Cablegate: Status of Hiv/Aids: Low Prevalence, Low Prioirty

This record is a partial extract of the original cable. The full text of the original cable is not available.




E.O.12958: N/A


1. Post used the delivery of Ref A materials on the
President's Emergency Plan for AIDS Relief to obtain updated
information on HIV/AIDS in Turkey from the Ministry of
Health (MOH), Ministry of Foreign Affairs and UN Population
Fund. The institutions appreciated receiving the materials,
acknowledged U.S. leadership in HIV/AIDS programming, and
agree that developed nations need to provide support for
AIDS prevention. The MOH requested that Turkey be
considered for participation in any worldwide training that
might be offered.

Incidence of HIV/AIDS is low

2. The MOH General Directorate of Primary Health Care
reports that at the end of 2002, there were 1,515 HIV/AIDS
cases in Turkey: 1,063 HIV and 452 AIDS. Since 1992, those
numbers have been relatively stable, with fewer than 50 new
AIDS cases reported each year. The incidence of new HIV
cases have been low but steady since 1997, with the greatest
increase in 2001 of 144 new cases. There were 142 new HIV
cases in 2002.

3. Seventy (70) percent of HIV/AIDS patients are male.
Most are between the ages of 20 and 39. The source of about
half the cases is heterosexual contact. Drug use accounts
for about 6.5 percent of the cases and blood transfusions
for less than three (3) percent. The source of about a third
of the cases is considered unknown. Istanbul has the highest
prevalence of HIV/AIDS cases.

4. Healthcare professionals acknowledge that there are
insufficient mechanisms for tracking HIV/AIDS patients and
that an inadequate legislative base leads to under
reporting. In 2002, a representative from the CDC office of
Public Health and Practice found that Turkey has literally
no system for monitoring any infectious disease, let alone
HIV. The World Health Organization estimates that Turkey's
HIV/AIDS incidence estimates are likely to be off by a
factor of 50.

Key Milestones, Programs

5. MOH became active in AIDS prevention upon detecting the
first case in Turkey in 1985. AIDS testing began back then
and is now offered free of charge. Over the years, outreach
expanded to include establishing a National Advisory
Committee, supporting sexual health education in schools,
distributing free condoms, providing disposable syringes,
covering health care costs for patients, and instituting a
telephone information line. Provincial health managers have
received training in sexually transmitted diseases. (Note:
Some programs offered are costly, yet MOH officials could
not provide a budget estimate for HIV/AIDS prevention,
treatment or testing. End note.) Turkey also works
cooperatively with international organizations such as WHO,

6. In 1996, GOT formed a multi-sectoral National AIDS
Committee (NAC). The Prime Minister leads it, MOH supports
it, and 32 ministries, institutions, professional
associations, and NGOs are represented on it. The NAC
adopted the country's first National Strategic Action Plan
last year. Its primary goals are to educate the public,
ensure safe blood supply, standardize testing, provide
counseling, ensure legislation is respectful to individuals,
and improve monitoring. The NAC will monitor these targets.

Low Prevalence, Low Priority

7. Despite these efforts, Turkey's HIV/AIDS infrastructure
operates at a minimal level. Post's healthcare provider
finds that Turkey has demonstrated minimal commitment to
following accepted epidemiological procedures.
Professionals are insufficiently trained, data are
unreliable and public awareness is low. Mission employees
rarely see any of the public educational materials
purportedly disseminated on the media and in schools. Even
with the Prime Minister heading the NAC, most professionals
agree that policy-makers rate HIV/AIDS a low priority.
Turkey did not participate in the XIV International AIDS
conference in Barcelona in July 2002.

8. That said, MOH has submitted a $6.5 million proposal to
the Global AIDS Fund. Winning such a grant would provide
the boost needed to fully implement Turkey's national
strategic action plan and invigorate education, prevention
and treatment programs.


9. Thus far, Turkey seems to have dodged the HIV/AIDS
bullet. Some attribute this to conservative family values,
others to geographic luck. But this luck might not
continue. The inability to track the sex-trade industry,
prevent heroin trafficking from Afghanistan, and stem the
tide of a potentially exponentially increasing epidemic over
time requires vigilance, support, and a higher priority than
HIV/AIDS now receives.

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