Armenia: HIV/AIDS – looking back on 2008

On this day one year ago I posted a comprehensive overview of HIV/AIDS situation in Armenia.

Today, as we mark World AIDS Day (1988 - 2008), I decided to look back on the past year to remind Armenia related main HIV/AIDS stories which were reflected in this blog, as well as other more recent reports by media and blogs.

There will be a special World AIDS Day 2008 event in Armenian capital Yerevan - Rock bands join NGOs to mark World AIDS Day 2008 in Yerevan. Coverage of this and related events will be done in separate posts as/when news reports, reflections, photos and/or videos become available.

December – National Centre For AIDS Prevention: HIV/AIDS Epidemic in Armenia

From 1988 to 1 December 2008 656 HIV cases had been registered in the Republic of Armenia among its citizens with 118 new cases of HIV infection registered in 2008. 74 of the AIDS cases were registered in 2008. The main modes of HIV transmission are through heterosexual practices (48.9%) and injecting drug use (43.9%). HIV/AIDS situation assessment has shown that the estimated number of people living with HIV in the country is about 2300.

November – School children in five Armenian regions to brain-ring on HIV/AIDS

On 1 December, school children in five regions of Armenia will play brain-ring (popular in former Soviet countries intellectual game) on HIV/AIDS topic.

The event, organised by the World Vision Armenia, aims at raising awareness of Armenian students on HIV/AIDS related issues. In addition, it aims to facilitate an atmosphere of tolerance for HIV-positive people and patients with AIDS.

November - ArmenHES: Armenia & World AIDS Day provides an overview of HIV/AIDS situation in Armenia, as well as reflects on EurasiaNet report on “The Armenicum Fiasco”.

November – EurasiaNet: Ten years on, Armenia’s so-called "miracle cure" for AIDS still unproven

For ten years, Armenians have been told about the wonders of Armenicum, the locally produced formula whose makers claim it has curative powers over the deadly HIV virus.

And while doctors who use the drug say it does seem to relieve some of the symptoms of HIV, after a decade the company has yet to produce any viable clinical trials proving more substantive curing options.

What most Armenians probably do not know is that their tax dollars are paying for Armenicum, which is more than triple the cost of the world’s only proven treatment for HIV, antiretroviral (ARV) drugs. They probably also are not aware that in a few months Armenicum may be the only choice available in Armenia for future HIV-infected patients.

In Armenia, treating HIV-positive patients should not be a major problem -- and on the surface, the system seems to be working. The HIV-positive population is small, with only 649 reported cases. Even when one includes the estimated 3,000 unreported cases out there, they still make up a mere 0.1 percent of the total population. Armenia does offer an efficient, government-funded National Center for AIDS Prevention, which not only records, but also offers testing and treatment to anyone who needs it, based on World Health Organization standards of care.

But instead of paying for all accepted treatments for HIV patients, the government is throwing all its money and resources towards supporting Armenicum, and is requiring that AIDS Center doctors offer the drug, while unproven, as a choice. Currently, it costs about $6,000 per patient per year to be treated with Armenicum, while the standard ARV regimen costs $1,700 per patient per year. That means it costs the Armenian taxpayer $300,000 to treat just the 50 Armenicum patients approved this year. Compare that to the estimated $160,000 it costs to treat 93 patients with ARV funded by the Global Fund.

So far, the international US-funded Global Fund, through the local World Vision office, has been paying for and procuring ARV treatments. But, technically, that money ran out in June, and though the grant has been extended until February and the National Centre for AIDS Prevention is currently applying for another five year grant, there is no guarantee that the Global Fund will continue to fund future ARV treatments.

"If the Global Fund does not finance Armenia again, the national HIV program will be in great jeopardy," said Mark Kelly, World Vision National Director. "Currently the Global Fund pays for the majority of testing and prevention programs, and all ARV treatments." [...]

Despite the lack of evidence supporting Armenicum’s claims, the National Center for AIDS Prevention clinicians say they consider Armenicum doctors colleagues in the fight against HIV, and have supported anecdotal claims that some of their patients have responded well to the treatment.

