The biological security of the country, the outbreak of monkeypox and… HIV infection in the cinema, — all this became the subject of expert discussions during the Second All-Russian Conference “HIV Infection 2020-2030: Challenges, Scenarios, Resources”, which was recently held in the capital. The event was held in the “hybrid” format, it was attended by well-known Russian and foreign scientists, as well as practicing clinicians.
«The mobilization experience in countering the new coronavirus infection was passed with dignity, — said the forum opener Natalia Pakskina, Deputy Director of the Department for Organization of Emergency Medical Care and Health Risk Management of the Ministry of Health of Russia. — Now Russian healthcare is on the verge of solving new problems in the field of virology. Special responsibility and burden falls on the infectious service, in particular, the AIDS service. Today, in the face of unprecedented pressure on Russia — a very precise historical moment when memory must be restored and treated with due attention and respect, resolutely and firmly defending the honor and dignity of not only the profession, but the country as a whole.
The struggle of meanings
This sentiment set the tone for the event. It was about the socio-cultural aspects of HIV infection. So, the participants noticed that recently a whole series — about how HIV appeared in the USSR. Everyone agreed that this “film experiment” — an obvious example of how art becomes a hostage to the political situation. Alas, the main idea of this television production is that the country was not protected from the outbreak of a new disease by science with its names, which gave the world and the country deliverance from many real tragedies, and the powerful “sanitary shield” not created in the USSR; countries. The fate of public health, according to the authors of the series, was in the hands of, in fact, a random person — a young epidemiologist who is ashamed of his father, a great medical director in the Union Ministry of Health.
This is a significant “artistic assumption”; completely ignores the fundamental foundations that our great predecessors laid down for decades and which really protected the country at the moment of an unexpected epidemiological challenge. And not the ambitions and personal roles of individual conflicting “heroes.” The opinion and activity of a junior researcher in this system a priori could not matter.
Successfully the creators of the series calculated the time of the premiere! Added their loud shout to the hoots for the “exception” Russia. And they offer us to look at ourselves through this fake prism — health care failure and eventually — historical weakness.
Anti-epidemic service of the USSR and Russia — traditionally one of the strengths of the national health care system. And besides, by the way, in response to the tragedy in the city of Elista, there was also a powerful public consolidation. In the late 1980s as a reflection of the will of many progressive politicians, journalists and cultural figures to help the country fight a new challenge, the Ogonyok-AntiAIDS Foundation was created, in whose initiatives, together with prominent doctors, people of such a magnitude as Mstislav Rostropovich took part . The Foundation did a lot then to educate the population about the dangers of HIV.
Today, it is the efforts of the professional community that largely determine which vector the “great social reset” will take.
The experts unanimously agreed that in order not to end up near the ruins, it is necessary to organize a decisive, total opposition to the systemic work that multiplies and popularizes an “alternative reality” based on myths. The first of which — millions, even tens of millions of patients, their country is “attributed” since the early 2000s. According to forecasts, in 2020 in Russia there should have been from 5 to 14 million HIV-positive residents. However, there is no real million in 2022.
The more important is professional work with the population and medical students — about the glorious traditions of domestic fundamental science. Indeed, a brilliant scientific virological school has been formed in our country, recognized by specialists all over the world. Outstanding Soviet scientists stood at its origins — virologists, epidemiologists and clinicians. So, academician Viktor Mikhailovich Zhdanov, who proposed to the World Health Organization in 1958 a program to eradicate smallpox, began to study HIV from the moment it was first published in the United States, when not a single patient had yet been seen in the USSR. And even then, he largely laid the foundations for working strategies to combat the epidemic, which are relevant today.
And the first cases of HIV infection and AIDS in the USSR were detected by academician Nikolai Sergeevich Potekaev: foreign students-Africans — in 1984, a citizen of the USSR — in 1986. As part of the “Rakhmanov Readings” in 1988, Academician Potekaev held the All-Union Conference on HIV infection — the first event of this magnitude dedicated to this disease. Under the leadership of academicians Rem Viktorovich Petrov and Rakhim Musaevich Khaitovfundamental approaches to the development of a vaccine were created, the first Soviet test system for detecting HIV infection was put into production.
It was these people who laid the foundation for the entire architecture of the modern organization of the AIDS service, including work on the early detection of HIV -infection and mass examination of the population.
It is impossible not to recall the unique period of Peter Nikolaevich Burgasov, For 20 years, he headed one of the most effective anti-epidemic services in the world, represented not only by powerful scientific and production sites, but also by a network of anti-plague and sanitary-epidemiological stations. And, of course, the results that he provided, unprecedented for his time: it was Academician P. N. Burgasov who in 1980 signed the act on the complete eradication of smallpox on Earth.
