Russia’s HIV epidemic dismissed as part of Western ‘information war’

Russia’s HIV epidemic dismissed as part of Western ‘information war’

(latest in Sydney Morning Herald)

Even as a UN conference began last week in New York, taking up the subject of ending AIDS, a Kremlin-backed research institute claimed the West is using HIV and AIDS as part of an “information war” against Russia.

The Russian Institute for Strategic Research (RISR) presented a report to the Moscow City Council last week on HIV in Russia where, unlike almost everywhere else in the world, rates of HIV infection are on the rise.

According to RISR deputy director Tatyana Guzenkova and her colleagues, the real goal of the West’s fights against HIV “is the implementation of the economic and political interests of US-led global structures, relying on an extensive network of international and quasi-NGOs.”

But none of this comes as a shock to Anya Sarang, head of the Andrey Rylkov Foundation.

“We’re not surprised at these kinds of statements anymore,” she tells me from Moscow, where she works with drug users and sees the scale of Russia’s growing HIV epidemic firsthand.

“It’s the usual thing in Russia now to discard science for ideology.”

There are two models for fighting HIV, according to the RISR report. The Western model, it says, is made of “neoliberal ideological content, insensitivity towards national sensitivities and over-focus of certain at-risk groups such as drug addicts and LGBT people.”

The Russian model, on the other hand, “takes into account the cultural, historical, and psychological characteristics of the Russian population, and is based on a conservative ideology and traditional values.”

The Russian model

The science says the Russian model isn’t working.

Approximately 93,000 new HIV cases were reported in Russia in 2015 – a per-capita rate almost fifteen times that of Australia. A million people in Russia have HIV, including almost one percent of all pregnant women – the threshold for a generalised epidemic.
Dr Vadim Pokrovsky heads up Russia’s federal AIDS research centre and is a longtime critic of the Kremlin’s HIV policies.

“The last five years of the conservative approach have led to the doubling of the number of HIV-infected people” Pokrovsky told AFP last year.

The arch-conservative head of Moscow City Council’s health committee, Lyudmila Stebenkova, described Dr Pokrovsky last year as a “typical agent working against the national interests of Russia.”

Not surprisingly, Pokrovsky doesn’t think much of RISR’s report.

“They use some questionable sources of information and incorrectly interpret the data they present,” he tells me from Moscow.

“Their arguments are not convincing.”

The Western contraceptive industry

According to Igor Beloborodov, one of the RISR report’s co-authors, attitudes to condom use is one of the main factors behind Russia’s HIV epidemic.

“The [Western] contraceptive industry is interested in selling their products and encouraging underage people to engage in sex,” he told Moscow City Council.

He and his RISR colleagues argue in the report that condoms “create the illusion of the safety of sex” and should not be “gratuitously distributed” in Russian schools. The solution, they say, is to completely abstain from sex outside of (heterosexual) marriage.

Dr Pokrovsky is dismissive of arguments like these.

“This is traditional rhetoric that was used thirty years ago and still used in conservative circles throughout the world. It is not particularly troubling evidence.”

Pokrovsky also takes issue with the report’s argument that “risk elimination” – in other words, completely giving up drugs and extramarital sex – is superior to harm reduction approaches.

He stresses that “risk elimination” is actually impossible. “The experts who understand this know that people cannot just give up extramarital sex,” he says, “and people dependent on drugs cannot just stop using them.”

‘AIDS and drugs will solve each other’

Even though 60 per cent of HIV-positive Russians are injection drug users, methadone replacement therapy remains illegal in Russia despite clear evidence of its effectiveness.

It’s an approach that has led some commentators to question if the Kremlin is even that interested in the fight against HIV at all.

“I have had conversations with Russian government officials who have said things like ‘AIDS and drugs will solve each other,'” Daniel Wolfe, director of the International Harm Reduction Program at the Open Society Foundations (an organisation funded by frequent Kremlin target George Soros), told The Verge.

“So I think there’s some question about whether or not Russia is actually committed to protecting the lives of everyone, or whether drug users fall into the category of ‘socially unproductive citizens’ the state might just as well do without.”

In Moscow, Anya Sarang worries about the impact the “information war” rhetoric from the Kremlin and its allies might have on Russian with HIV.

“It send the completely wrong message,” she says of the RISR report. “Basically this report is saying that the HIV problem is something made up by western media.”

“The Russian population is really psyched up now with this whole anti-Western ideology and discourse,” she warns. “People might take this seriously and think ‘oh, HIV isn’t a Russian problem – it’s just a part of the information war.'”

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Digging into the data: Ukraine’s pursuit of happiness

Digging into the data: Ukraine’s pursuit of happiness

Ukraine isn’t the happiest place in the world right now, and according to some stats that’ve come out recently it might actually be one of the unhappiest.

Take a look at data released last month in the World Happiness Report 2016, a project that ranks countries by their happiness levels using data from the Gallup World Poll, which 1,000 Ukrainians take part in every year.

The main measure of happiness they use is a zero to 10 scale called the Cantril Ladder, which to get all psychometricky is “a measurement of subjective well-being”:

“Please imagine a ladder, with steps numbered from 0 at the bottom to 10 at the top. The top of the ladder represents the best possible life for you and the bottom of the ladder represents the worst possible life for you. On which step of the ladder would you say you personally feel you stand at this time?”

