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

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SUMMARY
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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
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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
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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
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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
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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
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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