Is Russia's HIV/AIDS problem worse than Africa's?

The New York office director of UNAIDS, Bertil Lindblad, is worried about the one region of the world where HIV infections are increasing, even as rates in the rest of the world level off. It's not in Africa or Asia, or even Latin America. It's Eastern Europe -- countries like Russia and Ukraine -- where a recent UNICEF report notes that increases in infection rates of as high as 700 percent have been seen since 2006.

"There is an urgent need for the whole Eastern European and Central Asian region to act quickly," Lindblad said this morning. "This is really quite scary given the fact that there is denial, and so much stigma and homophobia [in that region.] This could really create huge problems if HIV continues to spread from smaller groups in the population to wider."

It's HIV/AIDS's silent crisis, one that has been underway for the last decade. The region is home to a quarter of all injection drug users in the world (3.7 million), and this is where the epidemic is believed to have begun. These users are young -- most of them teenagers. But from there, HIV spread to sex workers (the majority of whom are also under 30), and now has fully moved into the everday lives of men and women in the region, married and unmarried. A mark of the epidemics progression -- from specific populations into the majority -- is the new incidence of HIV among women, who account for 40 percent of all new infections (that's up from only 24 percent at the turn of the century.)

The stigma attached to the disease -- and more importantly, to the groups of people percieved to be the majority infected with it -- is the biggest obstacle to doing anything about the disease. "Those living with HIV have been silenced and excluded, and risky behaviours borne of futility and hopelessness have been sanctioned or repressed," the UNICEF report notes. Government officials are said to be resistant to admitting the scale of the problem, and today that country remains a difficult places for AIDS advocacy, says Lindblad, who formerly worked in the UNAIDS office in Moscow.

But where there is challenge such as this, there is also often opportunity. Russia, I would think, should have a very serious interest in addressing this crisis. For starters, because AIDS threatens to exacerbate its larger demographic problem -- that of a fast-shrinking population. But the other point might be even more convincing: The injection drug users are using heroin. And that heroin comes from Afghan poppies. For Russia, tackling the illegal drug market in Afghanistan -- one which fuels the insurgency -- is a serious national security issue.

Of course, good old fashioned peer pressure might help edge them along as well. And when the U.N. General Assembly meets later this month, one of the side conversations, according to Lindblad, will be a discussion on HIV/AIDS "co-hosted by the government of China, the government of Nigeria, and UNAIDS," specifically, the Chinese premier and the Nigerian president (South Africa's President Jacob Zuma was also supposed to come, but had to cancel.) "That could influence other big countries such as Russia, for example, to turn around."



Study: Australians and New Zealanders are the world's most generous people

The Charities Aid Foundation has launched the World Giving Index, an interesting tool for measuring generosity. The index uses Gallup survey data on the percentage of a population that has given money or time to charity or helped a stranger to rank countries by charitability. The countries in the top 5 -- Australia, New Zealand, Canada, Ireland, Switzerland, and the United States, are not all that shocking, but there are some surprises in the top 20 including Sri Lanka, Laos, Sierra Leone, and Turkmenistan. The people of Turkmenistan turn out to be the most generous with their time -- though you have to wonder about the reliability of survey data in a country with a government as authoritarian as Turkmenistan's -- while Liberians are most likely to have helped a stranger. 

Overall, the study concludes, generosity seems to be correlated more strongly with measures general well-being than with GDP. (Sierra Leone, which has one of Gallup's lowest well-being scores is the major exception.) The numbers also don't seem to be that closely correlated with governmental foreign aid. The people of Sweden, who have the world's most generous government by far, are a relatively lowly 45th on the Giving Index. 

On the stingy end of the scale are some countries that can probably be excused -- Madagascar, Burundi -- as well as a few that should probably be embarrassed. Rising power China is seventh from the bottom. Greece, which just received a second installment of emergency EU loans worth $11.4 billion and loses more than $20 billion per year to tax evasion, is fifth from the bottom.