Gov't won't fund HIV prevention

Despite rising instances of HIV/AIDS and prevention funding that is already at an all-time low, the Health Ministry has further slashed its financial commitments, and experts say the result will be a continued increase in infections.

As reported by The Prague Post in September, funding for HIV/AIDS programs for 2010 was cut from 7 million Kč ($390,843) to 3.5 million Kč earlier this year. In the intervening two months, at least 20 more cases of HIV/AIDS have emerged. Meanwhile, money for prevention programs has been completely eliminated for all NGOs but one, the Czech AIDS Help Society (ČSAP), which will only receive 1.5 million Kč of the 2.7 million Kč originally pledged.

At current infection rates, the Czech Republic will have more than 200 new HIV/AIDS cases this year, a 400 percent increase on 10 years ago, which correlates with an 85 percent cut to annual funding of prevention programs over the same period. 

"The problem is that this year, we were the only ones who got the subsidies. The other 25 NGOs did not get a single crown," said Miroslav Hlavatý, secretary of ČSAP and director of Lighthouse (Dům světla), an HIV/AIDS prevention and treatment center in Prague. "2010 is the last year of HIV/AIDS prevention; there are not many fools left who will stay involved in this."

The 39 projects that had initially been approved by the Health Ministry have been cut to 16, most of which are based in state hospitals and are focused on treatment, not prevention, according to the ministry.

"The Health Ministry has decided to give firm support to anonymous testing in particular, through which most of the identifying of infected people happens," said Vlastimil Sršeň, a ministry spokesman. "The Health Ministry considers it better than dividing money among different items." 

Meanwhile, organizations that depend on ministry funding for HIV/AIDS prevention initiatives recently learned through letters from the ministry that their financing - which had been approved earlier this year - will be canceled completely.

Hana Malinová, executive director of Bliss Without Risk, an NGO that works with sex workers to address HIV/AIDS, said she now has had to depend on an unreliable patchwork of funding from the Labor and Social Affairs Ministry and the city of Prague.

"You never know; they can go back on a decision because it's not their duty to pay for HIV-related programs," Malinová said. "How is it possible that after 18 years in existence, we didn't get any money? We can't plan because we don't know what will happen next year or even next week."

Cuts in funding for ČSAP, which depends on the government for 70 percent of its funding, will force the organization to cancel three of its flagship projects, including educational lectures at schools and the production and distribution of printed materials.

As of September, there were 138 confirmed HIV/AIDS cases in the Czech Republic, according to government statistics, though Hlavatý said he estimates that number could be 10 times more.

And without preventive programs, that number would be much higher, experts say.

"[The budget cut] is quite alarming news," said Dr. Bernd Rechel, who specializes in Central European health systems at the European Observatory on Health Systems and Policies in London. "Prevention efforts are crucial in addressing the HIV epidemic. ? Without any prevention activities, it is very likely more people will put themselves at risk."

Malinová estimated her organization had prevented around 500 people from contracting the virus.

"It is because of the hard work of organizations that we have low incidences of HIV in this country," she said, adding that this was in spite of the fact the country is in a high risk area because of drug trafficking and immigration.

Currently, the growth in HIV/AIDS cases occurs among homosexual men, who account for 57.5 percent of Czech HIV/AIDS cases, but other populations could be at risk.

"I don't need to be a scientist to assess the situation as a potential risk," said Viktor Mravčík, head of the Czech National Monitoring Center for Drugs and Drug Addiction. "The situation is getting worse, and any reduction in prevention action and consequently our ability to control the situation is not good."

Mravčík's organization does not depend on HIV/AIDS funding but gets money through a fund specifically for drug-harm reduction that has also seen cuts, and is expected to go down again next year, Mravčík said.

In the heterosexual population, Malinová said there has been a marked increase in the prevalence of syphilis - out of 1,600 tests her organization gave this year, 39 were positive - a trend studies show is directly linked to future HIV/AIDS cases, according to the United States' Center for Disease Control.

"In the history of HIV/AIDS, the first wave is syphilis, and it's followed in many other cases by a wave of HIV," Malinová said.

- Klára Jiřičná contributed to this report.

Cat Contiguglia can be reached at
ccontiguglia@praguepost.com