Despite being a “low prevalence” country in HIV/AIDS figures, the problem still remains in Mongolia

I was surprised when the door opened and Undraa introduced herself. She was an attractive woman with energetic eyes. Despite attempting to disavow myself of any pre-conceived ideas about what an HIV infected person should look like, I was still surprised to discover that she looked so healthy. For Undraa, aged in her 30s, her everyday life is similar to that of others. She takes her child to kindergarten and afterwards goes to work. She socializes often and is enjoying her life, despite being HIV positive. For many Mongolians, HIV/AIDS is misunderstood. While the public is aware of its existence, it is often treated as a number.

The media, in particular, has continued the mis-conceptions to do with the illnesses. Often newspapers consider it merely a number or tally, as though it were a scorecard the public must be updated on. Even worse is the tendency among some in the Mongolian media to treat people infected with HIV/AIDS as gossip fodder.

What is missing is the human understanding of those infected and their families. Undraa said she believes the media typically would misrepresent her and the illness in general. Undraa, who requested her real name not be used, has made a great contribution to the HIV/AIDS prevention activities in Mongolia. Indeed, she has formed an NGO aiming to involve people living and affected by HIV/AIDS in decreasing the stigma and discrimination found in Mongolian society. The NGO, which works with the Mongolian Red Cross Society (MRCS), National AIDS Foundation (NAF) and the Global Fund, provides care and medical services for HIV/AIDS infected people. Ultimately, Undraa says, it gives hope.

Undraa was diagnosed with HIV several years ago, and although she has struggled with the discovery, she has aimed to improve the services available to HIV/AIDS positive people. “If Minister of Health appeals ‘Let’s use protection’ to the public, it cannot bring a good result,” Undraa said. “Instead of this, the people who are living with HIV should share their story of infection and attend the against-HIV/AIDS activities, which will achieve a positive outcome.

“From 1998, some people living HIV have attended the above activities, even today,” she said. She added that Government of Mongolia should allocate some financial assistance to NGO, MRCS, NAF and individuals who run its activities for HIV/AIDS, which will increase motivation. According to MRCS’s HIV/AIDS programme chief Nyamdorj, Mongolia is considered an HIV low prevalence country, with the total number of people estimated to be living with HIV less than 0.01 percent of the total population. However, the country has recently faced a rapid increase in HIV cases.

According to the MRCS reports, since the first case of HIV in 1992, to date, it is reported that a total of 35 people were infected with HIV, five of whom have died. Nine were infected with AIDS by October, 2007. About 70 percent of them are singles, again 70 percent of them are unemployed, 48 percent of them are high educated and 52 percent are in elementary and primary educations, respectively.

It is estimated that this number will continue to grow over the coming years, gradually. Among them, 69 percent of them are male and rest of 31 percent of them are female. More than 70 percent of the officially reported cases are among men who have sex with men, and many think that the country’s vulnerability to the epidemic has been underestimated. According to UNAIDS estimates, at least 500 people are infected with HIV in Mongolia, as opposed to the official number of 35. Between 2004 - 2014, if HIV preventative measures are not taken, it is estimated that 2,500 people will be die due to the illness, added by Nyamdorj to the UB POST. HIV/AIDS’ economic outbreak its main loss is every death individuals’ expected creating resource or wealth, its current rate is estimated between Tg29-33 million. As well reducing the number of labor force of total population affects to the macro economy and influences to decrease the GDP growth.

About 10 and 15 years later, due to HIV/AIDS outbreak, Mongolia’s GDP is expected to decrease by two percent. The investment to the treatment of HIV/AIDS will be increased and in other fields’ investment will be lacked.

Between 2004 and 2014, the cost of HIV/AIDS outbreak will reach at Tg1.3 to Tg3.6 billion and the expenses of death rate will be Tg11.9 to Tg15.4 billion, according to a Ministry of Health survey.

That’s why HIV/AIDS is influenced negatively to the life expectancy, economy and human development also increased poverty. HIV/AIDS could potentially devestate the Mongolian development. However, a range of risks and factors make Mongolia extremely vulnerable to the HIV epidemic, such as the current high prevalence of sexually transmitted infections, the low level of knowledge of HIV prevention measures among the general population and the lack of a supportive environment for key vulnerable groups.

Also the high levels of poverty, low access to health services and the high discrimination among the public against these groups contribute to the potential for a HIV epidemic. There is also a rapid increase in HIV in Mongolia’s neighboring countries, Kazakhstan (12,000), Russia (940,000) and China (650,000), where the epidemic is fuelled primarily by drug injection. There are high levels of international migration between these countries. Although programs for STI and HIV have been established, prevention efforts have also been hampered by insufficient enforcement of policies and procedures within the health care system. The National AIDS Foundation (NAF) has provided financial and technical support to 45 NGOs to work in the area of HIV.

It has recently introduced a new voluntary counseling and testing (VCT) strategy for vulnerable groups such as sex workers, men who have sex with men, injecting drug users and mobile traders.

“The Mongolian Red Cross Society’s (MRCS) mission is to focus on their core activities, identifying the most vulnerable in the community, and to contribute to building civil society, and becoming a well-functioning National Society,” Nyamdorj said.

“The International Federation’s mission is to improve the lives of vulnerable people by mobilizing the power of humanity.

“The Federation is the world’s largest humanitarian organization, and its millions of volunteers are active in over 186 countries,” he said.

They are seeking nearly US$2 million for its HIV Programme for the next three years. This total budget includes all contributions, domestic and international, funding from partner Red Cross national societies and other organisations.

Between 2008–2010, the programme will benefit a total of 163,797 individuals, which represents roughly 10 percent of the country’s total adult population of 15-49 years.

Among these, the MRCS plans to significantly increase its volume of HIV work for and with key vulnerable populations, such as men having sex with men, female sex workers, male prisoners, single mothers, mobile populations, people living with HIV and youth.

The MRCS has a network throughout the country of 35 mid-level Red Cross branches covering all 21 aimags and eight districts of Ulaanbaatar, and 902 primary level branches with 13,000 volunteers throughout Mongolia.The MRCS HIV Program, established in 2003, has gained considerable programming experience and earned a national reputation in leading programs in the field of HIV response. It has developed good partnerships with affected groups, which is the key asset to effective HIV response and has been truly groundbreaking in Mongolia. In its HIV programming, the MRCS follows its nation-wide Red Cross strategic plan on HIV and continually strives to keep its strategic documents, manuals, training materials and approaches relevant to the needs of affected communities.

In addition, the programme will build the capacity of 1,139 MRCS staff and volunteers and 3,100 media journalists in HIV response.

by Sh.Batmonkh
THE UB POST

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