The World Happiness Report then takes an average of these rankings for each country and ranks each country by that average score.

Back in 2007 and 2008, Ukraine didn’t rank too badly, as you can see below in the first chart I’ve done up – about half of countries scored lower than Ukraine, including several other European countries.

But in 2013, almost three-quarters of all countries surveyed had higher happiness scores than Ukraine, though Ukraine’s was still higher than Bulgaria, Georgia and Armenia.

By 2014, around 80 per cent of countries had higher scores than Ukraine and by 2015, Ukraine ranked in 120th place out of 136 countries – the lowest of any European country.

graph11

The World Happiness Report also looks at a few other measures, including the freedom to make life choices. To calculate this measure, they take a national average of responses to the question “Are you satisfied or dissatisfied with your freedom to choose what you do with your life?”

This figure’s never been too high in Ukraine to begin with; only in 2011 did Ukraine come close to breaking out of the bottom fifth of countries on this measure.

But it’s the decline from 2013 to 2015 that’s the most jarring, as you can see in the graph below (I’ve cut the y-axis to the 50th percentile to make it more obvious). In 2015, Ukrainians ranked second last out of all countries on this measure, behind only Haiti.

graph22

I also took a look at the corruption measure, but I’m not sure the way they calculate the corruption measure is that well-suited for Ukraine. The measure the World Happiness Survey uses is the national average of survey responses to two questions: “Is corruption widespread throughout the government or not?” and “Is corruption widespread within businesses or not?” Splitting the question into a ‘government’ corruption question and a ‘business’ corruption question seems weird to me – aren’t they kind of one and the same thing? – but it’s the only data I’ve got, it’s still worth looking at and, plus, I’m no perceptions-of-corruption expert.

When it comes to corruption, these stats aren’t at all shocking. Ukrainians perceive far more corruption in their own country than people in most other countries, and this perception’s only got worse in the past few years – only Bosnians/Herzegovinians and Romanians felt corruption was worse in their own countries.

There’s other data from the Gallup World Poll 2015, released in January, that paints an even unhappier picture of Ukraine:

  • The percentage of Ukrainians who reported being satisfied with their standard of living dropped from 27% to 17% in 2015
  • 6% of Ukrainians are “suffering” – the highest among all post-Soviet states Gallup surveyed
  • 56% of Ukrainians feel they’re “struggling”
  • Only 9% of Ukrainians feel they’re “thriving”

On top of that, last year I ran some data from the 2012 version of the European Social Survey (for which, despite the name, was done in July 2013 in Ukraine), and found some more unhappy stats.

Aside from being some of the most likely people to feel depressed over the past week (only Hungarians and Albanians were more depressed), Ukrainians also were more likely than anyone from the other 28 countries surveyed to have:

  • Felt anxious in the past week (29% compared to 11% on average)
  • Felt sad in the past week (23% compared to 9% on average)
  • Felt lonely in the past week (21% compared to 8% on average).

None of these stats should be a revelation to anyone even minimally aware of goings-on in Ukraine over the past few years, and they raise more questions than answers.

For one, why are Ukrainians so unhappy? Well, yes, obvious answer is obvious (something like “uh, you know, everything? Like, do you know anything, Michael?”) but I mean more in the sense of whether there’s one or two things that Ukrainians really hit on when they talk about being unhappy. The war? Corruption? The economy? Or is it a not-easily-quantifiable combination of factors, the aforementioned ‘everything’?

What does this unhappiness mean for Ukraine’s already-stretched health and social systems? Does this unhappiness mean we’ll see an increase in mental health issues (e.g., PTSD, depression, even suicide) in Ukraine? Have we already?

What are the implications of all this ballooning unhappiness for Ukraine’s political leaders as they continue to pretend to fight corruption and reduce the power of the oligarchs? Does all this unhappiness mean that Ukrainians will sit back, or will it make them angry enough to make yet another stand?

Taskforce aims to bolster rural physicians

Taskforce aims to bolster rural physicians

(latest in CMAJ)

Having worked in the interior of British Columbia since 1989 Dr. John Soles life as a rural family physician has been nothing like his urban colleagues. He has done “the full spectrum,” he says, from delivering babies and treating colds to mentoring young physicians and managing the business side of his practice.

“It’s about how to work with fewer resources and always dealing with a degree of uncertainty,” says Soles, president of the Society of Rural Physicians of Canada (SRPC).

Although about 18% of Canadians live in rural or remote areas, only 14% of family physicians practise there. Adding to their stress is the fact that family physicians provide 85% of primary care needs. Continue reading “Taskforce aims to bolster rural physicians”

Britain debates “sugar tax” to fight obesity

Britain debates “sugar tax” to fight obesity

The United Kingdom is considering a “sugar tax” to reduce sugar intake and help tackle its obesity epidemic. The recommendation was made by Public Health England (PHE), the government’s advisory body on health.

Read more: http://www.cmaj.ca/site/earlyreleases/2dec15_britain-debates-sugar-tax-to-fight-obesity-cmaj.109-5201.xhtml

Continue reading “Britain debates “sugar tax” to fight obesity”