Health indicators in Azerbaijan have
deteriorated during the 1990s, reflecting the economic hardship, widespread unemployment,
environmental pollution, military conflict and population displacement in the country. Low
incomes and high costs for preventive medical care have resulted in many people utilizing
health services only when in dire need. While an immunization campaign has reduced the
prevalence of some diseases, the health of the population remains compromised by
unsanitary housing conditions, inadequate nutrition and increased formal and informal
charges for health care services.

An area of particular concern in Azerbaijan is the growing incidence of HIV/AIDS and
STDs. The number of HIV cases reported annually has increased rapidly in recent years.
Only seven cases were registered between 1987 and 1992, but in 1998 alone 68 new cases
were registered. By January 2000, a total of 164 HIV cases had been confirmed in the
country. It is unanimously agreed that official figures do not reflect the true
epidemiological situation. The actual number of infected may be as much as ten times
greater. Although by international comparison, Azerbaijan is still at an early stage of
the AIDS epidemic, there is strong evidence that the country could experience a dramatic
expansion in HIV incidences unless rapid steps are taken.

Since 1991, Azerbaijan has experienced rapidly changing social conditions including
greatly increased economic vulnerability, more frequent travel abroad for temporary
employment, increased drug use and commercial sex activities, and a growing incidence of
STDs. In Azerbaijan, HIV/AIDS prevention is still very much influenced by Soviet-era
policies, including intensive HIV testing and mandatory actions among those infected.
However, now the combined efforts of five United Nations agencies (UN Development Program,
UN Population Fund, UN High Commissioner for Refugees, UNAIDS and UN Children’s Fund)
are addressing the social, political, economic and health factors in the spread of the
diseases and are helping to foster behavioral changes.

Initiated in 1998, the joint UN program on HIV and STD prevention in Azerbaijan builds
community and national capabilities to prevent the further spread of these diseases.
Project activities are being undertaken to develop a multi-sector response to the
epidemic, to create new national policies and guidelines on STD case management, and to
design effective information, education and communication programs. Research for the
program is coordinated by the International Center for Reproductive Health, Belgium and
implemented with support from Medecins Sans Frontiere, Belgium. The UN program encourages
a civil society response to the growing STD and HIV epidemics by supporting local
institutions and NGOs involved in STD and HIV/AIDS activities. The UN program also
established an HIV/AIDS Resource Center for NGOs to enlarge opportunities for national
organizations undertaking AIDS prevention activities.

Jason Thomson is the Baku-based Assistant Project Manager of the joint UN
Project on the Prevention of STDs and HIV/AIDS in Azerbaijan. (office@un.azeri.com)