Publication: Reversing the Tide: Priorities for HIV/AIDS Prevention in Central Asia
Loading...
Date
2005
ISSN
Published
2005
Editor(s)
Abstract
Although the number of reported cases of HIV in Central Asia is still very low, the growth rate of the epidemic (about 500 cases in 2000 to over 12,000 in 2004) is a cause for serious concern. Central Asia lies along the drug routes from Afghanistan to Russia and Western Europe, and it is estimated that it has half a million drug users, of which more than half inject drugs. Without concerted action, we may expect to see the rapid development of an HIV epidemic concentrated among injecting drug users over the next four or five years, followed by the spread among the 15- to 30-year-old population, with sexual transmission as the predominant mode. This would follow the pattern of the epidemic in other regional countries such as Russia, Ukraine, and Moldova.
Link to Data Set
Citation
“Godinho, Joana; Renton, Adrian; Vinogradov, Viatcheslav; Novotny, Thomas; Rivers, Mary-Jane; Gotsadze, George; Bravo, Mario. 2005. Reversing the Tide: Priorities for HIV/AIDS Prevention in Central Asia. World Bank Working Paper No. 54. © World Bank. http://hdl.handle.net/10986/7354 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Publication A Novel Tobacco Market Diversification(World Bank, Washington, DC, 2022-04-27)In this working paper, an exploration of available data and information is conducted and findings presented, to support the view that the dichotomous business model and related harm reduction narrative promoted nowadays by the tobacco industry, merits scrutiny by the international community. The promotion of e-cigarettes as welfare enhancing in rich countries, particularly because they are posited to help adult smokers quit, tends to obfuscate a dire reality. The same tobacco industry that promotes (e-cigarettes as harm reduction in rich countries, derives the bulk of its profits by selling cigarettes in lower income countries.Publication Environmental Implications of a Central Bank Digital Currency (CBDC)(Washington, DC : World Bank, 2022-07)Two-thirds of central banks in the East Asia and Pacific (EAP) region have started researching or testing the implementation of a Central Bank Digital Currency (CBDC). At the same time, the region accounts for one-third of world CO2 emissions and is vulnerable to climate risks. As the Group of 7 (G7), European Central Bank (ECB), and Bank of England (BoE) have stated in their public statements, it is increasingly important to consider environmental impact when designing CBDC. However, only a few brief studies have been done on this subject, which will be crucial for the region. This Note explores the environmental implications of CBDC by comparing technical mechanisms and energy consumption within its distributed structure. It also illustrates differences in ecological footprint between CBDC and other payment methods (cryptocurrency, cash, and card networks). As the legitimacy of CBDC is backed by the trust of central banks, CBDC does not need to prove its legitimacy through its technological structure. Therefore, CBDC does not require the energy-intensive consensus or mining mechanisms used by a cryptocurrency, so its energy consumption is lower (comparable to that of a credit card system). CBDC can be designed to use various systems, such as Real Time Gross Settlement (RTGS), Distributed Ledger Technology (DLT), or a mixture of both. Careful deliberation to meet the objectives and implications will be important as CBDC can be a catalyst for financial innovation.Publication Sustainable Cities Towards A Green, Resilient and Inclusive Recovery(Washington, DC, 2022-03)Cities are key to unlocking a climate-smart future for all, as they account for more than 50 percent of the global population, about 70 percent of global energy-related CO2 emissions and 80 percent of global GDP. Urban centers’ share of emissions is expected to grow as the urban population is projected to increase by 2.3 billion people by 20502. As the world recovers from the COVID-19 crisis, cities will present a huge opportunity to rebuild in a way that is climate friendly and meets some of the world’s ambitious climate targets. Cities are viewed as the source of and the solution to many of today's economic, social, and environmental challenges. This is not only because of the concentration of population and economic assets in urban areas, but also because local authorities perform key functions that impact the quality of life of their residents. From an urban management perspective, the leading resource and knowledge sharing platform is the GEF funded Global Platform for Sustainable Cities (GPSC), hosted by the World Bank. The GPSC states that achieving sustainability requires the balanced accomplishment of outcomes against four pillars, namely (1) robust economic growth, prosperity, and competitiveness across all parts of the city; (2) protection and conservation of ecosystems and natural resources into perpetuity; (3) mitigation of greenhouse gas (GHG) emissions while fostering overall city resilience; and (4) inclusiveness and livability, mainly through the reduction of city poverty levels and inequality. The Urban Sustainability Framework (USF), developed to outline the areas of work and support by the GPSC, offers a very useful representation of both outcomes as well as enabling