Tragedy in Romania: HIV and Shakespeare

Romania would be better off paying for more Shakespeare festivals than for HIV-prevention efforts, the country’s culture minister recently said.

Last December, our Minister of Culture said that Romania would be better off paying for more Shakespeare festivals than supporting efforts to prevent the transmission of HIV.
In the wake of furor over this statement, the Minister resigned. However, many Romanians at risk for HIV are left to hope that the sentiment underlying his comments—namely, that programs to prevent HIV are a waste of taxpayers’ money—will be as easy to dislodge as the man himself.

Romania is currently experiencing a spike in HIV rates that hits hardest among the most vulnerable populations, such as people who use drugs. Meanwhile, Romanians find themselves caught between a lack of clear national commitments to HIV prevention, and diminishing funds for HIV responses in the context of European and global austerity.
In the 1990s, our government and the world rallied to help Romanian orphans with HIV. At the same time, other groups at risk—particularly people who inject drugs—have received less support. Since then, big donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria have supposed that Romania is too rich to continue receiving support, and international funding for Romanian programs to reduce drug-related HIV transmission have all but disappeared.
Not surprisingly, HIV infections among at-risk populations are skyrocketing. A 2012 report on the outbreak of HIV and AIDS among injecting drug users in Romania, co-authored by National Antidrug Agency, the Romanian Association against AIDS, the National Institute for Infectious Diseases and Carusel Association, reports a spike in HIV rates from 3 to 5 cases annually between 2007 and 2009, to 12 cases in 2010, to 129 in 2011.
Halfway through 2012, 102 new cases were already registered—more than three times the number reported for the same period in the previous year. ARAS and Carusel, two community-based organizations, report that HIV-positive cases among injection drug users tested at their drug treatment services have exploded from 1.1 percent in 2008 to 11.6 percent in 2011.
These numbers have been rising still further as funding for HIV prevention continues to erode. This summer, the European Union ended its financial support for programs in Romania that distribute clean needles and syringes. The Romanian government has been slow to respond, despite the fact that initiatives such as needle and syringe programs that have been proven in repeated scientific studies to reduce incidence of by as much as 80 percent among people who inject drugs. The city of Bucharest has put forward some support by purchasing needles and issuing a call for proposals—but the urgent need still greatly outstrips the supply.
Those who think that HIV among drug users is “not their problem” are short-sighted. Like all easily transmissible diseases, HIV does not remain localized in one community. Countries that have ignored or responded inadequately to HIV epidemics that centered on their drug-using populations, such as the Russian Federation and Ukraine, are now seeing the disease spread to the general population through sexual contact.
The cost of ignoring HIV can be felt in other ways too. While clean needles cost mere cents apiece, their availability to the people who use them saves hundreds of thousands of dollars in infections prevented. The Minister of Culture’s remarks were a bald expression of prejudice.
There is no cure yet for AIDS, but there are demonstrated ways to prevent HIV transmission. Romania must provide the necessary funds for these, and so help cure the other crisis in our country—indifference.
Failure to respond? Now, that would be a tragedy of Shakespearean proportions.

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