Irish Times examines HIV/AIDS efforts in Moldovan region

The Irish Times on Tuesday examined the efforts of a Medecins Sans Frontieres mission in Transdniestria -- an enclave in Moldova that supports Russia and declared its independence from Moldova in 1990 -- to improve its health care system and implement an HIV/AIDS center in light of the region's high prevalence of the disease, which is four times that of the national average.

According to the Times, health care in Transdniestria has deteriorated greatly largely because of isolation from the international community. The Moldovan Ministry of Health reports that at the end of 2007 there were 1,192 HIV/AIDS cases in the region out of 4,131 total cases in all of Moldova. However, medical professionals believe the actual figure is at least two to three times higher. In addition, although Moldova was receiving tens of millions of dollars in HIV/AIDS assistance from the Global Fund To Fight AIDS, Tuberculosis and Malaria, the World Bank and other agencies, none of the money reached those living in Transdniestria unless they traveled to Moldova's capital of Chisinau. The Times reports that such a journey was impossible for prisoners in Transdniestria, as well as for those too sick to travel or without proper documentation. MSF also discovered that access to health care was being denied to Transdniestrians for political reasons, the Times reports.

The program includes a customized, modern HIV/AIDS unit at a hospital in Transdniestria's capital of Tiraspol; weekly clinics at both a men's and women's prison; and outpatient treatment in a clinic in the northern city of Rybernzita. Prior to the initiative, local health care providers had almost no knowledge of HIV/AIDS, but following training provided by MSF, they began referring patients to the mission, the Times reports. In addition, MSF began lobbying the Global Fund, the World Health Organization and other potential stakeholders to visit the region and see that it is possible to operate successfully there. MSF's goal was to have international donors encourage Moldova to extend HIV/AIDS programs to Transdniestria and, eventually, the two sides began to share some resources, including antiretroviral drugs supplied by the Global Fund.

As the mission prepares to end in 2009, its head, Mark Walsh, said, "We have shown that it is possible to work in Transdniestria and have seen a burgeoning interest by other agencies to extend existing programs to the region." Walsh said the main achievement is that the mission "succeeded in prolonging the lives of hundreds of HIV/AIDS patients ... who might otherwise have died" (Fleming, Irish Times, 9/9).