actions and requirements (such as spatial data and good governance) cities could focus on.Publication Structured Lesson Plans for Literacy Instruction(World Bank, Washington, DC, 2022-03-31)Literacy is the cornerstone of education, and a driver of human economic, social, and civic wellbeing. Despite its importance, far too many children fail to become literate. The World Bank uses a measure called learning poverty to indicate when a child cannot read and understand an age-appropriate text by age ten. The best available data showed that more than two-thirds of children in low- and middle-income countries suffer learning poverty. The World Bank is committed to helping countries achieve the learning target: to cut learning poverty by at least half by 2030. Achieving better outcomes in literacy requires a comprehensive effort in many domains. One of the most important is ensuring that students and teachers have and use high-quality instructional materials, especially textbooks, for reading instruction. As countries and systems review their literacy teaching and learning materials, they will want to compare them to the materials from other countries and systems. The purpose of the compendium is to allow such reviews and comparisons by grouping a critical mass of structured pedagogy lesson plans and related materials in one place.Publication WBG COVID-19 Crisis Response Operational Update(Washington, DC, 2022-03-31)This note provides an update on the WBG’s COVID-19 Crisis Response, outlined in June 2020 to help developing countries address the impacts of the pandemic while maintaining a line of sight to long-term development goals. It comprises five short sections: (I) the impacts of COVID-19 and compounding crises on developing countries, (II) an update on the WBG’s operational crisis response and priorities moving forward, (III) the critical role of international coordination, (IV) WBG financing framework for GRID, and (V) concluding remarks.
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication HIV/AIDS in the Western Balkans : Priorities for Early Prevention in a High-Risk Environment(2005)In recent years, Europe and Central Asia (ECA) has seen the world's fastest growing HIV/AIDS epidemic. The Balkans countries and territories under study - Albania, Bosnia and Herzegovina, Macedonia, Serbia and Montenegro, and the UN-administered Kosovo -- have reported over 2,000 HIV/AIDS cases since the beginning of the epidemic in 1985. In ECA, HIV/AIDS disproportionably affects the youth population: 80 percent of HIV infected people are 30 years old or younger. This study confirms that the Balkans region faces a triple jeopardy: 1) All structural factors are present to drive epidemics transmitted predominantly by heterosexual drug users; 2) Conflict and economic decline handicap the ability of governments and civil society to make an effective response; and 3) Old ideologies and vested interests are set against key elements of intervention known to be effective. Although the low number of cases identified, and lack of reliability of existing data, do not allow future trends of the HIV/AIDS epidemic in the Balkans to be predicted with certainty, a potential epidemic may develop or be halted in one of three ways: Following the pattern of the epidemic in other regional countries, it can become concentrated among intravenous drug users and eventually spread to other groups of the population through sexual contact. If Injecting drug use does not become widespread, sexual transmission can continue to be the most likely route for transmitting the infection and establishing the epidemic. An epidemic is prevented through early concerted efforts by the public sector, nongovernmental organizations, and the international community who closely cooperate with young people at high risk of being infected or that are already infected. In this scenario, highly vulnerable groups reduce the harm of injecting drugs by avoiding associated risky practices such as sharing needles and syringes; and both highly vulnerable groups and vulnerable groups such as youth increase their knowledge about the epidemic and adopt safe sex practices. The study concludes that to decrease the risk of an HIV/AIDS epidemic spreading throughout the Balkans region, and becoming a long-term development problem as it has happened in other regions, requires a mix of interventions aimed at reducing the risk of infection in the short term, and interventions aimed at tackling structural factors in the medium to long term. However, political commitment has to increase for action to occur promptly.Publication HIV/AIDS and Tuberculosis in Central Asia(Washington, DC: World Bank, 2004)The countries of Central Asia are still at the earliest stages of an HIV/AIDS epidemic. However, there is cause for serious concern due to: the steep growth of new HIV cases in the region; the established related epidemics of injecting drug use, sexually transmitted infections (STIs) and tuberculosis (TB); youth representing more than 40 percent of the total regional population; and the low levels of knowledge about the epidemics. The underlying causes for the interlinked epidemics of drug abuse, HIV/AIDS, STIs and TB in Central Asia are many, including drug production in Afghanistan and its distribution throughout the Former Soviet Union (FSU); unemployment among youth; imprisonment for drug use; overcrowding