We also talked about how to build work in the new geopolitical realities. The participants in the discussion agreed that the domestic healthcare in the field of combating infectious diseases, including new challenges, is absolutely competitive today. Joint research with partners from the BRICS countries, which are determined to strengthen strategic cooperation with Russia, is at the stage of dynamic development. A solid foundation has been created for the development of a single influential expert space for combating HIV/AIDS and COVID-19 with Chinese colleagues.
«An eloquent confirmation of international cooperation was the publication of a unique work concerning the results of an unprecedented large-scale comparative study on the vaccination of HIV-infected patients against COVID-19 in one of the journals of the Lancet family (the world's leading scientific publication), prepared by a team of Moscow doctors, researchers from the Institute. N.F. Gamaleya and colleagues from the field of intelligent systems and information technologies, — stresseddeputy head of the Moscow Department of Health Elena Khavkina.
In turn, head of the institute Academician Gamalei Alexander Gintsburgemphasized that, according to the vector outlined by the country's leadership and the Russian government, in the new reality, which requires the intensification of the country's own development, it is scientific centers that should become the basis for this development. They will take an active part in the implementation of large-scale programs of national importance, starting with the priority areas most sensitive to the country's security.
“The formation of a strong, reliable protection against new infections was designated as the most demanded task,” &mdash ; summed up Mr. Gunzburg.
Chief Freelance Specialist on HIV Infection of the Ministry of Health of Russia and the Department of Health of Moscow, Head of the Moscow Center for the Prevention and Control of AIDS Alexey Mazus >spoke about the special potential of Moscow in ensuring infection safety. He noted that it was the capital's approach to combating HIV/AIDS that largely formed the basis of the State Strategy to Combat the Spread of HIV Infection in the country for the period up to 2030. This situation was the result of many years of work on building the “Moscow model”; counteracting HIV/AIDS — with an emphasis on mass screening, broad multicomponent prevention, analysis of the social and behavioral aspects of the disease.
The expert pointed to the effectiveness of the system for early detection of HIV, as well as to the expansion of the arsenal of prevention programs aimed at a confidential dialogue with each target group. In addition, he noted that the issue of HIV in the context of infection prevention fits into the broader concept of promoting a healthy and environmentally friendly lifestyle and a value-based approach to it.
At the same time, Aleksey Mazus emphasized that the successful dynamics of the Moscow work for many years has traditionally been accompanied by information “stuffing”; from her opponents — a number of global structures interested in advancing their own agenda.
“One of the main components of an effective system for combating HIV infection — this is a diagnostic. If in the EU statistics are formed against the background of low and extremely low rates of testing for HIV infection (3-5%), then in Moscow about 40% of the city's population is examined annually: this is significantly higher than the average Russian indicator, but is obviously a benchmark for the largest world cities», — said Professor Mazus.
He also noted that he managed to maintain the leading position even in 2020 against the backdrop of quarantine restrictive measures in connection with the COVID-19 pandemic, with a decrease in the number of examinations by 20%. Today, Moscow has already returned to the “pre-Covid” indicators, to the level of 2019: HIV testing coverage in the capital in 2021 increased by 1.1 million (up to 5.5 million examinations) and amounted to 43.4% of the population. At the same time, the “calculations” used in some media, which should indicate the supposedly low coverage of ART among HIV-infected residents of Moscow, do not correspond to reality.
According to the data of the Federal State Statistical Observation Form No. 61 for Moscow, antiretroviral therapy coverage in 2021 amounted to 90.5% of the number of patients under dispensary observation, which is also one of the benchmark indicators for global healthcare of the effectiveness of measures to combat HIV/AIDS.
“The figure cited in some sources is below 50%,” to which the collective “analysts” refer, to be precise, obviously obtained by comparing the number of positive results of laboratory tests for HIV infection conducted in the city with the real number of infected people who are here. It is important that of all the positive results received, only a little more than 30% belongs to permanent residents of the capital. Moreover, some of the people from other cities, in whose blood the Moscow laboratories detected HIV, did not even come here, but donated blood in their regions, the rest only came to the capital for a short period for medical help, — the expert noted.
In addition, according to Alexei Mazus, to compare the number of biomaterial samples studied with the number of people actually living in the city, and on this basis, either non-professionals or people inclined to consciously discredit the Russian  can draw far-reaching conclusions. ;and, in particular, Moscow healthcare.
Epidemiological monitoring data show a steady trend: among Moscow residents, the number of new HIV-infected people is decreasing every year. In 2021, it decreased by another 8%. Among all HIV-infected people identified in Moscow last year, the proportion of Muscovites was only 31%. The majority of identified HIV-positive — nonresident citizens.
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