UNCLAS ZAGREB 002171

SIPDIS


PLEASE PASS ESTH OFFICER
DEPARTMENT FOR S/GAC AND EUR/PGI/BRETT POMAINVILLE
BUDAPEST FOR KARYN POSNER-MULLEN

E.O. 12958: N/A
TAGS: KHIV PHUM PGOV HR
SUBJECT: HIV/AIDS IN CROATIA: LOW PREVALENCE AND LOW
AWARENESS

SUMMARY AND COMMENT
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1. Croatia's few registered cases of HIV/AIDS and low
knowledge about the disease and how it spreads translate into
an HIV/AIDS strategy focused on prevention and education.
Stigmatization continues be an obstacle, as alarmist press
accounts beat out a small cadre of dedicated health
professionals in dictating the terms of the HIV/AIDS
discussion. A long-overdue updated National Action Plan and
proposed anti-discrimination law are encouraging signs that
Croatia is getting serious about dealing with HIV/AIDS before
it becomes a major problem.


2. This is the first in a series of three cables looking at
HIV/AIDS in Croatia. Reports on Global Fund efforts to
expand free, anonymous testing and efforts to combat high
antiretroviral drug prices will follow septel. END SUMMARY
AND COMMENT

PREVALENCE
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3. With just 470 registered cases in a population of 4.4
million, Croatia's HIV/AIDS prevalence is low. Two hundred
eighteen individuals currently receive drug treatment for
AIDS. Four out of five infected are men. Transmission since
1985 has occurred primarily by sexual contact within the
homosexual (38%) and heterosexual (27%) communities;
intravenous drug users account for 10% of all HIV infections.
Two cases of transmission occurred via blood transfusion in

2004. Most reported cases come from large cities; however,
large cities also have the best mechanisms for reporting new
cases.


4. Official statistics likely underestimate the true extent
of the problem owing to complicated (but improving)
bureaucratic procedures to get confirmed test results and to
register a case with the national health system. Whereas
patients until recently were given a choice of paying cash
for an HIV test or presenting their national insurance card
-- with identifying details -- to their care provider,
Croatia's health system now allows for free and anonymous
testing. Official GoC HIV/AIDS statistics come from drug
treatment centers (including needle exchange centers),
hospitals, HIV testing centers, and blood transfusion centers.

JOURNALISTS AND POLITICIANS FAIL TO SHAKE PUBLIC APAT

HY
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5. Croatia's low prevalence of HIV/AIDS coexists with
sensationalist journalism, silence from political leaders,
and indifference from most of the public. Media coverage
surrounding a trafficking victim in Mostar (reftel) and a man
in Split publicly accused of intentionally spreading HIV
brought HIV/AIDS to the headlines just ahead of World AIDS
Day 2004. A large daily recently ran a headline announcing
that a Split-based herbologist had 'cured' 5 patients of
AIDS. A number of NGO-sponsored group discussions and film
festivals included speeches specifically criticizing
journalists for creating anxieties about AIDS rather than
promoting a serious discussion on how HIV is transmitted and
how Croatians can protect themselves. Yet whereas alarmism
characterizes the reporting on HIV, silence seems more the
rule in the political class, as politicians frequently go to
great lengths to avoid speaking up on HIV/AIDS for fear of
alienating voters. The Church has likewise shied away from
speaking out about HIV/AIDS, though some in the NGO community
have expressed frustration with the Church's obstructionism
in expanding peer education. Tabloid journalism and
political silence in general, however, have done little to
shake public indifference.

REASONS FOR OPTIMISM -- A NEW NATIONAL PLAN AND
ANTIDISCRIMINATION LAW
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6. On the occasion of World AIDS Day, Croatia's reconfigured
National AIDS Committee convened for the first time all year
on December 1 to adopt an updated National Action Plan on
combating the spread of HIV/AIDS. The plan, drafted by the
Ministry of Health to replace the previous 1993 version,
emphasizes assistance to people living with HIV/AIDS,
targeted interventions into at-risk populations, expanded
peer education, upping test numbers through voluntary
counseling and testing centers, and improved surveillance of
how HIV/AIDS spreads in Croatia. The Committee's membership
includes a mix of Ministry of Health politicians,
immunologists, NGOs, doctors, the UNDP Resident
Representative, and a Catholic priest. NGOs and GoC


representatives were united in supporting the updated plan as
a positive step towards de-stigmatization and prevention,
while stressing that its implementation -- with Global Fund
assistance -- had been ongoing since 2003.


7. Croatia has no law banning discrimination against
individuals with HIV/AIDS; however, the Labor Law provides
some protection from discrimination in hiring and firing.
Several HIV-themed NGOs recently teamed up with a professor
from the Zagreb Faculty of Law to draft a comprehensive
anti-discrimination law that would incorporate HIV/AIDS
discrimination into a larger disabilities movement. The
proposed law would address discrimination in employment,
education, welfare payments, and access to legal services
while criminalizing mandatory HIV testing and hate speed
associated with HIV/AIDS. The law will also ban
discrimination based on membership in a risk group or
personal connections to an infected person. The NGO
consortium believes they have support in the Parliamentary
Committee on Human Rights and hopes to have the bill ready
for debate by March.
FRANK


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