"We are cooperating all the time, and we always discuss every case to find a better solution," said Dr. Arshak Papoyan, head of the National Centre for AIDS Prevention Epidemiology Unit.

But it’s hard to find a doctor treating HIV patients who will be quoted publicly saying the drug doesn’t work, some say, because the pressure for the Armenian-made drug to succeed is so high that criticizing it is not allowed.

"I know many clinicians who don’t believe in Armenicum, but they are not allowed to say anything," said one doctor involved in the HIV treatment field, who refused to be identified.Even if the jury is still out on Armenicum, World Vision and Global Fund representatives say the most important thing is to make sure HIV patients have an informed choice between all the treatment options.

"We just want to make sure ARVs are available," said Kelly. "The most important thing is that every person living with HIV can be treated with ARVs if they choose."

September – Armenia should abandon its unjust and unwise travel ban on people with HIV

Prominent HIV/AIDS campaigners and international health advocates of Armenian origin Jirair Ratevosian and Dr. Amy Hagopian co-authored this editorial on Armenia's discriminatory HIV-related travel restrictions. It calls on the government of Armenia to consider the widespread consensus among medical and public health professionals regarding the lack of evidence to support HIV-related travel restrictions and to reverse the policy (see below).The editorial was first published by The Armenian Weekly and subsequently reprinted in Asbarez on Friday, September 5, 2008. Unzipped and Unzipped: Gay Armenia joins this call.

September – HIV/AIDS posters in Armenia’s international Zvartnots airport

I spotted quite a few HIV/AIDS related posters in Armenia's international Zvartnots airport. Migrant workers are the main target for this campaign as they are among the key risk groups for HIV transmission in Armenia.

June – Basketball against HIV/AIDS

A1+ reports on basketball tournament organised by Armenian Red Cross with the help of the Basketball Federation of Armenia to raise awareness of HIV/AIDS among teenagers and school children. The game was accompanied by educational campaign on HIV/AIDS related issues.

May – Russian Health Ministry Ends Ban on Blood Donations by Gays

Russian gay activists celebrate their first major victory two years after the start of the campaign. MOSCOW, May 23, 2008 (GayRussia.ru) – The Russian Ministry of Health and Social Development has repealed the ban on blood donations by homosexual people, it emerged last night. ***

Answering my question (passed by a reader of this blog), Trygve Utstumo (Armenia and me blog), who is working with Armenian Red Cross now says the following re gay blood donation in Armenia (I agree and assume that in Armenia it is like in most countries, for now, and it is discrimination!):
"About the blood donations: Armenia Red Cross is currently not involved in the blood transfusions in Armenia. As far as I’ve understood this is organized by a sub-body of the Ministry of Health. I honestly can’t answer his question, but I would assume that they do as in most other countries: not accepting blood donations from practicing homosexuals. (Not saying that I agree with this practice.)" Hopefully, this great news from Russia will have influence at some point on Armenia too.

May – HIV/AIDS Candlelight March in Yerevan

Armenia and me reports that Red Cross youth volunteers organised a candlelight march in Yerevan this Sunday in memory for the victims of AIDS and to raise awareness on HIV/AIDS related issues, as part of international day of actions:"In Yerevan, more than 60 Red Cross youth volunteers marched through the citycenter with candles this sunday. By posters and talking with curious bystanders they managed to get a lot of attention on this important case. Several bystanders also tagged along and followed us to the square by Moscow cinema where we filled an HIV ribbon on the ground with candles."

April – Medical profession prejudice towards HIV/AIDS in Armenia

While public prejudice towards HIV/AIDS in Armenia is a very serious issue which needs to be tackled via education and awareness programmes, even more serious and unacceptable is medical profession prejudice which has direct impact on prevention and treatment of people with HIV/AIDS. Below is an account by HIV-positive Armenian, via report published by IWPR (Institute For War & Peace Reporting). It also raises a serious issue of lack of proper ethical regulation (and its enforcement) of medical profession in Armenia.