Responding to the threat of an epidemic Since September 1996 MSF has been running HIV/AIDS prevention programs based in Moscow, in response to the rapid spread of HIV infection in the Russian Federation, which was perceived as a major public threat. In December 1995, the total number of HIV-positive cases in Russia was relatively small at 1,061 persons.

The Russian authorities had established AIDS centres throughout the country and had instituted mass testing for surveillance. By the end of 1996 a cumulative total of over 200 million tests had been performed. The year 1996 proved to be a turning point: 1,546 new infections were officially registered - more than the 10 previous years combined.

The total number of registered HIV-positive cases has risen from about 1,000 in 1995 to more than 100,000 in the spring of 2001 (103,024 on April 2, according to data from the Ministry of Health and Federal AIDS Centre of the Russian Federation). The number of actual cases may be five to ten times higher - meaning that at least half a million people in Russia are infected with the virus (source: World Health Organization). About 80% of them are young intravenous drug users, and a large majority contracted the virus by sharing injecting equipment. From this high-risk group, HIV threatens to spread to the general population by sexual transmission.

The Russian Ministry of Health estimates that by the year 2005 there will be 10 million Russians living with HIV/AIDS. MSF's prevention programs were set up in close collaboration with Russian health authorities and national non-governmental organizations (NGOs), and aim to serve as a model for preventive health programs nation-wide. Last year, both the Ministry of Health and the Ministry of Justice drafted concrete directives supporting preventive programs among intravenous drug users and prisoners in Russia.