in prisons; and striking levels of poverty. HIV/AIDS and tuberculosis may have a potentially devastating effect on human capital, economic development, and health systems reform. In Russia, economic analysis has described the significant future impact on health and health systems if the concentrated epidemic in that country goes unchecked (Ruhl et al. 2002). The opportunity for prevention in low prevalence environments provides an imperative for action, because when HIV prevalence among high-risk groups reaches 20 percent or more, prevention is no longer possible and expensive treatment for AIDS and related opportunistic infections will overwhelm under funded health care systems such as those in Central Asia. Low prevalence, or nascent epidemics of HIV create little incentive for focused attention. However, through careful consideration of the potential for these epidemics to grow, the World Bank can help client countries incorporate effective prevention strategies into health systems development projects or into specific public health projects to address these infections.Publication HIV/AIDS in Southeastern Europe : Case Studies from Bulgaria, Croatia, and Romania(Washington, DC: World Bank, 2003-05)In June 2002, the countries of Southeastern Europe (SEE) recommitted themselves to scale up action on the prevention and treatment of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). Given the rapid increase in the rate of HIV infection in Eastern Europe in general, and the generally similar risk conditions for low HIV prevalence SEE populations, this commitment is timely in terms of preventing a more widespread epidemic. It should also be recognized by the World Bank as a call to action to support these countries through the application of its comparative advantage in both lending and non-lending activities. The purpose of this paper is to review the current status of the AIDS epidemics in three countries of the Sub-region (Bulgaria, Croatia, and Romania - which constitute the ECC05 Country Department of the World Bank), to evaluate the approaches and strategies currently being used in each country, and to make recommendations both for government strategies and for the Bank's current and potential future involvement in relation to these strategies. The current low levels of HIV infection in SEE present a challenge in gaining recognition of the potential impact of HIV/AIDS on health systems, social structures, and individuals. Moreover, the approach to HIV/AIDS in SEE is complicated by relatively high levels of stigma against vulnerable groups (intravenous drug users [IDU], commercial sex workers [CSW], ethnic minorities such as the Roma, mobile populations, and men who have sex with men [MSM]).Publication Stopping Tuberculosis in Central Asia : Priorities for Action(Washington, DC: World Bank, 2005)Stopping Tuberculosis in Central Asia reviews the epidemiological situation, control efforts, and financing of tuberculosis programs in Kazakhstan, Kyrgyz Republic, Tajikistan, and Uzbekistan. It was based on a review of existing statistics and reports, and on consultation with key stakeholders-Governments, NGOs, and donors in Central Asia. This work contributes an agenda for action to address the impending epidemiological crisis that has been posed by the sudden increase in cases of HIV/AIDS infection combined with a prevalent epidemic of TB.Publication HIV/AIDS in Latin America : The Challenges Ahead(World Bank, Washington, DC, 2003-03)Information on HIV/AIDS epidemics in Latin America is disperse and lacks comprehensiveness. Sound and timely policies can limit the current and future impact of the epidemics but good policies are built on a strong epidemiological base and according to the countries' needs. The aim of this study was to assemble all the information available on the epidemiological pattern of the epidemics in Latin America and to gather information on current national surveillance capacity, national responses of the health sector to identify key areas where specific interventions are needed. Through national statistics, data published by international organizations, and databases searches, the authors collected data on the extent, trends and patterns of HIV/AIDS epidemic in 17 Latin American countries. Data on national surveillance systems and national responses from the health sector were gathered through questionnaires applied to managers of the national HIV/AIDS surveillance system, director of the National HIV/AIDS program, NGOs, and physicians. Despite relatively high rates of HIV infection in most countries, many Latin American countries have not yet faced a full-scale AIDS epidemic. HIV/AIDS falls within the framework of a low endemic setting; in the majority of the countries the epidemic is still concentrated in high-risk populations. Latin America has the necessary infrastructure to efficiently and effectively confront the HIV/AIDS epidemic. However, the capacity to respond has been limited by political, technical and social problems. Several key problems on the areas of prevention, access to health and social services, human rights and national capacity were identified. The results of the study suggest that the main challenges to meeting the current needs are (i) availability of resources; (ii) institutional capacity to provide training in all areas; and (iii) cultural, social and religious factors.
