By Irina Glushchenko
MOSCOW — When Russian President Boris Yeltsin in late December refused to sign this country's first-ever AIDS legislation into effect, the broad response among health workers and human rights activists was one of relief. Instead of creating a framework for combating the disease and helping its sufferers, the bill adopted by the State Duma proposed to waste the scanty funds available for AIDS prevention on running a scare campaign against foreigners.
If one believes the official statistics, Russia is among the countries of the world that have suffered least from the AIDS epidemic. At the beginning of November, there were only 831 people in the country, including 279 children, officially recorded as being HIV-positive. Only 149 people were registered as having developed full-blown AIDS. Total deaths from AIDS were put at 126, including 59 children.
Other sources, however, suggest that the official figures are at least 10 times too low, since only a small minority of the people who have contracted the virus have been tested for it. A further pointer to the real situation has been a rapid increase in the number of registered cases during 1993 and 1994.
The greatest concentration of known HIV infections in Russia is in St Petersburg. Of those infected, as many as a third are women. A substantial number of the infections are the result of failure to observe sanitary norms for blood transfusions and injections.
Between 1989 and 1991 an acute shortage of single-use syringes became a political issue. Various public figures, including Yeltsin himself, sought to prove their concern by bringing back quantities of these syringes from trips abroad and passing them on to hospitals.
These days, the authorities see the main danger not in the shortage of syringes, but in the uncontrolled migration of the population and in vastly increased contacts with foreigners. This attitude is shared both by many officials of the executive branch and by legislators. A law on the struggle against AIDS, drafted by the State Committee on Health Care and adopted on the first reading by the State Duma, proposed to introduce compulsory testing for all foreigners entering the country. Anyone who refused would swiftly be deported.
Journalists quickly depicted the scenes likely to unfold in Russian airports and at border posts, where alongside the border guards and customs officers there would also be a medical orderly with a syringe.
HIV tests were to be compulsory not only for foreigners. Under the draft law, the government would have been empowered to designate categories of citizens subject to compulsory testing. Penalties were specified for people who refused to be tested. For example, they could be refused medical treatment, and could be banned from a list of professions once again to be decided by the authorities.
Not surprisingly, the draft law stirred an international wave of protest, as well as drawing angry condemnation within Russia. The first people to object were medical personnel specialising in AIDS. Vadim Pokrovsky, the head of the Russian Centre for the Struggle Against AIDS, warned that compulsory testing would "consume 95% of the funds assigned by the state for the fight against AIDS and for research into the disease".
According to specialists, the great majority of the people in Russia infected with the HIV virus did not contract it from foreigners but from their fellow citizens. Even if the program were successful, therefore, it would have very little impact on the epidemic. With the present equipment available to Russian medicine, it would be necessary to wait about a month for the results of analyses. How the supporters of the legislation proposed to deal with tourists and business people coming to Russia for a few days remains a mystery.
Russian tourism firms and their Western counterparts erupted in a chorus of protest. Some Western travel agencies threatened to cease their activity in Russia altogether. According to experts, the already modest number of tourists coming to Russia would have fallen by 90%. The losses began even before the law was passed. A single television report on the prospect of compulsory testing was enough to set thousands of clients phoning Western travel agencies with requests to cancel trips.
Commenting on the decision, Committee on Health Care chairperson Bela Denisenko declared that she was "struck by the fierce defence of the rights of foreigners", adding that "for 70 years we showed more concern for the rights of blacks in America than for the rights of our own citizens". In Denisenko's view, the laws needed to be especially strict in relation to African countries, "where as many as 50% of the people are infected". Asked whether she thought this attitude was racist, Denisenko replied airily, "The scale of the epidemic in these countries is not our fault".
Denisenko also expressed dissatisfaction at the relative cheapness of the methods used to combat AIDS in Russia (for example, the cost of carrying out tests is only a tenth that in the West). In her view, this could lead to infected people "flooding" into Russia from around the world, attracted by the promise of receiving treatment on the cheap.
The provisions for mass HIV testing contained in the law would not have been implemented, since officials of the Health Ministry admitted that they had not the slightest idea of how to carry them out. Along with these sections, meanwhile, a series of realistic and useful provisions of the legislation have now been buried as well.