With some of the world's most rapidly rising HIV/AIDS infection rates, Eastern Europe and Central Asia present a snapshot of the face of the virus' newest demographic: young, diverse and at a crossroad.

The infection rate in Eastern Europe and Central Asia has increased more than twenty-fold in less than 10 years, regional experts from the Joint UN Programme on HIV/AIDS (UNAIDS) told a gathering in New York on the eve of World AIDS Day (1 December 2006). The infected population has crossed over from one of mainly intravenous drug users to the mainstream, and in many countries more than 75 per cent of those infected is under 30 years old.

In such an environment, suppressing the spread of the virus is of utmost urgency. "The clock is ticking and the window of opportunity is very quickly closing", said Bertil Lindblad, UNAIDS representative to the Russian Federation. According to the recently released UNAIDS/World Health Organization AIDS Epidemic Update, the Eastern European region has more than 1.7 million reported cases of HIV/AIDS. While this number is dwarfed by sub-Saharan Africa's 24.7 million cases, it is an alarming statistic for a region where the virus arrived relatively recently, he said.

UN AIDS photo

"It's the most dramatic [regional increase] in the world now", agreed Tonka Varleva, Secretary-General of Bulgaria's National Committee on AIDS Prevention. But there is hope for the region as well, she said. At a conference in Bucharest, Romania in March 2006, ministers met to discuss stronger commitments to solving the AIDS crisis. In Bulgaria, some of Eastern Europe's earliest anti-HIV/AIDS measures have evolved into a model for neighbouring countries. It has been offering its citizens free HIV-testing, monitoring and even treatment since 1986. Bulgaria now uses a $15 million grant from the Global Fund to continue this programme, while adding new progressive measures, such as establishing local drop-in counselling centres, needle-exchange programmes and even mobile medical units to visit at-risk neighbourhoods. However, funds continue to be tight, Dr. Varleva said. And like most of the region, Bulgaria struggles with intense stigma and discrimination.

New hope also arose in April 2006, said Mr. Lindblad, as the Russian Federation's governing Council met for over four hours on the topic of HIV/AIDS, during which President Vladimir Putin and the Council established the National AIDS Commission, charged with overseeing national aspects of the struggle against the virus. The meeting is the country's most serious high-level discussion on the epidemic to date, he said, adding that he hopes it will inspire significant action on the part of Russia's leadership. "We really need national strategies for prevention", he said.

While some Eastern European States have mobilized against the crisis quickly, still others find themselves lagging. At-risk communities - especially drug users, sex workers and marginalized ethnic minorities - continue to flourish in parts of the region, and many nations lack the capital and infrastructure needed to effectively counteract the disease. Both experts noted that basic health education is essential. Bulgaria has hesitantly installed sexual health curricula in some of its schools, Dr. Varleva said, but like most HIV/AIDS work, this kind of progress is difficult.

Since it was declared by the United Nations General Assembly and the World Health Organization in 1988, World AIDS Day has been celebrated annually on 1 December, giving people around the globe an opportunity to reflect on the struggles and successes of the fight against AIDS. The year 2006 is a particularly poignant commemoration, as it marks the 25th anniversary of the first diagnosed case of the virus.

Please join the UN Chronicle in supporting the struggle against HIV/AIDS on Friday, 1 December, by wearing a red ribbon. To find out how you can help, http://www.unaids.org.