Users also downloaded
Showing related downloaded files
Publication Disease Control Priorities, Third Edition(Washington, DC: World Bank, 2016-04-06)This book focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. It also includes the transition to older childhood, in particular, the overlap and commonality with the child development volume.Publication Early Child Development, From Measurement to Action : A priority for Growth and Equity(Washington, DC: World Bank, 2007)The World Bank recently hosted a symposium on the priority of early child development (ECD) for economic growth and equity. The participants urged application of population-based tools and measures to assess the outcomes of children's early years and children's readiness for school. This study is derived from the symposium and is a valuable resource for policy makers, economists, donors, and investors, as well as researchers and practitioners in early child development. It summarizes the current neuroscience on early child development and major longitudinal studies, the rationale and urgency for greater investment, and countries' innovative funding strategies. The report consists of 15 chapters authored by ECD experts and leaders in the field. The chapters are grouped into five main parts relating to the: business imperative and societal benefits of ECD investments; lessons from evaluation of longitudinal ECD interventions; countries' experiences in monitoring ECD interventions; innovative approaches to countries' financing of ECD initiatives; and next steps on the ECD agenda for the next 5 years. A theme highlighted at the symposium and enlarged upon here is the urgent need for evidence- and population-based instruments and measures to monitor, evaluate, and compare ECD interventions over time and across settings.Publication Making Monitoring and Evaluation Systems Work : A Capacity Development Toolkit(World Bank, 2009)There are constant and growing pressures on governments and organizations around the world to be more responsive to demands from internal and external stakeholders for good governance, accountability and transparency, greater development effectiveness and delivery of tangible results. Governments, parliaments, citizens, the private sector, non-governmental organizations (NGOs), civil society, international organizations, and donors are all among stakeholders interested in better performance. As demands for greater accountability and results have grown, there is an accompanying need for useful and useable results-based monitoring and evaluation systems to support the management of policies, programs, and projects. Governments and other organizations have many different kinds of tracking systems as part of their management toolkits: good human resource systems, financial systems, and accountability systems. They also need good feedback systems. A results-based monitoring and evaluation (M&E) system is essentially such a feedback system; it is a management tool to measure and evaluate outcomes, providing information for governance and decision making. Many management systems have been missing a feedback component to enable them to track the consequences of actions. Building an M&E system gives decision-makers an additional management tool by providing feedback on performance as a basis for future improvement.Publication Changing the Face of the Waters : The Promise and Challenge of Sustainable Aquaculture(Washington, DC: World Bank, 2007)This study provides strategic orientations and recommendations for Bank client countries and suggests approaches for the Bank's role in a rapidly changing industry with high economic potential. It identifies priorities and options for policy adjustments, catalytic investments, and entry points for the Bank and other investors to foster environmentally friendly, wealth-creating, and sustainable aquaculture. The objectives of the study are to inform and provide guidance on sustainable aquaculture to decision makers in the international development community and in client countries of international finance institutions. The study focuses on several critical issues and challenges: 1) Harnessing the contribution of aquaculture to economic development, including poverty alleviation and wealth creation, to employment and to food security and trade, particularly for least developed countries (LDCs); 2) Building environmentally sustainable aquaculture, including the role of aquaculture in the broader suite of environmental management measures; 3) Creating the enabling conditions for sustainable aquaculture, including the governance, policy, and regulatory frameworks, and identifying the roles of the public and private sectors; and 4) Developing and transferring human and institutional capacity in governance, technologies, and business models with special reference to the application of lessons from Asia to Sub-Saharan Africa and Latin America.Publication Climate Change and Migration : Evidence from the Middle East and North Africa(Washington, DC: World Bank, 2014-07-15)Climate change is a major source of concern in the Middle East and North Africa (MENA) region, and migration is often understood as one of several strategies used by households to respond to changes in climate and environmental conditions, including extreme weather events. This study focuses on the link between climate change and migration. Most micro-level studies measure climate change either by the incidences of extreme weather events or by variation in temperature or rainfall. A few studies have found that formal and informal institutions as well as policies also affect migration. Institutions that make government more responsive to households (for example through public spending) discourage both international and domestic migration in the aftermath of extreme weather events. Migration is often an option of last resort after vulnerable rural populations attempting to cope with new and challenging circumstances have exhausted other options such as eating less, selling assets, or removing children from school. This study is based in large part on new data collected in 2011 in Algeria, Egypt, Morocco, Syria, and the Republic of Yemen. The surveys were administered by in-country partners to a randomly selected set of 800 households per country. It is also important to emphasize that neither the household survey results nor the findings from the qualitative focus groups are meant to be representative of the five countries in which the work was carried, since only a few areas were surveyed in each country. This report is organized as follows: section one gives synthesis. Section two discusses household perceptions about climate change and extreme weather events. Section three focuses on migration as a coping mechanisms and income diversification strategy. Section four examines other coping and adaptation strategies. Section five discusses perceptions about government and community programs.