providing medical care and social support to people infected with HIV", "ensuring the availability of antiretroviral drugs".
The priority direction of primary HIV prevention is again called "advocacy." According to the drafters of the project, it “will allow the population to form the skills of a responsible attitude to their health, motivate citizens, including representatives of the youth community, to take safe behavior, and will also help strengthen traditional family and moral values”.
The document promises to update treatment regimens based on WHO recommendations. It is also promised to take into account the combination of the disease with viral hepatitis B and C, tuberculosis in the prevention, diagnosis and treatment of HIV patients, to develop HIV prevention programs for all regions separately and to combat discrimination.
Experts noted that the new strategy almost completely - 80% - duplicates the previous one.
According to Academician Pokrovsky, this is "clearly a technical solution".
- In fact, the previous strategy was not very good, and successes were achieved very modest. It was necessary to make more radical proposals”, - he stated.
According to him, the Ministry of Health has changed the system for counting new cases of HIV - only those registered are added. This explains the “sharp decrease” in the number of new cases. Rospotrebnadzor includes all registered cases.
Pokrovsky called non-specific the main goal of the current strategy - to reduce the threat to public health. He pointed out that the authorities of the Russian Federation act on the principle of "identify and treat." At the same time, only half of the measures recommended by WHO and which are practiced in other countries of the world where there are “special programs for key risk groups”, “pre- and postexposure prophylaxis”, and “training the population in safe behavior” are used.
Denis Godlevsky, the head of the HIV-AIDS organization AIDS, Statistics, Health, said that in the previous strategy, prevention was not focused on key groups, but on the general population.
“And this is almost the same as in this strategy, and also does not correspond to the approaches of the UN International Program on HIV / AIDS and WHO”, - he said.
Recall that earlier, Russian President Vladimir Putin instructed the Cabinet to develop a document taking into account WHO recommendations. Godlevsky notes that the new strategy uses a classification of risk groups that is not consistent with WHO.
“The WHO recommendations also explicitly speak about the correct and constant use of condoms and lubricants in order to prevent HIV transmission, pre-exposure and post-exposure prophylaxis of HIV infection, low-threshold testing and prevention programs,” the expert said, pointing out that in the new document no measures are contained.
The head of the monitoring department of the Coalition for Preparedness for Treatment project, Alexei Mikhailov, described the document as “weak” and pointed out that the role of Non-profit organizations in the new strategy is limited to “at the discretion of local authorities”.
- Non-profit organizations do not appear in this document as fully legitimate participants in the development of programs and tasks to combat the spread of HIV both at the federal and regional levels. Once again, they are only performers”, - the expert noted.
Earlier, the Ministry of Health proposed the introduction of postexposure HIV prophylaxis.
Recall that the journalist Mikhail Makogon, who analyzed the reasons why the country cannot cope with the HIV epidemic, wrote that "the problem of HIV in Russia is not even in the monstrous statistics, but in the reason leading to it".