AIDS IN LITHUANIA

UNCLAS SECTION 01 OF 02 VILNIUS 001447 SIPDIS STATE FOR EUR/NB, EUR/PGI:BPOMAINVILLE, IO/T/HTTP:ABLACKWOOD, M/R:APONCE, OES/IHA, S/ES/SWO:KMAYFIELD, AND USAID:LMORSE HHS FOR WSTEIGER E.O. 12958: N/A TAGS: TBIO KHIV PREL LH SUBJECT: AIDS IN LITHUANIA REF: A) VILNIUS 540, B) VILNIUS 880, C) VILNIUS 1180 -------------- SUMMARY -------------- ¶1. As it prepares to celebrate World AIDS Day, Lithuania's incidence of HIV/AIDS is the lowest in Central and Eastern Europe. The GOL is working to keep it that way, despite pressures of rapid social change. Lithuania has a National HIV/AIDS prevention strategy, but poorly monitors its implementation. The Embassy continues to reinforce GOL efforts to combat HIV/AIDS by encouraging discussion at the policy-making level and funding professional training and cross-border collaboration. End Summary. HIV/AIDS demographics in Lithuania -------------- ¶2. Lithuania has to date registered 928 HIV positive patients since its first case in 1998 -- the vast majority in the last three years. Transmission of more than 80 percent of cases occurred through shared needles. Some 241 cases are located in Lithuania's third-largest (port) city of Klaipeda, 148 in Vilnius, and 34 in the nation's second largest city of Kaunas. Approximately 76 persons carry the diagnosis of AIDS and 34 persons have died from the disease. ¶3. The European HIV Monitoring Center lists Lithuania as a country with a low rate of HIV infection. Lithuania's HIV rate per 100,000 people was 24.4 in 2003, in contrast to 470 in Russia's Kaliningrad region, 272.2 in Estonia, 169.6 in Russia as a whole, 112.9 in Latvia, and 49.7 in Belarus. Trends point to a probable increase -------------- ¶4. Health Minister Juozas Olekas recently stated that although the number of HIV cases in Lithuania is low, the country may face new threats arising from increased exposure to surrounding countries with a higher number of infected people. For instance, exposure to disease in the Kaliningrad region has increased due to recent growth in business and leisure travel (including sex tourism). Likewise, greater exposure to Latvia's higher rate has followed the easing of travel restrictions across the two new EU member-states' common border. Mazeikiai, a Lithuanian transit point for truck drivers on the border with Latvia, has one of the highest rates in the country. ¶5. Dr. Saulius Caplinskas, Director of the Lithuanian AIDS Center, told us that the GOL must step up its surveillance of high-risk "bridge populations," such as drug abusers, prisoners, and their sexual partners, to prevent them from infecting the general population. He said that free movement of persons within the EU, new kinds of injectable drugs, and immigration may introduce new avenues for the spread of HIV/AIDS. Already, twelve refugees in Lithuania have been found to be HIV positive. Caplinskas predicted that absent increased prevention, HIV/AIDS would rapidly spread. He observed that Russia had an epidemiological profile similar to Lithuania's before a lack of early controls permitted the disease to progress unchecked. A recent UNDP report also recommends that Lithuania rapidly undertake appropriate actions to prevent the rate of new HIV infections from increasing. ¶6. Other HIV/AIDS experts endorse Caplinskas' views. Dr. Alvydas Laiskonas, Director of the Kaunas Medical University Infectious Diseases Clinic, said that Lithuania's low rate reflects a lack of active surveillance by public health authorities. Rather than the current practice of testing only risk groups in the capital, he recommended free testing of all volunteers throughout the country, as is the practice in Estonia and Latvia. Laiskonas suggested that the government undertake a strong education campaign stressing prevention among youth. Good national strategy, poor implementation -------------- ¶7. The Lithuanian government approved in 2003 the National HIV/AIDS Prevention and Control Strategy for 2003-2008. The Strategy emphasizes education and treatment of high- risk groups (e.g., intravenous injections users, prostitutes, etc.) and includes program-specific budgeting. The GOL had also constituted a National Coordinating Committee to oversee implementation of this plan. ¶8. The Strategy identifies priorities, implementing structures, activities and timelines, but the Ministry of Health does not monitor its implementation on an ongoing basis. MOH Public Health Division Head Romualdas Sabaliauskas told us that the GOL and the AIDS Center had no information on the actual funds various institutions had allocated to date, the measures they had implemented, and the results they had achieved. Sabaliauskas observed, however, that the Ministry plans to prepare a one-year review report soon. ¶9. A recent United Nations report, evaluating Lithuania's implementation of the Millennium Development Goals, indicated that implementation of the National Strategy lacks sufficient resources. The report urges the GOL to prioritize activities and allocate sufficient funding to support the Strategy's wide range of activities and ensure its implementation. Embassy efforts -------------- ¶10. The Mission is a key contributor to Lithuania's fight against AIDS. We are funding professional training and NGO AIDS advocacy programs here. Embassy programs in 2004, which total $160K, will: -- enhance knowledge in HIV prevention in 10 districts of Lithuania, by training up to 200 health specialists; -- facilitate provision of necessary services to HIV infected persons though an NGO coalition; and -- conduct Lithuanian/Kaliningrad cross-border HIV/AIDS training to promote sharing of Lithuania's experiences with Russian medical professionals. We are also hosting a number of events here during World AIDS Day, including a roundtable discussion inaugurated by the Ambassador that will assemble Lithuania's top authorities on the disease. Comment -------------- ¶11. The GOL has a good plan to tackle HIV/AIDS. Its actions, however, must match its words. Therefore, we will continue to encourage the GOL to ensure effective implementation and funding of its national strategy, by involving all relevant ministries and stakeholders. In particular, we will encourage the GOL to decentralize HIV/AIDS services, and modify provisions of its health law that establish a right of free treatment only for AIDS patients, but not for the HIV infected. ¶12. We will also seek to help the GOL to strengthen capacity at the district level in order to complement efforts at the national level. For this, we will use our training programs to impart to professionals in Lithuania's regions much-needed knowledge on how to improve surveillance of HIV positive individuals and reduce high- risk groups' vulnerability. MULL