Publication:
Reversing the Tide: Priorities for HIV/AIDS Prevention in Central Asia

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
Report Series
Report Series
Other publications in this report series
  • Publication
    A Novel Tobacco Market Diversification
    (World Bank, Washington, DC, 2022-04-27) Marquez, Patricio V.
    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) Lee, Soohyang; Park, Jinhee
    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
    Assessing Incentives to Increase Digital Payment Acceptance and Usage
    (World Bank, Washington, DC, 2022-01-18) Allen, Jeff; Carbo Valverde, Santiago; Chakravorti, Sujit; Rodriguez-Fernandez, Francisco; Pinar Ardic, Oya
    An important step to achieve greater financial inclusion is to increase the acceptance and usage of digital payments. Although consumer adoption of digital payments has improved dramatically globally, the acceptance and usage of digital payments for micro, small, and medium-sized retailers (MSMRs) remain challenging. Using random forest estimation, The authors identify 14 key predictors out of 190 variables with the largest predictive power for MSMR adoption and usage of digital payments. Using conditional inference trees, they study the importance of sequencing and interactions of various factors such as public policy initiatives, technological advancements, and private sector incentives. The authors find that in countries with low point of sale (POS) terminal adoption, killer applications such as mobile phone payment apps increase the likelihood of P2B digital transactions. They also find the likelihood of digital P2B payments at MSMRs increases when MSMRs pay their employees and suppliers digitally. The level of ownership of basic financial accounts by consumers and the size of the shadow economy are also important predictors of greater adoption and usage of digital payments. Using causal forest estimation, they find a positive and economically significant marginal effect for merchant and consumer fiscal incentives on POS terminal adoption on average. When countries implement financial inclusion initiatives, POS terminal adoption increases significantly and MSMRs’ share of person-to-business (P2B) digital payments also increases. Merchant and consumer fiscal incentives also increase MSMRs’ share of P2B electronic payments.
  • Publication
    Greening Digital in Korea
    (Washington, DC, 2022-02) World Bank
    Digital technologies are making a significant impact on societies, economies, and the physical world, presenting both opportunities and challenges for the green agenda. Applications of these technologies in sectors such as energy, urban, transport, and agriculture are creating new possibilities for climate change mitigation strategies. However, the rapid expansion of digital technologies increases energy usage too, and is therefore also increasing greenhouse gas (GHG) emissions. In seeking to address these challenges, the World Bank’s Digital Development Global Practice (DD) will publish a flagship report on Digital Development Opportunities for Climate Change, which will assess opportunities for greening with information communication technology (ICT), as well as opportunities for greening the ICT sector itself. To inspire and inform this flagship report, DD studied Korea’s experience in greening its ICT sector, with support from the Korean Green Growth Trust Fund. The Republic of Korea was selected for the case study due to its experience in both the digital and green sectors, and its status as a globally recognized ICT powerhouse. The country was also an early adopter of a green policy agenda, and is integrating DNA (data, network, and AI) into these policies. The government announced a national policy vision of “Low Carbon, Green Growth” in 2008 and has taken concrete steps to build a solid foundation for the green transition, through legislation, standardization, information-based instruments, economic instruments, research and development (R&D), and green procurement. More recently, the country has been aligning its green ICT strategy with the broader national GHG reduction target. Korea's experience can offer meaningful lessons to other countries looking to reduce the ICT sector’s climate impact. It shows that public policies have an important impact on the ICT market. The policy tools that can spur decarbonization of the ICT sector include green government procurement, information-based instruments, economic instruments, and provision of guidelines on green business practices. Keys to success in applying such tools include strong and early political commitment; long-term planning and comprehensive policies; prioritization; research and development (R&D) and investment; and a governance structure that allows a whole-of-government approach. Additionally, Korea’s experience shows that renewable energy will play an increasingly important role in reducing GHG emissions from the energy-intensive ICT industry. Korea’s experience also underscores the fact that more evidence and analysis are needed to measure and determine the effectiveness of policy and regulatory pathways for greening the ICT sector.
  • Publication
    WBG COVID-19 Crisis Response Operational Update
    (Washington, DC, 2022-03-31) World Bank
    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

Related items

Showing items related by metadata.

  • Publication
    HIV/AIDS in the Western Balkans : Priorities for Early Prevention in a High-Risk Environment
    (2005) Godinho, Joana; Jaganjac, Nedim; Eckertz, Dorothee; Renton, Adrian; Novotny, Thomas; Garbus, Lias
    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) Godinho, Joana; Novotny, Thomas; Tadesse, Hiwote; Vinokur, Anatoly
    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) Novotny, Thomas; Haazen, Dominic; Adeyi, Olusoji
    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) Godinho, Joana; Veen, Jaap; Dara, Masoud; Cercone, James; Pacheco, José
    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) Garcia-Abreu, Anabela; Noguer, Isabel; Cowgill, Karen
    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
    The Journey Ahead
    (Washington, DC: World Bank, 2024-10-31) Bossavie, Laurent; Garrote Sánchez, Daniel; Makovec, Mattia
    The Journey Ahead: Supporting Successful Migration in Europe and Central Asia provides an in-depth analysis of international migration in Europe and Central Asia (ECA) and the implications for policy making. By identifying challenges and opportunities associated with migration in the region, it aims to inform a more nuanced, evidencebased debate on the costs and benefits of cross-border mobility. Using data-driven insights and new analysis, the report shows that migration has been an engine of prosperity and has helped address some of ECA’s demographic and socioeconomic disparities. Yet, migration’s full economic potential remains untapped. The report identifies multiple barriers keeping migration from achieving its full potential. Crucially, it argues that policies in both origin and destination countries can help maximize the development impacts of migration and effectively manage the economic, social, and political costs. Drawing from a wide range of literature, country experiences, and novel analysis, The Journey Ahead presents actionable policy options to enhance the benefits of migration for destination and origin countries and migrants themselves. Some measures can be taken unilaterally by countries, whereas others require close bilateral or regional coordination. The recommendations are tailored to different types of migration— forced displacement as well as high-skilled and low-skilled economic migration—and from the perspectives of both sending and receiving countries. This report serves as a comprehensive resource for governments, development partners, and other stakeholders throughout Europe and Central Asia, where the richness and diversity of migration experiences provide valuable insights for policy makers in other regions of the world.
  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    Lebanon Economic Monitor, Fall 2022
    (Washington, DC, 2022-11) World Bank
    The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.
  • Publication
    Argentina Country Climate and Development Report
    (World Bank, Washington, DC, 2022-11) World Bank Group
    The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.
  • Publication
    World Development Report 2006
    (Washington, DC, 2005) World Bank
    This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.